The new health service dividing doctors

The Australian Medical Association (AMA) has cautioned people against using online health care services in place of visiting their doctor in person.

Online consultations are quickly rising in popularity in Australia with websites offering medical certificates, medication and Skype video calls with doctors – all from the comfort of the patient’s home and for less than the Medicare rebate.

However, AMA Vice President Tony Bartone says people who use these sites risk being misdiagnosed or having symptoms overlooked.

“We’re looking at a speedy option that suits the user and consumer in this day and age, but it’s in trying to be speedy and agile in the solution that things can get overlooked – that’s when things can get missed,” he told Starts at 60.

He said online doctors largely rely on patients telling them about their medical history to make a diagnosis, rather than examining them face to face.

“At the end of the day it’s important to remember that history does guide us to a diagnosis, but no exhaustive history can always reliably compare with the opportunity of examining a patient in real time.”

However, Qoctor director Dr Aifric Boylan disagrees, saying online consultations, like the ones offered on Qoctor, are the way of the future.

“Debate [on this issue] is necessary and healthy and the worst thing doctors can do is put their heads in the sand and pretend this is not happening,” she told Starts at 60. “I think healthcare going online is inevitable so we either adapt and are part of the change or we let it happen without input which I think would be detrimental to patients.”

Qoctor is run by a group of GPs and offers online medical certificates, referral notes, consultations with doctors and will soon begin offering prescription refills, too.

Dr Boylan said referral notes were a big draw card for Baby Boomers who may only need to see a specialist once a year. Instead of having to pay for a visit to the GP, they can speak to a doctor online and print the note out at home.

“I know a lot of people in the 50- to 60-plus age bracket are going online and they’re on Facebook and they’re pretty tech savvy,” she said.

“If they have no other medical issues at that time and just need the repeat referral they can get that from a website very efficiently.”

She said online doctors were careful to assess patients thoroughly and send them in for a face-to-face consultation with a GP if necessary.

“Any good doctor will identify the patients that need physical examination and advise them accordingly and will also recognise the patient that does not need to be physically examined and proceed in a different manner,” Dr Boylan said.

“I think for online medicine, especially to do with an online consultation, doctors are still duty bound to take a good patient history and then decided – ‘well I can treat this patient online’ or ‘I need to to tell them they need to go get tests or have some sort of further investigation or physical examination’,” she said.

Websites like Qoctor have seen a swift rise in popularity in recent years thanks to convenience and affordability. While the Medicare rebate gives people $37 back on their GP visit, Qoctor only charges patients $20 for their services, making it a more affordable option.

But Dr Bartone warns that people need to weigh up the value of their dollar compared to the value of their health.

“If it’s a question of time and a question of convenience, well clearly sometimes convenience and quick fix may not be in the patient’s best interest,” he said.

While the idea of online health once sounded incredible, some doctors are predicting that just like online banking, it will soon become the norm.

What are your thoughts on this? Would you consult a doctor online? Or do you prefer face-to-face meetings?