This created a new form of state, jamahiriya, supposedly based on direct consultation of the people, but in reality establishing a vast network of informers.

Programs are developed in direct consultation with the business and health care communities to satisfy industry demands for certain skill sets.

He also governed through a method that one historian described as civilian dictatorship, which drew its legitimacy from direct consultation with the people, in the form of a plebiscite.

Critics say that widespread adoption of the machines could also lead to independent pharmacies closing down and patients losing the human touch of direct consultations.

Direct consultations include a clinical history composition, physical examination, diagnosis, preparation of a treatment plan and provision of a range of therapies.