Digital doctors: Pros and cons

Digital GP and prescription services are on the rise in then UK — but what’s the appeal and when are they suitable? Lisa Salmon looks at the pros and cons.
Digital doctors: Pros and cons

SCREEN TIME: An online GP consultation can save time for both patient and doctor — but is not always the ideal scenario.

WITH some patients having to wait weeks to see a GP in the UK, it’s no surprise that consulting a ‘digital doctor’ has soared in popularity across the Irish Sea.

Research suggests the number of people searching for online GP and prescription services in the UK almost doubled between 2014-2018, and a recent poll by digital healthcare service found 68% of British adults would be happy to use alternatives to in-person GP appointments.

It’s a situation that could easily catch on here in Ireland, given the pressures our GPs and health service are under.

In the UK, the NHS is becoming ever more digital too, with video GP consultation service GP at Hand in London, as well as the newly-launched NHS App, through which people can book appointments, check symptoms and order prescriptions.

So what’s the appeal? Convenience and speed are thought to be the major drivers.

“For minor, straightforward complaints, digital consultations can work well, especially in terms of offering patients quicker and easier access to medical care,” says Professor Helen Stokes-Lampard, chair of the Royal College of GPs (RCGP).

“Ideally, digital consultations will become one of several ways patients can choose to access their GP practice, but it shouldn’t be the only way as they won’t be suitable for all patients or all conditions.”

So what are the pros and cons of digital doctor consultations? Here’s what the RCGP and Doctor Care Anywhere think...

The pros

1. Convenience

“Digital consultations — whether delivered online via text-based services or via a tablet or smartphone as a video consultation — can be convenient for some people, particularly patients who are time-short,” says Stokes-Lampard.

“They offer quick and easy access for patients with straightforward health complaints.”

2. Speed

Patients can consult a doctor quickly, usually within a few hours, says Dr Bayju Thakar, founder of Doctor Care Anywhere.

“They can do so from their own home, or from work, or wherever else they may be. That saves them time and money.”

3. Good for GP morale

Thakar stresses how tough being a doctor can be, and says: “GPs are not superhuman, and if they end up sleeping at the office after a 16-hour shift, they’re less able to help others.

“Digital appointments give clinicians the flexibility they need to achieve a better work-life balance, helping to maintain their passion for clinical excellence and patient care.”

4. May help ease pressure on the health services

Thakar believes digital consultations can help ease pressures on NHS practices too, as they reduce the workload of NHS GPs.

However, Stokes-Lampard says: “Digital consultations do not necessarily reduce workload for GPs — a 10-minute consultation via an app, for example, is equal to the 10 minutes a GP might spend in a face-to-face consultation. And if as a result of the digital consultation, a further face-to-face appointment is required, then this can add to the workload for GPs, as well as being inconvenient for the patient.”

5. Gives a second opinion and can direct to appropriate care

Thakar says digital GPs can help direct patients to emergency care if they present with more serious problems or health issues that can’t be dealt with digitally.

“Sometimes people just want the peace of mind they can get from a second opinion, so they can use our service alongside in-person appointments at the local clinic if they want to,” he adds.

Stokes-Lampard agrees that digital services can include “useful triage systems that direct patients to the most appropriate care”.

The cons

1. Not suitable for all patients

Stokes-Lampard points out that digital consultations aren’t right for everyone, particularly the growing number of patients living with complex health needs, as well as patients who might not be tech-savvy and could prefer to access their GP surgery in person or by phone.

“It’s essential that as new technologies become more widespread, patients without smartphones and who prefer accessing their GP via more traditional means are not left behind,” she says.

Thakar agrees digital consultations aren’t for everyone, and says: “An elderly person with early-stage Alzheimer’s disease who’s hard of hearing, for instance, might have more trouble with an online appointment than a 40-something who’s generally healthy but needs a new prescription.

“But at the same time, if a patient has mobility issues, being able to speak to someone from their home could really help.”

2. Not suitable for all complaints

Thakar estimates digital care can deal with around three-quarters of the health problems typically presented at GP clinics — but he stresses they shouldn’t be used for emergency health problems, or those which require close physical examination that can’t be achieved digitally.

“We certainly can’t manage all health problems, and nor should we pretend we can,” he says.

“As a general rule, if you have difficulty breathing, severe chest pains, suspected strokes or seizures, or severe mental health concerns like suicidal thoughts, you shouldn’t be turning to digital appointments.”

3. Cost

While most patients in Ireland have to pay for a GP appointment, there is also a fee attached to digital GP appointments, which vary widely in price in the UK. Babylon Health, for example, charges £9.99 (€11.20) a month for unlimited appointments if you subscribe, or £49 (€56) for a first one-off appointment, while Doctor Care Anywhere wants £12 (€13.50) a month for unlimited appointments for subscribers, or £60 (€67.50) for one pay-as-you-go appointment.

4. You may be asked to de-register from previous GP

Some, but not all, online GP operations in the UK don’t allow new patients to register without them de-registering from their usual NHS GP.

It tends to be more tech-savvy, younger and therefore healthier patients who leave NHS practices, taking their per-capita funding with them, and critics say this means traditional bricks-and-mortar GP clinics are left with less funding to cope with older patients who are more likely to have complex health needs.

5. No human touch

Doctors don’t just provide healthcare, they play an important social role too.

“It’s not one we should be trying to replace with tech,” Thakar admits. “If you’ve just had a very bleak prognosis, or if you’re a carer — or for all sorts of reasons — sometimes you really do need someone in the room with you when you face up to life’s harsher side.

“Digital appointments needn’t be impersonal — plenty of warmth and sensitivity is possible by video chat. But part of the point of digital appointments is that they free-up time for those who need that in-person face time.”

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