The head of the HSE has compared online GP consultations to psychic phone lines amid claims that patients who use the service are being misdiagnosed and over-prescribed drugs.
Tony O’Brien, director-general of the HSE, was asked if online video calls and mobile apps which allow GPs to diagnose and prescribe drugs without face-to-face consultations met proper standards of practice.
“Personally I would not use such a service. I’d sooner phone Psychics Live,” Mr O’Brien tweeted in response.
The specific question was about Laya Healthcare’s new GP Live service which offers to treat conditions such as urinary tract infections, stress and colds. Laya’s doctors also provide general medical advice via online video calls. Aviva, VHI and Irish Life Health also offer online consultations.
Mark Murphy, chairman of communications with the Irish College of General Practitioners, said that the services were a misappropriation of the name GP. “It is not general practice when someone who is not your GP does a one-off consultation and you never see them again,” he said.
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The move to video consultations was not based on evidence that they benefit patients and are being driven by corporate interests, he added. “We have to be alive to the concern that people may be being falsely incentivised to pay for care with online consultations.” The Irish Medical Organisation (IMO) warned that there is an increased risk of misdiagnosis with online consultations and it urged patients to proceed with caution. “Private healthcare companies are purely seeking to make profit by offering these online services,” Padraig McGarry, GP chairman of the IMO, said.
“While online consultations can be suitable in certain scenarios such as emergency situations where a person may need specialist medical advice and support to talk them through steps to stabilise a patient before the arrival of emergency services, it does not and cannot replace a face-to-face consultation with a GP.”
The UK Care Quality Commission issued a damning report in June which found that inappropriate prescription and a lack of testing before diagnosis were common during online consultations. The IMO said that nine of the services reviewed by the commission were found to be unsafe.
Dr McGarry said that regulation could protect patients offered these services in Ireland. Chris Goodey, chief executive of the National Association of General Practitioners (NAGP), said that video consultations were only appropriate between GPs and their own patients.
“Video consultations should not replace face-to-face consultations. We recognise that video consultations are not appropriate for all medical complaints, including those requiring a physical examination,” he said.
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“ Video consultations with a GP who is not familiar with your medical history does not ensure adequate patient safety and continuity of care.”
Mr Goodey said that video consultations were useful where patients were unable to see their GP, but they should only be done when the doctor had a relationship or access to the person’s medical history.
The NAGP has developed GP Online which allows doctors to speak to their patients online to prevent people from seeking alternative consultations.
A Laya healthcare spokesman said it was inappropriate for Mr O’Reilly to compare their service with a psychic telephone line. “Laya healthcare takes our commitment to look after the healthcare needs of our more than half a million members very seriously.”