Four in five doctors fear increased remote consultations impact on vulnerable, survey finds

Four out of five doctors fear vulnerable patients could be left behind if remote consultations remain widely used following the COVID-19 pandemic, a Medical Protection Society (MPS) poll shows.

Remote consultation (Photo: simpson33/Getty Images)
Remote consultation (Photo: simpson33/Getty Images)

The survey of 1,250 doctors found 83% were concerned about patients whose access to remote services may be impacted by factors such as digital literacy, disability, language, location or internet connection.

Although 70% of respondents agreed that the benefits of telemedicine were ‘unquestionable’ during the pandemic, 80% feared that the doctor-patient relationship could ‘break down’ or that exlclusion from telemedicine could deny some people treatment.

The findings come after a GPonline poll last month found more than two fifths of GPs felt their relationship with patients had worsened because of the shift to remote consultations during the pandemic.

Remote consultations

Close to three quarters of those responding to the MPS survey, conducted between September and October, admitted that they were ‘generally more worried’ about missing something in a remote consultation, with 60% saying they were concerned about a claim or investigation.

Over two thirds of participants said medico-legal risks associated with telemedicine were greater than with face-to-face consultations. Despite this, 61% of doctors said the profession had to stop thinking of telemedicine as a different kind of medicine and view it as medicine delivered in a different way.

Risk prevention lead at the MPS Dr Pallavi Bradshaw admitted the pandemic had fast-tracked the large-scale adoption of telemedicine, but argued that the burden should not be on doctors to address the digital inequalities across society.

She said: ‘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. Access to remote services could be impacted by factors such as digital literacy, disability, language, location or internet connection.

Excluded patients

‘As doctors have highlighted in our survey, if patients feel excluded from telemedicine, this could lead to a breakdown in the doctor-patient relationship or conditions going untreated. A significant number of doctors are concerned about the potential for medico-legal disputes and investigations to arise from this and other limitations of telemedicine.

Dr Bradshaw argued that the government should take a long-term strategic approach when considering the role of virtual care beyond the pandemic, based on the experiences of patients and concerns raised by doctors. ‘Doctors must feel supported by the government and should not be left to deal with any unintended repercussions from an increased use of telemedicine,’ she added.

Meanwhile, a poll by the Medical Defence Union (MDU) found that three quarters of GPs plan to continue to use remote working frequently after the pandemic. However, 73% cited concerns over a loss of contact with lonely or isolated patients as a potential disadvantage of more remote working.

The MDU survey found that 63% of GPs were concerned about facing a complaint or claim related to the pandemic, although two thirds of respondents had not yet noticed a rise in such cases.

Research published in the Journal of the Royal Society of Medicine recently found that black, Asian and minority ethnic (BAME) doctors face a 'double hit' from COVID-19 because they are likely to be disproportionately affected by rising complaints and health risks during the pandemic.

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