Online consultations, despite the reservations and concerns many GPs may have about them, are now an established inevitability of modern digital life and healthcare provision. There are many examples of where online consultations are becoming an established part of the patient-health service interface. The NHS in the UK has engaged in a large-scale contract with an online consultation provider (www.gpathand.nhs.uk/). The Union of Students in Ireland (USI), now contracts an online provider for student health (usi.ie/freegp/). Online consultations are offered by many private companies, including health insurers.

Research has shown outcomes from online consultations versus face-to-face consultation to be satisfactory in many settings, and indeed trials of online consultations in management of chronic conditions have found superior outcomes for online versus fact-to-face consultations during long-term follow-up.¹ However, online consultations and telemedicine do not appear as yet to be a routine part of undergraduate or postgraduate training. 

In October 2018, the UEMO (European Union of General Practitioners) debated the problem of the gap that exists between technologists and regulators in the discipline of e-health, and the providers or healthcare personnel.² The UEMO has argued that e-health should support and strengthen the relationship between healthcare professionals and patients. As e-health services and technologies advance, increasing availability of online medicine should free up time for office-based GPs to have more meaningful, longer and more resourceful consultations with other patients who can benefit from having more time with their physician; e-health, in other words, should be making our lives easier. If used correctly and responsibly, it should be seen as a complementary resource and not as a threat.

While some doctors have expressed dismay over their patients sometimes choosing to have e-consultations with remote services rather than presenting in the surgery, other doctors have also acknowledged that e-health can play a role in many of the small, rather burdensome portions of general practice outside of our working hours. However, as with any system that requires statutory regulation, commercial e-health and cyber consultations need to consistently show outcomes that guarantee quality for patients, increase job satisfaction for doctors, and enhance optimal doctor-patient communication in general.

Whether we like it or not, e-health, cyber-consultations and telemedicine are here to stay. It is inevitable that many GPs currently graduating will choose to work as e-health providers in the future, as this style of practice may offer many benefits in job satisfaction and work-life balance. This means that training in the provision of e-consultations needs to be fully integrated into both undergraduate and postgraduate curricula in general practice.  

References

1. Greenhalgh T, Vijayaraghavan S, Wherton J, et al. Virtual online consultations: advantages and limitations (VOCAL) study. BMJ Open 2016;6:e009388. doi: 10.1136/bmjopen-2015-009388
2. UEMO 2018. UEMO discussed e-Health in Brussels: How to bridge the gap between IT implementation and healthcare professionals? www.uemo.eueueu/2018/10/16/uemo-discussed-e-health-in-brussels-how-to-bridge-the-gap-between-it-implementation-and-healthcare-professionals/