Janice L. Zoeller

In January 2006, the American College of Physicians (ACP) warned that primary care, rightly referred to as the backbone of the nation's health care system, was on the verge of collapse. The ACP noted then that few young physicians were going into primary care and that many of those already in practice were leaving.

Last month I wrote about how patients-or rather consumers-were taking on greater responsibility for decisions affecting their own health, largely because of the Internet and the ability to research and form opinions about individual treatments. That was only scratching the surface of how the Internet is revolutionizing health care.

The first time I refused to go along with a physician’s directive, I was 8 months’ pregnant with my first child. My doctor wanted to order a glucose tolerance test to screen for gestational diabetes. I needed to drink a sugary cocktail and then be tested as my blood glucose levels first rose and then fell. Why? I asked. Wouldn’t this put undue stress on the baby? It didn’t make sense to me. I was not overweight and had no personal or family history or other risk factors that I could tell.

The idea that “you are what you eat” in terms of influencing one’s overall health may soon be tested in a unique way. Increasingly, employers seeking to reduce health care expenses are targeting employees’ unhealthy lifestyle practices. But will these programs cross the line and invade employees’ privacy?