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Wednesday, 26 July, 2000, 11:33 GMT 12:33 UK
Are web doctors dangerous?

If you had the choice would you rather have a consultation with your doctor face-to-face, or cut out the waiting room and talk to them on the internet?

A GP in the UK has decided to offer his medical services on the web - he can give both a diagnosis and prescriptions to patients without them having to enter his surgery.

However the British Medical Association warns that patients should not seek medical advice on the internet because there are no regulations to protect them against bogus doctors.

There are also concerns that the system could be open to abuse in prescribing drugs, or that mistakes could be made in diagnosis.

This debate is now closed. Read a selection of your comments below.


Your reaction

Wow this is stupid. There is a point to have a relationship with your GP. He or she will have some understanding of your medical history and can base a diagnosis on this. A doctor cannot properly work without this information. Crazy.
Mark, Denmark


The only way to tackle bogus and harmful medical services on the net is to set up better professional ones and teach citizens to use them

Jari Forsström, Specialist in Internal medicine, Finland
At Turku University in Finalnd, we have co-ordinated a European survey together with partners from UK as well where we wrote recommendations for the European Union on certification of web-based medical services, including telemedicine.

The feedback on the recommendations has been very good. In Finland the Ministry of Health has registered the first Virtual Hospital as an official health care service provider on the Internet. The service is supervised by the Ministry and the qualifications of all doctors are checked before they enter the service. Some sickness funds reimburse the service already.

For electronic prescriptions there are also new instruction published by Finnish Ministry of Health. Prescriptions can be written electronically to patients, if the need of treatment can be confirmed. In some cases it is not needed for the customer to visit physician. E.g. if one is travelling to Indonesia and needs vaccinations, the prescription for a vaccination can be written based on Internet consultation.

Also if there is an existing patient-physician relationship renewal of drugs is possible in many cases. The key issue here is that the physician and patient are identified. In addition, the pharmaceuticals have to be delivered through pharmacies to ensure that e.g. a grand child is not using grand mother usernames to order sleeping pills.

As a medical doctor myself, I feel that the Finnish open attitude to new developments is correct. In fact the only way to tackle bogus and harmful medical services on the net is to set up better professional ones and teach citizens to use them.
Jari Forsström, Specialist in Internal medicine, Finland


I believe that medical web consultations are the future, but with limitations

Peter Zettinig, Finland
I believe that medical web consultations are the future, but with limitations. I see that there have to be regulations to make sure that the patient meets a real physician and that this physician is handling my patient information confidentially. I believe also that for many cases a doctor I do not know will be able to give me good second opinions over the Internet. The perfect solution for me would be if my physician, my GP, would provide a service where he gives the possibility for me to consult him also over the internet and even prescribes me drugs, since he knows me. But I would also appreciate it if he could suggest to me good medical sites where I can find reliable information to research on my own. Besides that he should also tell me good on-line sources for web doctors for second opinions.
Peter Zettinig, Finland

Everyone seems convinced that minor problems can be sorted out over the Internet. But how can you decide which is a minor problem without a visit, since sometimes minor symptoms can hide a serious illness?
Ian Gianni, UK

This can't be much worse than sitting in front of an overworked, stressed GP who obviously has no time or sympathy left to give. Now what is unsafe?
Joanna Lawton, UK


No other country can claim to be so ridiculous that a nerd with a PC and a hacking manual can prescribe his own drugs

Steve, England
Are you serious? This cannot be legal. The majority of the population won't buy a pair of jeans on the internet because they worry whether the jeans will actually arrive, or their credit card details will become public knowledge; yet they can get a prescription!!
Superb. The UK has once again beaten the world in the medical arena. No other country can claim to be so ridiculous that a nerd with a PC and a hacking manual can prescribe his own drugs. Outstanding. Right up TB's street.
Steve, England

For most minor complaints this is great. No doubt the price will be less than a regular visit. After all what is the first thing a doctor asks? "What's wrong with you?"
The sooner the medical industry starts pricing its services based on the market instead of the golden goose called insurance the better for us all. People entering medical school would actually want to be doctors and not just looking for a way to make lots of money. Insurance, drug and hospital costs would plummet. I forgot this won't happen because the lawyers would have no-one worth suing!
Ant Brooks, USA


My brother died in March of this year following the use of prescription medicines obtained via the internet

Richard Long, UK
My brother died (aged 34) in March of this year following the use of prescription medicines obtained via the internet from international sites. I have raised this issue with the Government who are investigating. The use of prescription medicines is controlled because they need to be taken under medical supervision. Many are as dangerous as controlled drugs - especially if misused or used in combination with other medicines.
I am therefore alarmed that a UK based site is offering this prescription service - it is worrying enough to have international sites where at least there is a chance customs will intercept the packages. I am seeking to discover whether others share my concern and to establish an action group if there is sufficient interest.
Richard Long, UK

Having worked at a helpdesk I know from personal experience how difficult it is to form a mental picture of the situation on the other side of the line.
With web-based doctors the game of Q&A to form that picture is almost impossible other than using a form of "Chat". And if it's a chat you're after, pick up the phone and call your GP.
Ben, Netherlands


As a doctor, it would seem more logical and practical to me to offer a telephone service for such simple cases

Nick S, UK
As a doctor, it would seem more logical and practical to me to offer a telephone service for such simple cases. Indeed, GPs in most areas already offer this. The doctor gets more information by speaking directly to the patient than via email/ chat rooms. It is a more direct and human means of communication. One also cannot gauge accurately the level of anxiety or emotion via email necessary to give a professional opinion. If a prescription is needed it can be left at the GP surgery or chemist. Almost all people have a telephone, far fewer a PC. A computer in this instance is a hindrance, not a benefit. Let's not be fooled by this "web" of deceit and use our common sense.
Nick S, UK

For diagnosis of the unknown I would rather see and be seen. For reassurance and follow up, I cannot believe that a doctor separated by wires and modem is any less effective than one who knows me and sees me.
David Green, UK

Web medicine is a step in the right direction provided its limitations are realised. One can, at best, give an opinion but providing treatment may be a little dangerous. It can be argued that a large number of conditions are self-limiting and therefore require a little reassurance. The web can be an excellent support.
Vinod Dawda, UK

I think there is nothing wrong with a consultation over the net. If it is a serious problem, any responsible doctor will advise the patient to see a doctor in person. If is a minor illness, the doctor can advise the patient over the net, saving time for both doctor and patient.
Lisa Goveas, UAE

It will not be very a very accurate diagnosis. Face to face contact is healthy.
Helen, UK

The Net is a good source for research and ideas, but even as a knowledge base I am sceptical. Any moron can make claims and post it. This really is bad medicine.
Collin, Canada

I think it's possible for doctor to make diagnosis over the internet .The equipment for remote medical diagnosis are already exist such as video camera. The problem now is there is no regulation for such kind of action.
Kang Zhou, UK

It's not hard to imagine the near future - consultation by webcam, auscultation, vital signs, pulse oximetry can all be conveyed electronically. Sampling of body fluids is a bit of a hurdle but that too can be achieved. I think as in all new endeavours, consumers will need to be on guard and the profession must prepare for change.
Howard H. Haysom, MD, USA


Veterinarians are the best doctors since they cannot ask the patient what is wrong

Stephen B, US
Can a doctor diagnose anyone without a personal interview with the patient? It seems to be impossible. But I remember the words of our late leading philosopher and comedian, Will Rogers, who praised veterinarians as being the best doctors since they cannot ask the patient what is wrong. Perhaps vets can expand their practice by diagnosing humans using the same technique on the Net.
Stephen B, US

A patient's illness is cured 80% by the trust he/she has in the doctor. A net doctor may find it hard to get the trust but if he has it then he will be as good as any other doctor.
Ribu Jacob, Kuwait / India

If you have a minor trouble it might be possible to solve by telephone or net discussion. Any serious doctor cannot risk giving a diagnosis in any risky or suspicious case without seeing the patient. That I believe is self explanatory to all patients too.
Miklos Nomad, Hungary

Dangerous quackery. All good medical decisions are made by a patient and their doctor communicating and negotiating. Complete communication is more than verbal. Any good doctor is sensitive to their patients' voice and body language, and so is able to help when "things are not all they seem" - which is at least a third of a GP's consultations. Stripping all of this out in email will leave consultations very poor indeed.
Dr Robert Varnam, UK


Web consulting could save time, transport, and money in the search for an appropriate specialist consultant

P Morrison, USA/UK
Firstly, web doctoring can be a blessing to homebound/disabled or rural/people with no transport, no time. Web consulting could save time, transport, and money in the search for an appropriate specialist consultant. As a UK NHS patient with a special injury, I can't tell you how many inappropriate, unqualified consultants I travelled to, wasting my time and theirs, because they had insufficient advanced knowledge to address my medical/neuro condition.
P Morrison, USA/UK

I'm already appalled by the lack of attention I get when I visit my GP and he writes out a prescription for antibiotics after a 5 minute chat. This is just going to make things worse. I can have my suspicions about what's up with me, but I'm not qualified to say... What's going to happen when the first web doctor prescribes the wrong drugs just because the web patient didn't explain their symptoms correctly? And what about hypochondriacs and drug users? Is this going to be a free ride for them?
Christine, UK

It's difficult enough verifying the credentials of physicians and visiting, chatting or consulting with web doctors, I dare say, is impossible. How does one verify the "doctor's" credentials? How does one verify his or her medical track record? And, even more important, how does one ensure privacy on the Superhighway when talking to a complete stranger? Why would anyone put himself or herself in the position of allowing a stranger into your inner-most upfront and personal world? Only a fool would do so!!
Chinta Strausberg, USA

Most comments about the competency of alternative medical services delivery systems can be attributed more to the greed of the medical establishment than to any faux concern they may voice about public health.
Krow, USA


There is a danger that the person asking for drugs may need a one to one discussion, or that they could be used illegally

Rio, UK
In many circumstances discussing things with a GP and getting an internet prescription would be good but there is a danger that the person asking for drugs and saying he or she has something wrong would need a one to one discussion or there is a danger the drugs could be used illegally. Perhaps a unique password for each patient (allocated by the surgery following a visit by the patient) could be the easiest and safest way of preventing improper use of the drugs.
RIO, UK

I think that a database of medical conditions that people can consult would offload many trivial questions. Although, then again it may mask some of the more serious conditions that may need urgent medical attention. You're damned if you do and you're damned if you don't!!
Julia Smith, UK

Internet consulting is about providing information and opinion - not about prescribing drugs to unknown patients.
Dr Liz Miller, UK


the usefulness of doctors in inversely proportionate to their sense of social superiority

Roger Thomas, Wales
In my experience, the usefulness of doctors in inversely proportionate to their sense of social superiority. The relationship between doctor and patient over the web tends to be more 'Adult-Adult' rather than 'Parent-Child' or 'Patrician-Plebeian'. This makes for a better social and medical rapport.
Roger Thomas, Wales (Cymru)

It seems that many people complain about their doctors not taking interest in them when they do finally get an appointment, so a web doctor can hardly be less personal then that can they?
Tristan Abbott-Coates, UK/USA

It is an honour for a person to be a doctor. As a doctor I am dealing with human beings at stages of weakness in their lives. How on earth would a doctor practise good medicine electronically? He can follow up his patients electronically but certainly he cannot use the Internet in the initial evaluation.
Amr Gohar, Egypt

Web doctors are like any other doctors. All of them can be dangerous but most are satisfactory. People have elevated doctors entirely too much in their minds. They are nothing more than human beings who have to deal with personal problems and life like everyone else
Dave Adams, USA


If all I needed was something routine this is perfect as it saves me making a special trip by car

Willy Davidson, UK
If I had a life-threatening condition I would want to discuss it in person. However, if all I needed was something routine this is perfect as it saves me making a special trip by car. If the computer is wisely used it will also help spot the addict who fakes symptoms to try and get repeat prescriptions.
Willy Davidson, UK

I believe it depends on the doctor who sits to the other side of the net. He might be a conscientious one and tell you he can't provide a full diagnosis without seeing the body. But he may also deliver you some invaluable advice for you to decide what to do further. I welcome the progress in this case.
Lorenzo Medici, Croatia (from Italy)

If he is a recognised doctor what's the problem. It's no different to NHS direct and probably a lot more personal. Some patients also need anonymity.
John, UK

I would prefer to see a doctor face-to-face but, given the "government" has yet to pass laws snooping on doctors' surgeries the audit trail of an email is useful if there is any dispute over the suitability of the proposed treatment.
John B, UK


Last time I needed to see a doctor I was told it was two weeks before the first available appointment

J, UK
Last time I needed to see a doctor I was told it was two weeks before the first available appointment, despite the fact I was reporting stabbing chest pains. I saw a private doctor instead who diagnosed the problem as being muscular rather than cardiac. If only my doctor could have taken the time to tell me that - were I not in a well-paid job I would have had no option but to wait the two weeks and then lose pay since the surgery is only open during office hours anyway!
J, UK

There are pros and cons to this. As someone who lives in the country, I have to say that getting a suitable appointment is difficult and then managing to make your way to the surgery in the next town is a nightmare. Provided that concerns about abuse or misdiagnosis can be addressed I think this is a good idea.
Paul R, UK


It sounds easy for those people who have addictions to drugs to get hold of a fix

Paul Charters, England
Prescriptions over the internet are a very bad idea. It sounds easy for those people who have addictions to drugs to get hold of a fix. A library of information, such as on netdoctor, is invaluable. However, how a doctor thinks that he can tell what is wrong with a person's body without even seeing the body, symptoms or judging the mental state of the patient is beyond me.
Paul Charters, England

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