CLINICam The world's first live general practice on the Internet
MJA 1999; 171: 671 | |||
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Did you watch the world's first live birth on the Internet?2 Florida woman, Elizabeth, gave birth to baby Sean with an Internet-connected video camera capturing it all discreetly from over her shoulder, and sharing the event with a huge audience of curious onlookers in the United States and abroad. And you must have heard about "OurFirstTime"?3 Two purported virgins, Mike and Diane, who announced that they were going to lose their virginities live on the Internet in front of the world -- this turned out to be a hoax by two out-of-work actors. So what's next? Surely the Australian medical community can come up with something to challenge these North American innovations. Well, ladies and gentlemen, allow me to introduce you all to CLINICam, the world's first livecam General Practice on the Internet. The concept is simple -- a digital camera is to be set up in my consulting room, and each of my consultations will be beamed live to the world via the Internet. Each of my patients will sign a consent form agreeing to have their consultation videotaped and released "live". The patients will be able to control when the camera stays on and when it is turned off. The camera will be positioned so that it captures me and the patient sitting at my desk, as well as allowing a tantalising glimpse of the patient's feet when he or she is lying on my examination couch. It is conservatively estimated that approximately 100 000 people from around the world will be tuned in at any one time to watch CLINICam. We are going to have to extend the operating hours of our clinic to allow us to capture the North American and European markets. CLINICam has a sound educational basis. For the first time people will be able to see what actually happens to other people in a doctor's consulting room. They will be able to witness the wide array of biopsychosocial concerns which are presented daily to a typical Australian general practitioner. They will be able to compare the CLINICam doctor's advice about particular health issues with the advice they have been receiving from their own medical advisers. A number of discussion groups will be established to support the educational aims of CLINICam. For example, there will be a discussion group for medical practitioners, who will be invited to provide online peer review of my clinical performance, communication skills and medical decision making. This will lead to the most educationally useful consultations being archived and made available as "The Best of CLINICam" for medical student education at universities around the world. Other discussion groups for members of the public will allow them to make their own suggestions about alternative treatment options for individual patients. A popular feature is expected to be the live scoring system, which will be turned on whenever a representative from a pharmaceutical company comes to see me. Observers will be invited to rate the performance of the individual rep and a rating scale will appear on the screen -- is this rep getting his or her message across, and how likely will I be to change my prescribing behaviour? There will also be a discussion group focusing on what might have happened when a patient decided to turn the camera off during a consultation. And there will be an online dating service, so that if you think one of the patients (or the doctor) is cute you can send a saucy message. CLINICam will require some additional funding. A computer support technician will obviously be needed to keep the system running smoothly. A full-time make-up artist and hair stylist will be required to touch up the patients before they come into my consulting room. A publicist will be required to promote CLINICam to the pharmaceutical industry, offering sponsorship opportunities through discreet "product placement" of logo-emblazoned coffee mugs, calendars and pens on the doctor's desk for a sizeable weekly fee. And a talent scout will be required to interview prospective patients prior to consultations. Not surprisingly, there are still a few ethical issues to be ironed out. The key question for the ethics committee is this: "Does CLINICam represent a unique opportunity for worldwide health education, involving consenting individuals as 'case studies', and demonstrating the diagnosis and management of key primary healthcare issues for hundreds of thousands of online viewers? Or is it just another form of voyeurism?" We're almost ready to roll. Provided we all survive the millennium bug, CLINICam should be ready to go live early in the New Year. You can find us at www.say_ah.com.au Michael R Kidd
©MJA 1999
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