Another aspect of greater access to medical records is a distributive issue that will trouble administrators and planners as much as doctors. Data available through interactive hospital-based sites or e-mail are presently accessible only to patients who have access to computers. It doesn't take a social reformer to realize that any system failing to take technological capacity into account will disproportionately exclude the poor and the aged, as well as have a potentially disparate impact on minorities. For notes and records to be truly open, ways must be found to include patients who are not computer-based. A related problem, real but manageable, is how to deal with the mentally ill or other persons who are unable to take advantage of the available information. A final concern may present the greatest difficulty. Greater knowledge about one's medical situation has a strong tendency to level the playing field. My mother went along with the recommendation of my father's doctor in part because in those years you did not question what a doctor told you to do. No doubt there is a secondary benefit to patients in such a world because it's only a short step from acquiescence to belief that the problem has been turned over to the professional. But we now know that such beliefs are deceptive and unhelpful. To be sure, most decisions have to be made by doctors, and wise patients are happy to let them. However, passivity robs patients of a wide range of steps that they, and only they, can take toward improved well-being. Not incidentally, patient involvement frees doctors from being thought miracle workers or failed miracle workers.