20 December 2012

RACGP wary of rise in virtual consultations between a doctor and unknown patients

The RACGP has raised concerns for patient safety upon learning of planned video consultations set to take place between doctors and patients unknown to them.

The new online service known as ‘GP2U’ has been described as a “virtual clinic” allowing patients to register with the site and book an online appointment with a participating GP in Australia. The consultation takes place over Skype.

Dr Liz Marles, RACGP President said, “whilst the College is largely supportive of telehealth initiatives to improve access to health services, the GP2U service delivery model puts doctors in the difficult position of making diagnoses without a proper understanding of the patient’s medical history and social context, in addition to removing the opportunity to conduct a physical examination.”

“Video consultations can be of enormous benefit to those patients who have established professional relationships with their doctor. The doctor is able to professionally assess whether the patient’s medical needs can be safely met via online follow-up appointments,” Dr Marles said.

Another cause for serious concern with the proposed model is the risk of fragmenting patient care. The RACGP has long supported the medical home concept, whereby patients receive the benefits of continued, comprehensive and coordinated care currently found when visiting a regular GP or practice team.

“Arranging a one-off online appointment with an unknown GP is not in the best interests of the patient’s long-term health and wellbeing. We know that patients who maintain strong relationships with a regular GP or practice team, experience better health outcomes,” Dr Marles said.

It is unclear whether clinical notes taken during GP2U video consultations are shared with the patient’s regular GP or other relevant practitioners, as recommended in the Medical Board of Australia's Guidelines on Technology-Based patient consultations.

The proposed model of care also raises the question of whether more medical tests and investigations will be ordered in the absence of being able to physically conduct a physical examination on the patient. 

“Patients interested in finding out more about telehealth options available to them, are encouraged to have a conversation with their regular GP to see whether video consultation options are available to them and appropriate to meet their medical needs,” Dr Marles said.

GPs seeking further information on how their practice can implement video consultations can visit the telehealth resources available on the College website at www.racgp.org.au/telehealth.

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John Ronan

Senior Media Advisor