IN MY VIEW ... YOU GET SECOND-CLASS CARE ONLINE

BY THE start of this year, there were at least 34 online GP service providers registered in Britain.

Yet the inspector established to ensure that these ‘virtual doctors’ provide effective medical care has found 43 per cent of them do not meet patient safety criteria.

The concerns included inappropriate prescribing of antibiotics and failure to collect patient information from their GPs.

But, for me, the real issue with this kind of online doctoring is the potential for misdiagnosis. In my practice, we ensured there were doctors available on the phone for those unable to visit the surgery. Our patients were also able to email us.

Although this was all popular with the patients, we found that it mostly resulted in us asking them to attend for a physical examination, in order to make a diagnosis correctly. As doctors, we felt the information given over the phone just wasn’t enough.

To make a correct diagnosis requires taking a careful history and a physical examination, often supplemented by some tests.

These new online doctors abandon the idea of any physical contact with the patient.

The consultation is typically by telephone, video or email — but seeing a small picture of a person talking at the top of your mobile phone is no substitute for a face-to-face discussion and a physical examination.

What if the patient has earache? How can an online or telephone consultation distinguish between otitis media (a middle ear infection) and otitis externa (infection of the lining of the ear canal)?

And what about a patient phoning the doctor for help with a severe sore throat? How can a doctor tell if the patient has acute tonsillitis or glandular fever?

And how can a decision be made whether antibiotics are necessary?

The list of possible pitfalls is endless and there is the constant hazard of missing more sinister and worrying disorders.

I have strong reservations and believe that we are being led by commercial interests into second-class care. Only time will tell, but I hope the inspectors will continue to keep a close eye on such online services.