Australian GPs have slammed online doctor services, claiming websites offering medical certificates, specialist referrals and prescriptions fragment care and pose a serious risk to patient safety.
Online GP Qoctor has launched a pharmacy and medication delivery service, adding to its clinical offerings, but the Royal Australian College of General Practitioners claims patients should only access online services provided by their GP.
“The big risk with online services performed outside of the usual patient–doctor relationship is that they fragment care and do not provide continuous, comprehensive general practice care to patients,” RACGP President Dr Bastian Seidel said.
“They provide patients with prescriptions, referrals or medical certificates without sufficient understanding of their medical history and social context, which is a safety issue and may also affect quality of care.”
According to Qoctor, the “convenient, quick, safe, inexpensive, effective and very thorough” service is run by a team of GPs and has saved $305,762 in costs to Medicare. The online doctor fee is $19.99.
Responding to criticism, Director at Qoctor Dr Aifric Boylan told the Australian Journal of Pharmacy it is not always necessary for a patient to see a doctor in person.
“It comes down to wisely selecting the conditions and treatments that are amenable to an ‘online’ approach, and then ensuring that a thorough self-screening process takes place. Qoctor prescribes treatments which neatly fit this model – we ask the patient all the relevant questions in a simple, straight-forward way,” Boylan said.
“The reality is that in busy GP clinics, quite often patients do not get asked some of the important questions at all. For instance, it’s a very common occurrence to meet women who have been prescribed the contraceptive pill for years, despite having a clear history of migraine with aura – they’ve simply never been asked. And it’s also possible for a patient to misunderstand a question asked in person, just as they would on an online form.”
But Seidel said patient safety can be compromised by online services.
“Completing requests via an online survey can easily result in misdiagnosis due to a range of factors,” Seidel said.
“Without access to the treating GP’s notes, the doctor has no means of otherwise confirming the information provided. There is also no guarantee the patient’s usual GP will be informed following a patient accessing an online service, which again leads to fragmentation of medical records.”
Previously know as Dr Sicknote, Qoctor has plans to expand into GP tele-consultations, including for chronic disease management and mental health issues.