In 2009 I posted a blog here on videotaping of surgeries and the issues and challenges this would present.  I did not say I am in favor of this as a means of policing medical practice, but for documenting surgeries the technology can be very useful.  I do video as many of my surgeries as I can, and I offer to show these recordings when appropriate to my patients.  Most are very interested in seeing what I have done.  They understand as a result far better the goals, risks and challenges of doing surgery.   I have never experienced a negative reaction from any of my patients for doing so.  To the contrary, I believe seeing the complexities of surgery generates a new respect for the work we do.

My post was a warning that the technology existed, could become mainstream, and that doctors need to be prepared to deal with it in view of the perceived threats and challenges this may present.

I saw the future, and dared speak about it.  Some comments from colleagues were emphatic in their condemnation.  Now it appears this possibility is being taken seriously, and I bet few of the decision makers pushing for this legislation are doctors themselves.

All over social media stories abound about how the internet, Google, social media, the empowered patient, and even new technologies are making doctors’ lives more difficult.  The internet especially has exposed every doctor to positive and negative review with a reach far beyond that of simple word of mouth.  Patients can blast off, blog, recriminate with relative freedom.  So too can doctors using other social media.  Many do so anonymously, this itself causing many arguments about the ethics of doing so.

What amazes me however is how surprised some doctors are by the advent of this new business environment. Witness the response to Pamela Wible’s post on patients daring to bill their doctors for being kept waiting.  Over 360 responses and counting!  This is surely a record response.

To use a military analogy, the medical profession appears to me like an army engaged in a battle against the enemy of disease, with the latter using patients as soldiers, and politicians, managed care and administration as allies.  The battle conditions are changing, the enemy (you are welcome to think of patients as “the enemy” for the purpose of this analogy – I’m not for a moment suggesting this in reality) are rearming and using newer weapons.  In this battle, intelligence is everything, and to be forewarned is to be forearmed.  So the medical profession’s scouts and reconnaissance units should be out and about looking at the field of engagement, and coming back with reports and assessments of both impending threats and positions of advantage.

And what is this modern medical army doing with this information? Ignoring the intelligence.  Being reactive to threats, rather than proactive.  And not grasping the opportunities when they present themselves.

Other professions have had to adapt to change.  The medical profession will be no different.  I read the intensely angry responses to new ideas from my colleagues and to my posts, and sometimes I feel like a Biblical prophet of old, who after the event had an unsatisfying opportunity to say “Don’t say I didn’t warn you.”

The medical profession is at risk of reacting too little, too late.

Pamela Wible, and other adventurous and far-sighted doctors featured as authors in this and other blogs will know exactly what it means when Jesus knowingly said, “A prophet is never welcome in his own country.”

Martin Young is an otolaryngologist and founder and CEO of ConsentCare.

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