President of the RACGP Dr Bastian Seidel said patients should not be able to access prescriptions, referrals and/or medical certificates through online systems unless they are being provided by the patient's usual GP or a GP in the patient's usual general practice.
"The big risk with online services performed outside of the usual patient–doctor relationship is that they fragment care and do not provide continuous, comprehensive general practice care to patients," Dr Seidel said.
"They provide patients with prescriptions, referrals or medical certificates without sufficient understanding of their medical history and social context, which is a safety issue and may also affect quality of care."
Dr Seidel said continuity of care, communication and safety must always be supported in general practice, but online services for prescription, referral and medical certificate services performed by online doctors could erode continuity of care if not used appropriately.
"The Australian GP model of care has been very successful in keeping Australians well and out of hospital. General practice is characterised by personalised, longitudinal care," Dr Seidel said.
"Patients who maintain strong relationships with a usual GP or practice team experience better health outcomes.
"This continuity also increases the practitioner's knowledge of the patient, resulting in improved patient satisfaction and health outcomes.
"In circumstances where a patient's usual GP is unavailable, another GP or practice nurse at the patient's usual practice is best suited to provide care."
Dr Seidel said patient safety is compromised when a doctor prescribes medication for a patient about whom they have no prior knowledge.
"Completing requests via an online survey can easily result in misdiagnosis due to a range of factors," Dr Seidel said.
"Without access to the treating GP's notes, the doctor has no means of otherwise confirming the information provided.
"There is also no guarantee the patient's usual GP will be informed following a patient accessing an online service, which again leads to fragmentation of medical records."
Dr Seidel said that video consultations and telehealth services have a lot of potential; however, the RACGP supports general practices to provide online services to a patient only if they have an existing relationship with that patient.
"We need to look at new models of care, and innovation and convenience are understandably important factors here, but the RACGP does not support emerging business models that do not have an existing relationship with patients," Dr Seidel said.
For more information please read the RACGP's position statement on online prescription, referrals and medical certificate services.
