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owing to the majority of existing research and literature originating there. However, the content is alsoapplicable in most instances to other developed nations, due to the global nature of the Internet andsimilar cultural and medical constructs.Of key concern to this paper is the impact of the patient advocates on the traditional notions of authority
are they a replacement for more traditional figures of authority or are they complementary? How do theyoperate and how is their impact felt? Specifically, the paper will look at the example of prominent patientadvocates working in the area of thyroid disease to illustrate how traditional notions of authority are beingchallenged. Research, including a review of relevant academic research and study of advoca
websites and message boards, has provided the insights for this paper.
Traditional Notions of Authority
A study of the relevant literature reveals that the notion of authority in the medical profession is based onnumerous factors: knowledge, training or technical competence, access to information, clinical experience,qualifications and legal authority (for example to write prescriptions or perform operations) (Makoul:1998, Blumenthal: 2002, Gesler:1999).
Certain theorists have posited that these factors have eventuated in a particular dominant type of doctor-patient relationship that is variously described as paternalistic (Engel:1977), authoritarian, asymmetric(Eysenbach and Jadad: 2001), with the resulting relationship resulting in a situation according to The New
York Times where “the doctor gives orders and the patient obeys” (Hafner: 1998).
Citing Foucault amongst others, Segal notes that it wasn’t until the end of the 19
century that medicalcompetence was removed from patients and placed in the hands of licensed practitioners due to a rise in
certain types of technologies. Previously, Segal states that “Eighteenth century medicine was characterizedby the populist notion of ‘every man his own physician’“(Segal, 2009:
p.363). Requiring a prescription formedication is quite a recent development, only coming about well into the 20
century (Segal, 2009).
The democratisation of medical power
Access and use of information has had substantial coverage in the literature and undoubtedly plays afundamental role in the changing nature of the doctor-patient relationship. Types of health or medicalinformation can include: scientific research papers, symptom lists, treatment protocols, medication sideeffects and usage guidelines.