Online medicine a legal nightmare?

The proliferation of patients seeking medical advice over the Internet and a number of after-hour call centres springing up in Australia calls into question a doctor's indemnity and may legally be putting the medical profession's neck in a noose, according to the Australian Medical Association.

"Doctors must be extremely wary of not taking [patient] problems lightly," Dr David Rivett, Chair of AMA Counsel of General Practice, told ZDNet. "The legal responsibility is huge if you get [diagnosis] wrong," Rivett added, doctors could literally be "putting their necks in a noose".

Adrian McCullagh of Gadens Lawyers agrees that this area is "fraught with a lot of danger".

"Medical indemnity insurance won't cover them," McCullagh said of doctors who advice without seeing a patient.

Furthermore, under the Pharmaceutical Benefits Act consultation fees are paid if a doctor sees a patient "but not otherwise," Rivett said.

The issue also calls into question how doctors, who can only give advice within the jurisdiction in which they're registered, verify that a patient is resident in that jurisdiction.

Then there's the aspect of patient authentication and correct identification of ailments.

Although the Internet can be a great source of information, it can't replace face-to-face consultation with the patient when a doctor can assess a patient's nuances and body language and freely ask questions, according to Rivett.

"Even the telephone is a poor second best," he added.

Whilst it might sound as if a patient is dying on the phone they might be in not too bad a nick, according to Rivett.

Several call centres are currently being trialed in Western Australia and the AMA WA has formed a joint committee with the federal branch of the AMA to discuss all such issues of concern.

The committee, set up about six weeks ago, is expected to finalise a report in February.

Our view [of medical call centres] is that if people have symptoms they should go and see a doctor," a AMA WA spokesperson said.

"We're living in a society that apportions blame," he said. "All doctors are more aware now of the potential of litigation."

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