Caution urged over Skype consultations

DOCTORS considering consulting with patients via internet services such as Skype must be aware of potential pitfalls.

MDDUS is advising doctors to act with caution when communicating through internet video links.

Skype has been touted by some as a possible solution for the millions of pounds wasted from missed healthcare appointments and could provide an alternative to face-to-face consultations.

Online video links could benefit patients in rural areas or those with a disability who find it difficult to attend medical appointments. It could also be better than telephone calls, allowing easier communication and letting the doctor visually assess the patient.

But MDDUS medical adviser Dr Barry Parker has warned against an over-reliance on this method of consulting due to the limited scope for examination of patients.

He said: “Even with good picture quality, observation of skin conditions, for example, is likely in most cases to be much better at face-to-face than Skype consultations, and examination beyond superficial observation will be impossible.”

While the medico-legal issues of Skype are not yet fully apparent, it’s thought they would be similar to those in telephone consultations.

Dr Parker explained: “The key issue for doctors will be to recognise when this mode of consultation is not sufficient to properly assess the patient and address the problem, and to arrange a face-to-face consultation instead.”

Doctors must bear in mind the General Medical Council’s guidance which states: “good clinical care must include adequately assessing the patient’s conditions, taking account of the history (including the symptoms, and psychological and social factors), the patient’s views, and where necessary examining the patient.”

Confidentiality is another key issue in Skype consultations and Dr Parker urged doctors to seek expert IT advice when setting up such an internet service to ensure security is assured.

Doctors would have to provide patients with sufficient information about how Skype consultations would work, ideally through leaflets or posters.

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