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Resist Change or Join the Online Revolution: A Physician’s Dilemma and Opportunity

I enjoy taking a look back at a 2004 article published in the British Medical Journal entitled “Easy Ways to Resist Change in Medicine.”

Written by two evidence-based medicine gurus, the article satirizes the tactics physicians use to obstruct and resist change.

Of course, physicians aren’t alone in resisting change. The reasons for knee-jerk responses to change are numerous and entirely understandable. Among them:

• Fear of failure
• No obvious need
• Loss of control
• Fear of the unknown
• Unwillingness to learn
• Lack of support
• Fear that the new way won’t be any better
• Close mindedness
• Lack of money

Most of us have been guilty of these behaviors at some point in our professional lives. And yet, as physicians, we can no longer resist the dramatic shift in online health and medicine. The stakes are just too high and we can’t afford to miss another opportunity.

The first Internet revolution of the mid to late 1990s ushered in enormous advances in online content, community, commerce, customization, connectivity and choice. Remember the thrill you experienced when you first used Google to search for an article, or when you went online to make an airline reservation or buy a movie ticket? This was a time when Amazon.com and eBay revolutionized shopping and e-commerce, when text and instant messaging transformed communications, and when Palm pioneered miniaturized technologies like PDAs.

During the same period, however, physicians experienced relatively few benefits of the online revolution. Aside from a handful of online support services such as MDConsult, e-detailing opportunities such as http://www.medsite.com="">MedSite, and multi-specialty information sites such as Medscape, physicians seemed satisfied with online services that offered little more than frequently updated textbooks, journals, monographs and reports. After all, how many of us thought we had achieved Nirvana when we saw our names in an online physician directory or when we built a practice Web site? The online world had so much more to offer us—and it still does.

I often reflect on what medicine might have been like if we, as physicians, had not resisted the change inherent in a major cultural upheaval such as the Internet. What if we had brought our professional curiosity online? What if we had worked to find each other and build relationships in the online world? What if we had created communities to address the challenges of health care cost, quality and access? What if we had communicated and collaborated to reduce medical errors, improve health outcomes, and better manage disease and illness? Perhaps the health care system would be farther along the path toward authentic change than it is now.

The good news is that it’s not too late for us to take action and get involved in the new online world of health and medicine. While physicians can still take advantage of more traditional web sites, we can now tap into a full range of online opportunities—from sophisticated databases offering practice guidelines, to blogs, forums, podcasts, videos and online physician-based communities. Just as people have found each other through sites such as Facebook and MySpace, physicians can now find each other through networking and knowledge discovery sites such as Ozmosis.

Whether we choose to use the Internet to search for the best treatment guidelines, to market our practices, or to network with peers, we must keep our eyes and ears open to new technologies and fresh approaches to content, community and connectivity.

Only by staying engaged with and connected to the online world of health and medicine can we enhance professional practice of medicine and serve our patients in the best way possible.