The doctor is in ... on your computer.

• Author: Lester, Simon
• Position: Medicine & Health

THE INTERNET revolution has been disrupting traditional industries for years by enabling online provision of various services. The first industries to convert have been media services that can be digitized, such as journalism, music, and videos, but less obvious candidates for online provision are emerging. One of these is telemedicine, which is the delivery of health care services from one site to another via electronic communications.

Telemedicine already is being utilized in various ways to provide care to those who could not otherwise receive it. Benefiting are people in countries with a shortage of doctors, those in rural areas for whom access to medical facilities is difficult, and individuals who need immediate assistance in an emergency. This type of medical care has been expanding to the mainstream, as more routine services are being carried out online.

In the U.S., medical treatment typically has been segregated along state lines. With the ease of access between patients and physicians in different jurisdictions, however, this is beginning to change. Regulations will need to be adjusted to allow interstate trade so that consumers can reap the benefits.

Similarly, at the international level, governments should adapt their national regulations to allow trade in these services. This can be done in part through a number of ongoing trade negotiations that address barriers to trade in services. By using these negotiations to remove barriers and promote more international trade in medical services, governments can bring new competitive forces to a sector that traditionally has been characterized by an oligopolistic structure.

As anyone who received medical care in the 20th century can tell you, that care generally was provided in a low-tech, highly inefficient way. Typically, you would carve out a couple of hours from your daily schedule, traipse over to your doctor's office, fill out some forms, wait a while, then eventually see your physician. As a result of new technologies, this process soon no longer will be the norm. For many health concerns, an online consultation will be possible, from your home, office, or wherever you happen to be. This applies to more than just conversations with a medical professional; patients will be able to conduct actual medical tests, with the information passed on to the nurse or physician.

In and of itself, the benefits of bringing online interaction to this field are enormous. Almost as important, however, are the gains that will come from the international trade that now is possible in this area. The ability to take advantage of a whole world full of nurses and doctors will increase competition, raising quality and lowering prices--and many people who previously had very limited access to care, and sometimes none at all, now will be able to consult leading specialists from around the world.

Not surprisingly, there is resistance, mainly from the professionals whose livelihoods are being disrupted and who feel threatened by the prospective changes. Among other places, the resistance can be seen in trade negotiations, where interest groups have been working to maintain...