News from the CIUSSS

Medicine Without Doctors? Disintermediation and Patient Agency

May 8 & 9, 2019,  9h30 - 16h30

Jewish General Hospital
3755 Cote Ste Catherine, B-124, Montreal, Qc


For more details  see attachment.


‘Disintermediation’ in healthcare, removing the doctor from the diagnostic or therapeutic event or activity, is the result of ever-evolving technological change in medicine, communications and society overall.  The shifting away from the live human medical professional who has been given responsibility for problem diagnosis, treatment-type decision-making and how healthcare is delivered, represents a freedom.  Not unlike the demise of brick and mortar bookstores, some see the current tech trends as eliminating the direct doctor-patient relationship, most often deemed an important human contact factor offering knowledge and reassurance to concerned patients. The abundance of new free and individual mobile technologies available to society offers the user access to knowledge but also to a responsibility which was previously the domain of the doctor.  Should this new patient-centered ease of access to knowledge and treatment technologies be a cause for concern or is it in fact a beneficial democratization of healthcare?

Disintermediation in medicine however has a long history, reaching back to at least before the twentieth century, making the monopoly of the medical profession relatively recent. This professional monopoly replaced a more open model of medical pluralism before the nineteenth century, in which patients were able to choose from among a range of possible options; one being patients’ self-treatment, which was a frequent practice in traditional societies. 

This 4th workshop in the series on ‘The Impact of Technological Change on the Surgical Profession’ brings together international and national medical practitioners, social scientists, historians, all recognized researchers to provide a larger perspective on the topic of disintermediation in medicine. This event provides the opportunity to identify the stakes of this trend for the various groups involved (patients, practitioners, educators, technology providers, society overall). The knowledge resulting from this gathering will help situate recent developments within a larger historical context and elaborate how possible future trends of an increased role of patient agency in healthcare will impact medical training, practice, patient treatment and quality of care. 

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