my jaw dropped when i heard it News on Thursday that Amazon is acquiring One Medical, the office of a digitally savvy primary care physician I’ve trusted my medical care since 2009. My mind raced: Will Amazon now use my medical records to ship pills and broccoli? Will he tell my doctor if I’m drinking too much beer? Will Amazon manage my doctor like warehouse workers? Will it try to replace my healthcare with a Q&A from Alexa?
So I called one of America’s leading medical ethicists. Arthur Caplan From New York University Grossman School of Medicine, Dr.
“I think you should be feeling super nervous and a little depressed,” he told me. “Synergy makes great business sense, but for healthcare it can make terrible consumer sense.”
(Amazon founder Jeff Bezos owns The Washington Post, but I view all technology with the same critical eye.)
The news that mega-corporate consolidation will come to healthcare has been on the wall for a while. Insurance giant Aetna has merged with CVS. Amazon announces its interest by buying online pharmacies pill pack and developing products such as the Halo Band, a wearable device that collects body information and offers recommendations. And when Amazon gets a job, it doesn’t just tend to stay on the sidelines.
“This is another opportunity to collect a large cache of personal data to use this data and these relationships to further strengthen Amazon’s dominance as an online intermediary for many products and services,” he said. Stacy MitchellHe’s a sharp critic of the tech giant’s monopoly power, co-executive director of the Local Self Confidence Institute.
Amazon’s cross-industry tentacles give data a superpower to develop incredible insights about individuals that it can use to find very precise ways to manipulate us and the economy. It’s probably not the best idea for our streaming services and healthcare to come from the same company.
An Amazon spokesperson declined to answer my question about how it is good for consumers or patients to allow a company to have so much data.
Amazon executives often say that the company’s “customer obsession“This may be true for delivering products within two days, but in the last decade I have seen little evidence that the company prioritizes our privacy or has the kind of ethical culture that can make the right choices about human consequences. its technology. There are so many examples: Amazon eavesdrop on our conversationshis Ring brings doorbells police surveillance to our door and Amazon Sidewalk is pulling your internet connection without permission.
Amazon’s skewed priorities, a colleague and I viewed Halo, the first healthcare device and the most invasive technology I’ve ever tested. It asks you to undress and hook up a microphone so it can 3D scan your body fat and monitor your tone of voice. No kidding, he has a computer that tells you if he thinks you’re speaking “condescending”. It would be funny if there wasn’t a very serious possibility that this company would soon have my doctor’s office and have all my medical records.
To get patients like me to trust Amazon as the owner of One Medical, Caplan suggested four big questions we need to know the answers to. situation.
- Will Amazon commit to having a physician responsible for One Medical? Amazon said Amir Dan Rubin, the current non-doctor CEO of One Medical, will continue to operate the business. Of course Amazon has enough MBAs of its own – we need a doctor who protects our interests. There must be a big sick town hall where a Medicine talks about it and answers our questions. Unfortunately, One Medical didn’t even email patients on Thursday about the news.
- Will Amazon commit to setting up a firewall between patient data and Amazon’s other tentacles? Amazon spokesperson Dan Perlet said, “As required by law, Amazon will never share the personal health information of One Medical customers outside of One Medical for advertising or marketing purposes of other Amazon products and services without the customer’s express consent.” But the devil is in the details of that last sentence: Yes, America has a health privacy law called the Health Insurance Portability and Accountability Act. But HIPAA was not written for the internet age; as i found Again and Again, many companies are finding completely legal ways to obtain private health data for marketing and other purposes, and few patients have realized that they are giving them “with consent”. “I’m worried that the combination of a large product distributor and marketer with sensitive health data could lead to a tsunami of targeted advertising that you probably don’t want,” said Caplan. I’m particularly wary of Amazon trying to lure patients into handing over their data to the e-commerce giant in exchange for discounts and even – imagine – an Alexa-based telemedicine service.
- How does Amazon plan to ensure that doctors and nurses fulfill their ethical responsibilities? Neither he nor One Medical answered my question. Medicine is no ordinary business: Amazon now has a duty of care. “Putting patients first can mean resisting a subpoena or, conversely, reporting firearm injuries or abuse,” Caplan said. Said. In the newsletter announcing the deal, Amazon said, “We see many opportunities, both to improve the quality of the experience and to give people their precious time back,” quoting executive Neil Lindsay. Will Amazon start treating doctors like fulfillment center workers whose days are monitored to the minute and compressed for efficiency? That sounds like a horrible doctor’s visit, even if Amazon is more productive with time-consuming tasks like sitting in the waiting room.
- What will the government do to protect patients in a world of such horizontal mega-mergers? Will aging health update our privacy law? Will it put any limits on the way Amazon manages patient data? “This is not a done deal,” Mitchell said. “Antitrust agencies will be looking at this very closely.” But despite all the talk about reining Big Tech, Washington hasn’t had much success in doing so lately. On Thursday, you. Amy Klobuchar (D-Minn.) wrote an open letter asking the Federal Trade Commission to investigate the deal, saying: “Amazon has a history of engaging in business practices that raise serious anti-competitive concerns.”
I’ll give Amazon and One Medical a month to convince me to stay. After that, I’m going to look for a new doctor’s practice.
