Online doctors cannot be allowed to ‘tick and flick’ their patients
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The Medical Board of Australia’s impending decision to ban online doctors from prescribing drugs to patients they have never spoken to, let alone properly consulted, is a welcome and necessary response to the more troubling elements of the telehealth boom.
As The Age revealed this month, online start-up companies have exploited lax regulations to allow patients they have never seen to obtain medicine with the click of a button, simply by filling out a questionnaire.
Struggles in the primary healthcare system continue to burden a public hospital system in crisis.Credit: iStock
No real-time assessment of the patient is required, there is often no verification of patient claims about their condition or, often, their identity, and there are no face-to-face reviews for patients prescribed medication such as pain relief for extended periods.
The chair of the Medical Board of Australia, Dr Anne Tonkin, has warned that it is only a matter of time before these “tick and flick” prescribing practices lead to a patient dying or suffering serious harm. The Australian Health Practitioner Regulation Agency is meanwhile investigating telehealth companies for their failure to address potential adverse reactions to the drugs they prescribe.
These are serious developments. They demonstrate that, once again, authorities responsible for protecting the public have been caught flat-footed by the turbocharging potential of the digital realm and the need for its impacts to be tightly monitored.
The popularity of telehealth exploded during the COVID-19 pandemic and its inherent convenience has ensured that it will continue to be a prominent part of the healthcare sector. But healthcare is not just about convenience.
There are expected to be 600 fewer GPs in Australia than needed this year, according to Deloitte Access Economics, and the shortfall will be closer to 11,000 within a decade. Telehealth can certainly play a role in easing the strain on a primary healthcare system whose struggles continue to burden a public hospital system in crisis.
The telehealth start-ups that have emerged in this at-times dysfunctional environment say they are reducing the “friction” of getting a prescription, and there is no question that customer access to medication needed to be smoother. The federal government acknowledged as much earlier this month when it doubled the amount of medicine a person can collect with each script from one month to two months’ supply for more than 320 listed products.
That decision drew expected outrage from pharmacists, who, along with GPs, have long resisted disruption to their preferred practices. There will be costs, but this realignment of the playing field is sensible and needed.
The disruption wrought by some bold new players in the telehealth space is more problematic. A new frontier can quickly become the wild west when there’s gold – or in this case Ozempic – in the hills.
An Australian population in which three in four people are overweight or obese is being wooed by saturation advertising for a product that dovetails with the body-image expectations driven by celebrities and online influencers.
It is such an intoxicating cocktail that telehealth websites promoting Ozempic and precursor drugs such as Saxenda are attracting the backing of companies such as Woolworths and health insurer NIB. The telehealth companies say they are helping to fight obesity that costs the economy billions.
NIB chief executive Mark Fitzgibbon acknowledged the new “virtual setting” for healthcare brought “new risks which we need to manage and identify”.
Indeed it does because while telehealth companies claim to operate to high standards, and note that it is illegal to lie to a doctor to obtain prescription medication, an investigation by The Age found that the new weight-loss medications were easily bought through several telehealth sites by providing false details on questionnaires that were not queried.
Health experts point to the obvious dangers of these medications being misused. The Medical Board of Australia has some ground to recover, and quickly, if patients are to be properly protected from those risks as well as reap benefits from telehealth.
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