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Thursday, September 28, 2017

A Bit Of A War Seems To Have Broken Out Regarding Provision Of GP Services On Line!

First we have had articles like this:

Online GP and pharmacy services “second best”

Doctor and pharmacy groups criticise websites that offer online consultations, scripts and medication delivery

Following the announcement that Qoctor – formerly known as Dr Sicknote – is now expanding its services, the RACGP has stated that the increasing prevalence of medical online services fragments care.
Qoctor is an online medical hub that offers medical certificates, specialist referrals and online consultations, and this week announced it is expanding into providing online prescriptions for STIs, contraception and erectile dysfunction, as well as an online pharmacy and medication delivery service.
RACGP President Dr Bastian Seidel says patients should not be able to access prescriptions, referrals and/or medical certificates through online systems unless they are being provided by the patient’s usual GP, or a GP in the patient’s usual general practice.
More here:
Then the inevitable response here:

Don't be so quick to dismiss online GP clinics

21 September 2017

OPINION

Qoctor, an online GP clinic, has caused a stir in the medical community. Here, Dr Aifric Boylan, a GP and the clinic's CEO, tells her side of things.
The art of being a good listener has always been central to practising good medicine. From their first days in med school, students are taught that a thorough history will reveal the patient’s diagnosis in most cases, without a need for examination or tests.
But as information technology advances, and pervades all aspects of healthcare — from people Googling their symptoms, to remote diagnostics, cloud-based digital health records, and online consulting — the standard physical consultation between doctor and patient is now only one of many ways people seek answers to their health problems.
It’s relatively easy to define and understand what ‘good listening’ means in the traditional doctor-patient scenario.
But how do we define it in a more virtual environment? How can we effectively listen to our patients online? Can artificial intelligence (AI) be a ‘good listener’?
Medical knowledge may have advanced exponentially in the past 50 years, but doctors still, by and large, learn to consult in the traditional manner, adhering to traditions that go back to the teachings of the godfather of modern medicine, Sir William Osler.
There is a vast amount of wisdom in these practices. But things are changing. People are conducting so many aspects of their lives online and are seeking answers to their health-related questions in a different way.
For doctors to listen to (and learn from) their patients, there is now a need to listen ‘online’.
Lots more here:
And the most recent summary I have seen here:

Online doctor services pose a serious risk to patient safety, GPs claim

Lynne Minion | 22 Sep 2017
Australian GPs have slammed the rise in popularity of 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.
More here:
It will be interesting to see how all this plays out and whether the AHPRA becomes involved.
We watch and wait with interest. There are two sides to this I believe.
David.

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