Looking for Medical Advice in Everyday Digital Spaces

 - Vikalpa: The Journal for Decision Makers

Why does a person send a ‘friend’ request to a physician on Facebook? What is the nature of communication between such a person and the physician on Facebook? Do individuals get to interact with physicians on Facebook? Or, does it primarily offer them online access to physicians, the health information they post and the online community on their profile page? What does good health mean to such a person, and what does he do to maintain it?

This qualitative study strives to explore answers to such timely questions by conducting in-depth interviews with Indian men and women who are connected with physicians on Facebook. In this case, Facebook presents an intriguing site for study as it is not usually associated with communication with doctors (Mishra, 2018).

Moreover, physicians, especially in Western settings, have often expressed their discomfort in connecting with patients on the platform (Chretien, 2010; Jain, 2009). In the case of India, media reports highlight a growing trend in the use of social media platforms and apps by physicians and patients. However, academic research on such emerging phenomena in this country is still scarce. This study strives to explore this nascent area of research. Overall, the study seeks to contribute to the existing literature in critical health communication and healthcare management, especially in the case of online interface usage. It extends the Foucauldian concept of neoliberal governmentality to understand and interpret the health-related practices and performances of individuals in social media spaces such as Facebook in the Indian context.

The Indian healthcare sector comprises both government-run hospitals and private establishments. While the public healthcare sector continues to perform poorly due to insufficient funds and overall neglect (Chakravarthi et al., 2017), private medical care remains expensive (Kumar & Gupta, 2017). The country’s healthcare system also suffers from multiple contradictions. Its healthcare expenditure is amongst the lowest in the world. It comprised just 1.41% of its GDP in 2017–2018 (Press Trust of India, 2018). Around 71% of health spending in India is met by people’s own savings called ‘out-of-pocket’ expenses, which contributes to increasing poverty (Hooda, 2017). Apart from inadequate health insurance (Ghosh, 2017), other challenges include a low doctor–patient ratio, concentration of doctors in big cities (McIntyre, 2017) and the double burden of coping with both communicable and non-communicable diseases (The Lancet, 2018) apart from a burgeoning population of 1.3 billion people.

With more Indians getting access to the Internet, the current Indian government has repeatedly emphasized that it intends to use ICTs to improve healthcare facilities (Indo-Asian News Service, 2018). It has made health an important aspect of its ‘Digital India’ campaign (Mills & Hilberg, 2018) with the goal of transforming India into ‘a digitally empowered society and knowledge economy’ by using information technology in the field of public services (Government of India, n.d.). To understand the deep impacts of digital health technologies on people, it is important to understand the far-reaching changes in meanings and subjectivities associated with their usage. As people begin to self-manage various aspects of their health and lives, it is important to explore their assumptions and perspectives in this regard.





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