ABSTRACT
In America’s healthcare marketplace, the user has long been treated as both a patient and a consumer. She has had some choice over her physician and could demand access to some services, and was often left paying exorbitant prices. But her power has always been somewhat limited, constrained by government regulations over drugs and medical devices, the rules of insurance companies, and the expertise and authority of science policy advisors, physicians and other healthcare professionals. The technologies of the twenty-first century, facilitated by particular social, political, and economic systems, have pushed the identity of the healthcare user further toward that of a consumer who is presumed to be empowered by increased access to information and can, therefore, make independent decisions about herself, her healthcare, and her life. Scholars have argued, for example, that the internet allows users to come to medical appointments informed with information that diagnoses maladies and suggests treatments (Broom 2005, Fox et al. 2004). These technologies have shifted the power dynamics of the doctor-patient relationship, destabilizing the traditional role of the physician whose expertise was based on access to specialized knowledge.
