In an editorial for The BMJ, Dr. Martin Roland, a primary care physician and professor emeritus of health services research at the University of Cambridge, explained how, despite their seeming benefits, these digital services actually exacerbate many of the issues plaguing healthcare.
Dr. Roland cited a recent independent evaluation of a U.K. service, GP at Hand, that requires all patients seeking primary care to start with a smartphone consultation; only if their ailment cannot be solved virtually are the patients asked to visit a clinic. According to the evaluation, almost 100 percent of GP at Hand users are aged 20 to 64, the majority live in affluent areas and only a fraction of a percent have chronic care issues.
Because of these factors, he wrote, already overworked physicians may therefore be left spending all their time on the most complex cases. This increased workload could then prevent healthier patients whose problems nevertheless persist after the virtual consultation from accessing their primary care physician, and also worsen the overall shortage of primary care providers.
Beyond these challenges, even those whose ailments can be addressed via smartphone have found these services to be less than comprehensive; per the evaluation, around 25 percent of new GP at Hand users end up switching back to the traditional care model, many of them within just two weeks.
Therefore, Dr. Roland concluded, if virtual care models become widespread without addressing the underlying issues of the healthcare system, they “would risk destabilizing care for patients with the greatest needs and those who need regular proactive care.”
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