Doctors, Patients and Computers, The New Consultation: Reshaping medical care in the 21st Century

The New Consultation: This book contends that the computer is an active agent in the general practice consultation. This agency is enacted in different ways at different stages in the consultation. Flexible sets of alliances evolve in the communication among the three players: patient, doctor and computer. This means that the accepted dyadic model of patient/doctor relationship is no longer adequate to describe the interactions that occur. The consultation proceeds through a series of frames in which relationships are negotiated; in the first minute a complex process of negotiation between all three players occurs; in the early information gathering part of the consultation, a negotiation about the translation of information and authority occurs. In the later stages transmission of information from multiple sources are shaped and adapted to need. At this point the computer plays a more generative role. Computers also directly affect the pattern and flow of the consultation. Set notions of the different styles/models of the doctor-patient relationship do not endure when computers are introduced into the consultation and become integral to it.