Health affairs
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An emerging consensus supports online communication between patients and physicians in an existing relationship to improve the quality, timeliness, and efficiency of medical care. Patients are also seeking medical care online from physicians they have never met, ranging from one-time interactions for a second opinion to psychotherapy. These practices call for a new regulatory paradigm to ensure accountability, establish acceptable parameters for online medical practice, and distinguish online health care delivery from online health information. The new patient-physician encounters also challenge the medical profession and society to reexamine core assumptions that define medical practice and the patient-physician relationship.
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Since 1996 New Zealand has had a Code of Patients' Rights enforceable by complaints to an independent ombudsman. Patients are entitled to receive health care of an appropriate standard, to give informed consent, and to complain to a health commissioner about perceived malpractice. The commissioner investigates and reports on complaints, recommends practice changes by providers, is a gatekeeper to discipline by professional boards, and acts as a public advocate for patient safety. In this paper the current commissioner describes New Zealand's experience with the patients' complaints system and discusses the implications for the quality of health care.