Power Dynamics & Virtual Health: Protecting Professional Boundaries in an Unbounded Web

Virtual Health – however that’s defined – has become a hot topic lately, especially in light of the rapidly evolving two-way real-time Web. Power dynamics – the interplays between patient and provider – must be protected in order to safeguard patient rights and protect their dignity, privacy and well-being. There’s more to virtualized practice than may be apparent on the surface.

Here are some thoughts, including an explanation of what I am (half-humorously) calling the “intimacy-boundary membrane”. [Link to video]

Power Dynamics & Virtual Health: Protecting Professional Boundaries in an Unbounded Web from Phil Baumann on Vimeo.

Patients are increasingly demanding online ways of interacting with their providers. As social media evolve, improve and proliferate, the ePatient movement will continue to expand and the healthcare industry will have to develop ways to meet the demand.

This movement, however, will have to ensure that it does not overlook the important behaviors all health care providers must express. It will also have to mature so that we aren’t left with a virtual health care landscape that is little more than a circus of amateurs. Experience matters more than content.

But social media is also rapidly shortening the spaces of intimacy and boundaries between people. This means that as health care professionals interactively enter the Web, the tension between intimacy and boundaries will increase.

We could say that there exists a safety zone between intimacy and professional boundary. These zones have traditionally been worked out for in-person clinical relationships. Online, however, we have a long way until we establish a collective understanding of how these technologies affect our virtual health care experience.

Since the space is shrinking to a thin wall, I’ve decided to call this problem the intimacy-boundary membrane. How do we go about protecting that membrane? Is this metaphor useful? You tell me.

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