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Friday, 10 December, 1999, 09:45 GMT
Would you trust an online doctor?
For many, the idea of a doctor at their beck and call 24 hours a day over the internet sounds fantastic, especially for those who find it difficult to get to their surgery.
But could such a service ever really compete with a face-to-face appointment with your GP? Would you worry about accuracy? Send us your views on an online health service.
Several states already have computer booths where you can swipe your credit card and an automated program complete with video images of real lawyers, will take you through various steps and give you an instant and legally binding divorce in less than 20 minutes. Why shouldn't the same apply for medicine?
If sensitive, personal information about your health is sent over the internet, companies are going to compile data and people will be discriminated against on the basis of their health (or merely the appearance of ill-health). Just look at what has happened to financial information kept on computers by credit rating agencies. Employers will be able to check your GP consultation notes to determine whether to hire you or not. The fact that you went for an HIV test as a purely routine part of a college medical examination could be used to discriminate you from being hired.
I think that people are going to be diagnosing themselves to death, to be blunt. We all tend to have a higher view on how ill we really are. So helping people by telling them that it could be something, is only fuelling their own idea that there could be something wrong.
I think on-line doctoring is part of an increasing tendency of not communicating with the patient. Doctors should be taught how to communicate one to one basis with the patients because diagnosis depends on this. However, many doctors in modern times like to play the God - hardly opening their mouths or refusing to listen properly. Are they now trying to compensate this by not meeting the patient at all? The tests here in Germany shows that most on-line advice are way off the mark. Seems to be a very comfortable means for playing the god
Any method which is comfortable for the patient and reduces anxiety by increasing knowledge quickly is great.
With science and technology advancing as quickly as they are, I can foresee a time when your home computer could diagnose most ailments. With the use of assorted sensors and monitors attached to various parts of the body, and a CDROM full of medical information, you could be your own doctor!
Right now I'm working on a do-it-yourself dentistry kit. ;-)
Interesting ... perhaps if one's medical records can be maintained on the web, and universally accessible (subject to security protocols, obviously), then we'd be on to something. As it is, obtaining advice based solely on patients' observations might be somewhat dangerous. Still, we've got to start somewhere, so I don't object to it in principal.
Mark M. Newdick, USA/UK
As much as I would like to think that the idea has huge potential, it seems to me just another very thinly veiled attempt to reduce queues and waiting lists for treatment under the NHS.
It depends where you live - if your doctors are not accessible or not specialists then you'll probably get better and more information from your online doctor. Where I know I can visit the relevant specialist, I would much rather do so than consult the online doctor. It also depends on the quality of information provided. If all the online service does is tell your basic common sense information then it will only be of limited service.
I have just been to try out this service and it was dreadful I have suffered skin problems for many years but when I went to the 'skin' section it said 'no conditions are listed for this body part' . I don't understand this at all. Is the site unfinished or something? Looks like it is going to be as much use ad my own doctor - i.e. not a lot!
I'm truly surprised by the amount of negative criticism this initiative has received, I think the government should in fact be commended for starting such a worthy on-line medical support scheme. It could provide a vital second opinion for people reluctant to seek advice from another doctor. My only concern would be for data integrity, any on-line inaccuracies could have serious consequences.
Stewart Cromar, UK
The site is not a replacement for the GP but a compliment.
It may produce a particularly interesting result for so called 'embarrassing' problems.
There is already evidence that people are more likely to tell the truth when not face-to-face, such as over the telephone, than in person.
If the on-line service encourages people to check out symptoms they find too embarrassing to face a person with initially then we might make better progress on some serious conditions such as bowel and testicular cancer, some STDs and teenage pregnancy.
Some times a computers anonymity can be helpful compared to having to sit with your neighbours in a queue to see your family's GP!
An online consult is a great idea, but it has to be restricted to ailments which require minimal doctor-patient interaction. This method of consulting should be well monitored and be specific to those conditions that potentially can be analysed using a WebCam or by answering questions online.
Online Dr.'s could be a first step or for emergencies, but I don't think they should replace one to one contact. Online Dr.'s can give first aid and emergency information but I think that they should always direct the patient to see a real Dr.
I think that this is a great option for those of us that have difficulty getting to a GP (for whatever reasons). I just think users should be aware that if there is something seriously wrong or they feel that there is something wrong then they should have a 1 to 1 and not an online chat. Also a lot of regular prescriptions still need check-ups, for example blood pressure. Would this be skipped so that business ran quicker and more people are seen?
I welcome any initiative to help avoid the tedious trip to an over-crowded, under-resourced GP clinic. However the web site needs to be far more comprehensive to be of any real use. I looked up my two current ailments yesterday but did not learn anything new.
Graham Woodier, England
I have been sitting, trying to get onto the NHS direct website all morning, and its all making my chest pain worse. My left arm is now hurting so much that I cannot even use the mouse. I wonder if you could ask Mr Milburn whether I should persist.
I think this should be seen as a positive step and in some cases it will hopefully negate people getting unnecessarily worried about their symptoms and put their mind at rest. I just hope nobody tells Victor Meldrew about it though...
I welcome the moves of the NHS to provide an online consulting service. The sooner we can begin collecting information, the quicker the process can evolve and improve. Perhaps the fears over hackers and inaccessibility of patients notes could be solved by a cookie held on the patients computer in much the same way as localised tv guides and weather forecasts work. These problems will only be solved as the technology matures.
I might as well be talking to a faceless, expressionless computer screen when I visit my doctor so going online or telephoning for medical advice would be an improvement for me, it certainly could not be any worse.
Chris W, UK
NHS Direct costs more, results in
more referrals to a Dr, and takes longer.
The Govt now wants to do this on the net,
withdrawing resources from the existing GP's.
This is just part of a campaign to undermine the NHS
Who knows if the doctor is experimenting? I do not want to be part of his or her learning curve.
Yes, but only because it takes so long to get an appointment to see my GP. When I phone up I am given a date a week in advance.
Anything that spares one the ordeal of sitting in a crowded waiting room, full to overflowing with the dregs of society with their screaming brats, coughing and spluttering incessantly, must be welcome.
There is a serious question of computer security, in that a computer hacker could infiltrate the system, and give misleading advice to someone logging on. As the system develops with on-line doctors, a hacker could even pretend to be a doctor. The implications of this are sinister and much easier to achieve in a cyber space.
Would you trust anything that this government does?
I think it is a good idea and I know it will take some time to populate a database with enough information, but hopefully this will happen.
It is cheap to do, but this is a pathetic gesture. The internet can never be as interactive as the presence of a real person, and diagnosis over the internet is no greater a development than treat yourself books. Worse actually as the hardware costs at least £500. What I want to know is why is the government spending NHS funds on a service that can be used by anyone in the world. I don't mind tourists being treated for emergencies in the UK, but this is free advice for people who are not contributing to National Insurance.
I fully support the freedom to enable people to obtain a diagnosis on the net. Obviously this system will not be sufficient to diagnose complicated complaints, but in most cases it will promote peace of mind. I run a complementary health mail order co with a web presence, and believe in empowering people to make decisions about their own health.
Sarah Cole-Clough, UK
The answer to the question depends on who is on the other side. Video-conferencing would certainly be better. May be this will happen in the days or years to come. Online medical consultation also depends strongly on what site the doctors are hosted, whether the content included in the site is peer reviewed and follows the guidelines based on evidence.
The main purpose for an online doctor is to make money. He is never going to have that personal touch, which is very vital for a patient's well being. Also there are some symptoms visible, only to a naked eye of a doctor. So it's never going to work.
Last week I was suffering from tonsillitis and I visited my local GP only to be prescribed painkillers, I could have saved myself time if I had visited the site I thought to myself, so I did a quick search on 'tonsillitis' and it produced absolutely nothing, looks like I will be continuing to visit my GP.
I do not think that electronic access to medical advice would be a bad thing.
It might encourage, or force, better self-evaluation and communication from the patient.
As a former emergency room nurse and counsellor, I found that a good and accurate diagnosis is only as good as the information given by the patient/client. Otherwise you are fishing in the dark!
Personally, I think its a wonderful idea - anyone with anything they think is serious will go and see and doctor but there are a lot of non serious symptoms which many people just need reassurance on - describing ones aches and pains to a machine and having an answer back is fantastic.
There can be no harm as long as users view this service as complementary to the existing service, and not instead of. Too much information is rarely a bad thing. There are too many medical websites offering inaccurate information and advice. It is useful to have a reputable site that I can endorse for a change.
I feel that having a "physician" on the net is a great way to find out more detailed information about a current medical problem or the use of a prescription drug. Here in the USA we have several sites devoted to learning more about an illness or prescription medicine. A person could even check their own symptoms to see if they are ill.
I think a Dr who doesn't have all your notes is on dangerous ground making suggestions about your treatment. If this new scheme allows an authorised medical practitioner to instantly call up your notes then THAT and not the fact they are online will in fact have been the major NHS milestone.
If an online Dr prescribes the wrong thing because they fail to spot a visual symptom that would have been obvious face to face, who will be blamed?
There can never be a replacement for a visit to your GP. A health site could be useful, but in the end it is far more reassuring to talk to a doctor in person, and always will be.
Given that part of the skill of being a Doctor, Nurse or parent even is diagnostic gifting, as any consultant physician, will tell you this is the silliest idea Blair and his mates have come up with.
Indeed next to missionary hospitals in mud huts it looks positively primitive
But then Blair specialises in men with spurious qualifications. An education Minister who cannot see what is going on, a Press Secretary who wrote iffy books, and someone to talk up teachers who left school at 16 and produced two films - so who needs an education? And if anyone has any sense and opposes him he sacks them. As he thinks he knows all the answers. Hey ho one more rock and roll round the Christmas tree.
I don't disagree with the opinion that a doctor should see a patient face to face, but, it should be clear to all the sceptics out there, that this will at least help what a appears to be an over stressed and under funded health system.
There is a huge amount of health related information on the Internet. The NHS Direct site offers a very useful guide to quality approved content which is available. I would certainly use this site for the information provided and look forward to further additions and enhancements that I am sure will follow.
A doctor needs to see the patient for himself to make sure that he can prescribe the correct medicine for the patient. When the patient sees a doctor, he would feel more assured about what type of sickness he's having. I think a doctor on the net would prove to be useful only when they could "heal" certain sickness which have obvious symptoms.
Online doctors should complement, not compete with face-to-face contact. It's very similar to when you phone up the doctor, especially the out of hours on-call GP, and he has to do a diagnosis over the phone to decide whether you need to be seen in person. I'm reluctant to call a doctor out-of-hours except for something really serious, but often all you need is someone to tell you not to worry - the Internet service should provide this.
I would value being able to discuss my symptoms and ascertain whether a visit for examination was necessary. It would seem to me to be an improved service rather than a replacement for the traditional visit to the surgery.
Jackie Cross, England
What's so great about a face-to-face doctor? I've been to doctors who hardly look up from their prescription pads, and try as quickly as possible to get you out of their surgery as you're the second appointment of the day and they're already running half an hour behind schedule. That's the cost-effective 90s. An on-line doctor is a concept many will struggle to come to terms with, but surely it's the same as talking over the telephone, and how many of us would phone our doctor for advice if we were able to get through? I for one certainly would.
I strongly disagree, because there could be a human error when it comes to data input. I like to meet my doctor one on one.
Ferdinand Adu-Darko, Canada
Confidence in the medical profession is at the moment running at an all time low, thanks largely to the recent revelations of Doctors allowing the aged to "starve to death" and the wide spread practice of removing the organs from infants who have died, without permission - which is virtually vivisection on children!!
I would certainly be willing to gain as much information as I could over the net. Then I would consult my own GP and seek his or her opinion. If I wasn't then happy with their advice, I would seek alternatives. It is just another source of information.
In effect it should make no difference, as long as you have the opportunity to ask the doctor as many questions as is necessary. I have found recently that GPs seem much less inclined to examine the patient, but are more happy to talk at length about the problem and diagnose it that way. Obviously there are some circumstances when a physical examination is necessary, but this could keep the number of visits to GPs down and perhaps eliminate many of the hypochondriacs who waste GPs time.
But think about it, no more screaming children in the waiting room, no more catching germs from people who think they are dying of the common cold, no more 2 hour waits while your doctor persuades the previous patient that an in-growing toenail is not a terminal condition...
A doctor or paramedic needs to assess a patient face to face. Description of symptoms is only one phase on the road to accurate diagnosis. I think this scheme can only work in a 'first aid' kind of way, e.g. symptoms of flu - go to bed, fluids, paracetamol. Severe pains in chest? Dial 999.
And so on.
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