In Managing Media Work, Bozena talked about technological innovations with the ability to “disrupt” the business models of different sections of media industries. But something we should consider in an increasingly mediated world is the effects of ever-changing media technologies to infiltrate affect other businesses not always considered to be associated with media industries. Let’s say, for instance, psychology.

According to a recent New York Times article, there has been a growing trend in video conferencing therapy sessions. While teletherapy is nothing new, over the past few years there has been an increase in doctors and patients not using teletherapy as an alternative when distance becomes a necessity, but as an outright replacement for in-person sessions. There are a variety of questions that arise from such a practice – how to bill insurance for online sessions? how do you prevent being scammed by an online “psychiatrist” with less-than-valid credentials? – but the two issues that seem most relevant are issues of not only how it affects doctor/patient relationships, but also how it affects the business of practicing pscyhiatry.

The interpersonal issues are fairly obvious: how does the lack of in-person face time affect the relationship between a doctor and a patient? Can you still build a level of trust and intimacy with a face that is comprised totally of pixels? That issue is still contentious. Certainly, for patients who may have avoided therapy previously (agoraphobics, recluses, etc.) this option is a viable way for them to get the help they need without violating their sense of safety and security. At the same time, issues can arise when patients with significant issues in hallucination and delusion misinterpret the less-than-realistic digital portrayal of their doctors. (One doctor in the article, Michael Terry, had instances of lighting causing both a haloing effect, as well as a darkening effect; one patient thought he was talking directly to God, while another thought that he was speaking to the Devil.)

But what about the actual practice of psychiatry? Many therapists have found this a viable – and cost effective way to run their businesses. By being able to work exclusively from home with patients virtually, they cut business expenses such as gas for travel and office rentals. This, in turn, allows these doctors to charge their patients less for their on-line services than they would if they had an in-office practice. Practicing therapist, such as Eric Harris (cited in the article) feel that within as little as three years, these practices will become much more standard practice. If that’s the case, how can a doctor who values face time with a patient, and who believes that this in-person approach is necessary for proper treatment, compete with e-rivals who not only offer a less expensive service, but can offer service to their patients literally whenever and wherever they want?

What happens to a business (a business that is categorically not a media industry) when that business practice becomes literally mediated by the media?

– Shannon


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