Consulting a doctor over the Internet seems like a dream—you get a diagnosis and treatment without ever having to leave your own home, and the websites and apps that provide these services are generally affordable. It's no wonder, then, that direct-to-consumer telemedicine is rapidly expanding, attracting nearly 1.25 million patients in 2015.
Problem is, it may not be as effective or safe as seeing your doc face-to-face, new research suggests.
In the study published in JAMA Dermatology, researchers posed as six patients with skin issues, and submitted their cases to 16 of these sites and apps for diagnosis and advice. In all, 62 responses were included in the analysis.
Researchers found many of these sites provided inadequate care. Major diagnoses were repeatedly missed, including secondary syphilis and polycystic ovary syndrome. What's more, two-thirds of the sites neglected to collect medical history, and only 52% asked female patients about pregnancy or lactation. Clinicians in four cases provided diagnosis without even asking for photographs.
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Out of all the patients who were given a diagnosis, 65% were given a prescription, but were warned of the risks and side effects of the medicines only 32% of the time. Only six of the 62 responses offered to send a report to the patient’s primary care doctor.
In an interview with the New York Times, lead study author Jack S. Resneck Jr., MD, a professor of dermatology at the University of California, San Francisco, admitted that misdiagnoses can happen at in-person appointments, but argued that in face-to-face meetings patients and doctors have a better ability to engage in the "give and take" necessary to reach an accurate diagnosis.
“You could imagine a telemedicine conversation in which the patient discusses the diagnosis with the clinician,” he said, “but none of that was going on. There were no instances in which the clinician discussed the problem, asked about other symptoms and so on.”
Dr. Resneck told the Times that he hopes telemedicine succeeds. “We’re inclined to support this kind of innovation, but it needs to be done right. Our results were disappointing.”