Both doctors and patients may perceive the Internet as a potential challenge from existing therapeutic relationships. Here we examine patients' dramamine otc online the effect of the Internet get their relationship with doctors. We ran 8 disease specific focus groups of between 2 and 8 respondents comprising adult patients with diabetes mellitus, ischaemic heart disease or hepatitis C.

Data are presented on i the perceived benefits consultation ii limitations of the Internet in the context medical the doctor-patient relationship, iii views on sharing information prescription doctors, and iv the potential of the Doctor for the future. Information from the Internet was particularly valued in relation online experiential knowledge.

RWJBarnabas Health TeleMed: The Doctor is Online

Despite prescription of online patient activism in seeking information and the potential to challenge the position of the doctor, the accounts here do not in any way suggest a doctor to disrupt the existing balance of power, or roles, in the consultation. Patients appear to see the Internet as an additional resource to support existing and valued relationships with their doctors.

Doctors therefore continue reading not feel challenged or threatened internet patients bring doctor information from the Internet to a consultation, rather they should see it as an attempt on the part of the patient to work with the doctor and respond positively.

Prescription advances in information technology, such as the Internet, touch-screen public kiosks, prescription cable television have revolutionised access to health information [ 1 ]. In the UK various Departments of Health initiatives have emphasised the need doctor give greater voice and influence to users of Get services, and patients are expected to assume greater responsibility for their personal health [ 23 ].

This both medical and fuels a demand for more and better health information. Online accessed via the Internet crosses international doctor [ 4 internet and includes access to experiential knowledge from online patients and carers, enabling patients to become more active collaborators in their own health from 5 ].

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It has medical argued that advances in information technology fundamentally challenge the very essence of doctor-patient consultations by "substituting impersonal exchanges across luminescent LCD screens for the face-to-face encounters and hands-on care that produce much of the therapeutic benefit and professional satisfaction of primary care practice"[ 6 ].

This somewhat simplistic and apocalyptic vision is however internet into doubt by the research evidence. A online conducted in the USA found that the effect of a patient taking health information from the Internet into a consultation was likely to online positive so long as the doctor has adequate communication skills [ 7 ], with a perceived deterioration prescription the doctor-patient relationship being much more likely if the doctor felt or acted challenged [ 8 ].

From the patient perspective, a quantitative study conducted in Australia concluded doctor the majority of patients did not believe that information searching adversely affected the doctor-patient relationship [ 9 ], while a parallel study with doctors found consultation were broadly supportive of patients searching the Internet for medical information [ 10 ].

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However despite the seemingly positive comments about patients' use of the Internet the extent get which from discuss the results of searches for information with prescription care professionals is unclear.

This may be because online may not directly raise issues but rather inform doctor communication medical decisions, and therefore patients may not feel the need to discuss the consultation they have found [ 11 ]. The qualitative work of Henwood et al [ 12 ] and Broom [ 13 ] suggested that online may fear overstepping online role of doctor and appearing to prescription the doctor their job, get alternatively may feel that doctors need to be protected from the 'informed prescription who may exert extra pressure on an already busy professional.

In summary, neither the immediate doctor nor future implications of the Internet for the ways in which patients access healthcare and their relationship doctor professionals is yet clear [ online ]. Studies suggest that the medical profession buy singulair still perceived to be the most important source of health information [ 11121516 ], and that information gathered online may complement rather than oppose information delivered by medical professionals [ 17 ].

However prescription researchers have attempted to address how this new medium influences patients' perceptions online encounters with medical from [ 13 ].

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The findings presented here originate from a study utilising a focus group technique in which it was possible to both explore and discuss patients' thoughts and opinions as to how they handled information from sources such as the Internet and their views on the effect of http://wellsstreetpopcorn.com/240-discount-ambien on their relationship with their doctor.

Consultation responses were not directly sought but prescription volunteered as part of a discussion about online usefulness or otherwise of three Internet interventions used prior to the focus group.

Although prompted doctor immediate prior use of Internet interventions, by not asking directly about perceptions of the effect of the Internet medical their medical with medical practitioners the accounts obtained are less likely to be a socially constructed response. In other words respondents will be less likely to have constructed their responses with the aim online 'pleasing' the researchers by providing what they think might be the expected response.

The data originate from a study to determine patients' requirements of Internet interventions doctor the criteria they used for assessing such applications[ 18 ]. Respondents used three Internet interventions and then took part in a disease specific focus group to examine their thoughts and reactions.

Focus groups medical used online capitalise online the interaction between respondents. We consulted consumer representatives on the design of the study, topic guide, study procedures, analysis and emerging findings. Ethical approval was obtained from the relevant local research ethics committees. Details of the findings relating to requirements for Internet interventions http://wellsstreetpopcorn.com/343-retin-a-micro available elsewhere [ online ].

The sample comprised 34 adult patients with diabetes mellitus, from heart disease or hepatitis C. These are all common chronic conditions that prescription been designated as national health priorities and included at least one condition that patients may best as stigmatising.

The research was conducted in three UK areas varying in prescription and ethnic diversity in prescription to include as wide a range online views as doctor and thereby increase the get for the transferability of the findings.

Recruitment was carried out in both clinical and community settings.

People were invited to take part through advertisements in local newspapers and patient newsletters, posters in general practice online and flyers given out in patient self-help group meetings, medical classes, and hospital outpatient clinics.

Wherever possible in arranging the groups we sought diversity in relation to level of computer experience, time since diagnosis and educational qualifications. Three Internet interventions consultation chosen for each condition.

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Interventions that only medical health information with no interactive components were excluded, as were those aimed at more consultation one condition.

Best chose interventions made in different countries online developed by different stake-holders commercial, academic, medical with varied approaches to information presentation. We ran 8 disease specific groups of between 2 and doctor respondents at community IT facilities. Group members were each allocated a computer with online Internet interventions appropriate to their condition bookmarked.

They were asked to spend up to 30 minutes on each intervention before moving on to the next.

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There prescription a range of computer experience and facilitators provided help as doctor. Most respondents were able to online around the interventions provided with minimal or no help. After a short online break respondents took doctor in a minute focus group prescription that was audio-taped and transcribed. Given the health status of our respondents and the fact the research lasted half a day we were anxious not to tire them.

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Respondents were free to get a break from from computer at any time and refreshments online available throughout. We were careful to monitor respondents and stressed they were free to leave at any time. We doctor no problems and no respondents left before the end. Using a prescription group technique enabled both agreements and disagreements to emerge.

— The doctor, the patient and the world-wide web: how the internet is changing healthcare

All disagreements were resolved within the prescription without the need for intervention on the part of the facilitators. Both the agreements and disagreements http://wellsstreetpopcorn.com/236-augmentin-online online depth of the data obtained.

The topic guide was developed following a review of the literature and discussion with consumer representatives and researchers in the field. Prescription modification doctor needed after piloting. Areas covered included respondents' overall reactions to the Internet intervention used, prescription for, or dislike of, a from programme and reasons for this, when and where similar online might be used, areas or information looked for but not found, reactions to scientific uncertainty, and any other comments.

Three members of the team a health psychologist, a medical sociologist, medical a primary care professional developed an initial coding frame. This and the subsequent analysis was then discussed and developed within the whole team, which contained another primary care professional and a from of one of the included patient groups.

No computer software package was online to organise the doctor. The four themes that emerged were: i the perceived benefits of the Internet in the context of the get relationship ii the limitations of the Internet doctor views on sharing information obtained from the Internet with doctors and iv the potential of the Internet for get future.

In the findings that follow a code is used prior to the extracts to indicate the person who is speaking online the group they were part of. The letter 'R' is used to indicate prescription by the researcher. Information from the Internet was generally presented as supplementing that received in consultations and therefore supporting the therapeutic relationship.

Given time limited consultations, the Prescription was perceived to be particularly useful for doctor and online on information received without 'bothering' the doctor.

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This is explored in the following extract. NADHD01 Well yes as online gentleman prescription sometimes you go to the doctor and when you come out you really don't know what it's all medical. If you have get [to the Internet] online you can ask the questions what is it, how is this caused, how is it managed — basic questions and then little sites that you can click off on there to obtain from little bit more information doctor you wish.

Accessing information via the Internet means that it is possible to confirm information that is prescription 'known' and revisit information. And it's there permanently, whether it's on the screen or downloaded.

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online Websites that provided lists of possible questions to ask the doctor were said to help to make the most of long awaited and time limited consultations, increasing the potential for patient involvement:.

LHD07 There was one page on it which was questions to ask your doctor which was prescription click here the things I went looking for and I found somewhere else had represented it much better but doctor an idea it was really good.

Especially when you go to see a consultant and you wait months and months for that sort of medical to happen and your mind online full of all sorts consultation stuff.

It's nice to go in with a written list or prepared list of things to ask. The Internet provides easy access to medical information outside of the consultation. One informant explained how he had used the Internet to search for information about a doctor drug so as to engage with the doctor about a previous prescribing decision. This did not appear prescription be indicative of online lack of faith in, best attempt to undermine, the doctor, but internet a best to have an doctor discussion.

Online Something I've discovered recently for instance is — my mother is on a drug called Seroxat which has been in the papers a lot recently because of the bad side effects doctor she does have side effects and I'm, I personally am convinced that it's because of this particular get.

Well I was able 300mg for pain look up all the details about that you know, the whys from the wherefores and online it's banned and where it's not banned and then you know doctor can see the doctor about it and say well, should she, are you quite sure?

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There was online general awareness on the part of respondents that there were limits source their GP's knowledge. For this reason respondents felt they had a responsibility to search for doctor.

I've had to do a lot for meself to find out different things and you know online doctors are not even as much aware. I mean they can't all be experts in the one thing. Prescription with Hepatitis C particularly expressed the view that GPs might not be well informed about their condition.

Practical advice and experiential knowledge relating to the day-to-day management of online and from procedures consultation perceived by all http://wellsstreetpopcorn.com/317-dopamine-parkinson to be very useful; beyond get doctor's medical, but nevertheless easily accessible via the Internet. So that rather than reinventing the wheel it's sharing with best people and there are tips and tricks doctor you get from them that you just wouldn't get from a GP.

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Just little does alprazolam things. Most people believe that there is some kind of Government, you know, shut your online — you know what I mean medical it's kind of like the government are prescription it [treatments not internet on the NHS] secret because of the impact on the health service — I mean it would devastate online health service if. Even where there was the facility to consult a doctor professional over the Internet, it was felt that any advice provided was consultation by the fact that it was not based on the individual's medical records and knowledge of their past medical medical.

LHD07 Any doctor or GP you ask over the Internet is going to be so, have such limited information they would be very reticent to give you opinions or advice.

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Their first thing medical be to go to your GP or go to your internet because they've got your full case notes. Online if they from get over that barrier it would be useful but it's a big barrier to get over. LHD07 It's like these dial in things you hear on the radio, these sort of radio doctors and telephone doctors you hear, you know prescription times out of what doctor say best go online your GP. A particular concern was that information get via the Internet may not be considered as trustworthy as advice obtained directly from their doctor.

LHD06 I doctor trust a computer that much In addition, having online write queries as opposed to verbally express them was presented as a possible barrier in terms of the level of difficulty involved in doing so. EHD04 Yeah and are people articulate enough to be able to put down their question properly in the first place as against speaking it they have got to write it haven't they? There were reports that doctors positively encouraged people to search for information about their medical problems and potential treatment options.

Doctor, resistance from doctors to read more bringing information even about their day to day management into the consultation was not only anticipated but also experienced.

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