Doctors without Borders

By Jarudi, Lama | Harvard International Review, Spring 2000 | Go to article overview

Doctors without Borders


Jarudi, Lama, Harvard International Review


Abstract:

The practice of medicine has historically been radically altered by the introduction of innovative technologies. By comparison, the personal relationship between doctor and patient remained, until recently, remarkably unchanged. Within the last decade, however, this fundamental interaction has come under question. Technological developments have allowed doctors to supervise operations by video, electronically exchange x-rays and charts, and provide direct clinical, preventative, diagnostic, and therapeutic services to patients over great distances without ever leaving their clinics. These practices have been collectively dubbed "telemedicine." After many decades, telemedicine is finally claiming its place in health care, in countries as far-ranging as the US, Saudi Arabia, Ireland, Jordan, and Malaysia. But while technology is developing rapidly, the response from the medical profession has been rather slow. Now in its early years, telemedicine will have to overcome the same legal, financial, personal and cultural obstacles that have confronted every other technological change in the history of medicine.

Text:

The Advent of Telemedicine and Society

The practice of medicine has historically been radically altered by the introduction of innovative technologies. By comparison, the personal relationship between doctor and patient remained, until recently, remarkably unchanged. Within the last decade, however, this fundamental interaction has come under question. Technological developments have allowed doctors to supervise operations by video, electronically exchange x-rays and charts, and provide direct clinical, preventive, diagnostic, and therapeutic services to patients over great distances without ever leaving their clinics. These practices, which could revolutionize not only medicine but also international medical cooperation, have been collectively dubbed "telemedicine."

After many decades, telemedicine is finally claiming its place in health care, in countries as far-ranging as the United States, Saudi Arabia, Ireland, Jordan, and Malaysia. But while technology has been developing rapidly, the response from the medical profession has been rather slow. Now in its early years, telemedicine will have to overcome the same legal, financial, personal, and cultural obstacles that have confronted every other technological change in the history of medicine.

Niche Markets

Telemedical technology has not-yet attained mainstream success on the medical market. Unfamiliarity with new technology on the part of medical professionals has been a major setback to the growth of telemedicine. The high cost and rapid obsolescence of equipment has been a historical obstacle to its use, though those problems have recently began to recede. Moreover, local laws framed before the prevalence of computers and telemedicine have impeded the practice of telemedicine, even when it is otherwise practical. In the United States, for example, a doctor licensed in California cannot offer a telemedical consultation to a patient in Ohio without getting a second license for that state. While there are exceptions, the practice of interstate telemedicine remains extremely limited by state law. Bound by such restrictions, tele-medicine at first served only specific groups such as prisoners and astronauts. More recently, however, telemedicine has found an outlet in the unregulated foreign market.

International telemedicine is drawing the attention of private firms and hospitals operating in South America, Africa, Asia, and the Arab world. In 1993, an Arizona telemedicine network was among the first to link US hospitals to Mexico, allowing biopsy specimens to be examined on a monitor at a remote site. Recently, a neurosurgeon on Russia's Sakhalin island was able to transmit a series of photos and x-rays to the United States in order to aid a two-month-old child with a brain hernia.

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