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Should you consult an online doctor?

Digital GP and prescription services are on the rise - but what's the appeal and when are they suitable? Lisa Salmon looks at the pros and cons

Digital doctor: online GP appointments are becoming more popular
Digital doctor: online GP appointments are becoming more popular

With some patients having to wait weeks to see a GP, it's no surprise that consulting a 'digital doctor' has soared in popularity.

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

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, says Dr Bayju Thakar, Doctor Care Anywhere founder: "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 NHS

Thakar believes digital consultations could help ease pressures on NHS practices.

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."

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

Thakar says digital GPs can direct patients to emergency care if they present with more serious problems 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 "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 those with complex health needs, and patients who might not be tech-savvy.

"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: "An elderly person with early-stage Alzheimer's 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 physical examination.

"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 some patients may have to wait a while for an NHS GP appointment, they are at least free, unlike digital GP appointments, which vary widely in price.

Babylon Health, for example, charges £9.99 a month for unlimited appointments if you subscribe, or £49 for a first one-off appointment, while Doctor Care Anywhere asks £12 a month for unlimited appointments for subscribers, or £60 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 don't allow new patients to register without them de-registering from their usual NHS GP.

It tends to be 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 with complex health needs.

5. No human touch

"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," Thakar says.

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," he adds.

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