The medical, insurance, and public policy communities have all contributed to the development of practice standardization, especially with heightened research comparing patient outcomes across geographical boundaries. While the physician's exposure to new information was once geographically bound, information flow has circled outward away from its physical moorings. Printing presses, newspapers, and journals lifted information away from physical sources. More recently, telephones, televisions, videotapes, and computers have carried information further into the evanescent realm of electronic transfer. MRIs and radiographs can be transmitted electronically for long-distance consultations.
Physicians discuss treatment issues via e-mail discussion groups.
Television, videotape and CD-ROM computer discs exist for medical student training and continuing education of practicing physicians. Physicians now use computers to diagnose and treat patients, often doing medical literature searches to bolster their decisions. Apart from ease and convenience, decreased cost and availability of computer searches have increased their popularity. Full-text retrieval of journal articles via a desktop printer provides fast access to essential information 16 . Computer use increases with improved information access, as one study attests.