Limitations of Online Medical Care: Interpersonal Resistance and Cultural Hurdles in the Face of Technological Advances

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In 2009, a health care service organization in Hawaii launched a online medical consultation program intent to serve the needs of clients in rural Oahu and the neighboring islands, which faced increasing shortages of primary care clinicians. Patients could go online for medical advice from on-call Hawaii based clinicians. However, physicians and statewide medical agencies were critical of the program due to ethical concerns, medical licensure and insurance coverage, and deviation from socio-cultural practices specific to Hawaii. This empirical paper traces and examines the legal and medical ethics of telemedicine in the face of Hawaii's socio-cultural orthodoxy of interpersonal engagement and obligation called the ohana (Native Hawaiian for “family”), and the implications for telemedicine as a medical care resource for the state and nationally.

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