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Shift to remote medicine may disempower vulnerable

Medics fear a shift to remote consultations may disempower vulnerable patients, according to a new Medical Protection Society (MPS) survey.

Four in five doctors surveyed in Ireland (79%) are worried about the effects of a post-COVID expectation for more appointments to be delivered remotely.

In the MPS survey of 361 doctors in Ireland, 64% agreed that the benefits of telemedicine have been unquestionable during Covid-19, and that it will remain a fundamental tool in practice.

Digital literacy

However, 79% raised concerns about patients whose access to remote services may be affected by factors such as digital literacy, disability, language, location or internet connection.

A full 80% of the doctors surveyed went on to say that they are concerned that, if some patients feel excluded from telemedicine, this may result in a breakdown in the doctor/patient relationship, or their conditions being left untreated. 

Legal liability issues

Legal liability issues also arise for 78%, who said they are generally more worried about missing something in a remote consultation.

And 64% say they are more worried about a claim or investigation arising from a remote consultation.

Last month, the Medical Council reported a five-fold increase in the use of telemedicine in Ireland since the start of the pandemic.

Regulatory challenges

The body is examining the regulatory challenges presented by the increase in remote medicine. 

MPS has links to 21,000 medics in Ireland and said the Government and healthcare system must take a long-term strategic approach when it comes to the role of virtual care beyond the pandemic. 

Doctors’ concerns, patient experiences, and research on digital inequality must all be taken into account, MPS says.

Dr Pallavi Bradshaw (medico-legal lead for risk prevention at MPS) said: “Telemedicine is not a new concept, and the use of technology in delivering medical services has been slowly evolving over the years. 

Fast-tracked adoption

“COVID-19 has, however, fast-tracked large-scale adoption, and while the benefits have been indisputable during the pandemic, there are naturally concerns around its limitations, the need for support and training due to the different skills required when consulting in this way, and the desired role of virtual care beyond the pandemic.

“A key concern for doctors is the potential for vulnerable patient groups to be left behind, and for health inequalities to grow, if there is desire for more patient consultations to be delivered online after COVID-19.”

Mitigating risks

He added that, given the stated fear of medico-legal disputes, MPS has been working with doctors to help them to adapt to the significant increase in telemedicine and to mitigate risks.

However, he said that the burden should not be on doctors to address the digital inequalities across society.

Dr Bradshaw added that any long-term strategic approach must address the concerns raised by doctors, who should feel supported by the Government, and not be left to deal with unintended repercussions from the increased use of telemedicine.