First featured in The Times, Dr Murray Ellender, London GP and co-founder of eConsult, explains why online consultations are critical to the future of general.
Few now question that harnessing technology and digital innovation is critical to the future of the NHS. The model of booking a face-to-face appointment with your GP has barely changed since 1948 but the pressure on patients and doctors has changed beyond recognition. The growing proliferation of private and hybrid consulting models may have caused professional outcry and protest, but disruption at this level has kick-started a much needed debate as to what healthcare in the future will look like.
All NHS patients in England are expected to have digital access to their GP by the end of this year, and it is entirely possible that as many as nine in ten GP consultations will start in a digital space in the future. But that doesn’t mean we should stop paying attention to the basics. Digital has been slow to disrupt the health sector for good reasons, mainly ones of patient safety and clinical efficacy.
Modern digital triage tools that allow patients to seek advice from their GP online are exhaustively tried and tested, becoming more sophisticated and safer by the day. Patients can be reassured that potentially sinister conditions will raise a red flag immediately, while more routine concerns can be dealt with remotely, saving both patient and GP precious time.
But if we use social media as a benchmark, digital consulting is still at the Friends Reunited or MySpace stage. Today’s digitally native medical students are likely not only to embrace these technologies, but to see them as barely in the foothills. And yet a significant cohort of frontline GPs remain hostile to change, which makes us appear obstructive and unreasonable.
They will cite evidence, such as it is, that online access doesn’t save time or money and has limited impact on quality of care. But just as our systems are imperfect, so too are studies of their effectiveness. Academic studies tend, by their very nature, to be outdated by the time they are published, and this is especially true in a fast-paced technology environment.
So, what will the future look like? Will GPs no longer be seeing their patients in person? No. Our face-to-face consultations are critical, as are phone consultations. But we are well past the point of debating whether digital has a place in general practice. Without it, primary care may no longer be sustainable. As GPs, we should be embracing the technologies that make access easier for our patients and also reduce the pressures on our working lives.