Letter of the week #3: Let heartland doctors teleconsult with patients

To obtain a teleconsultation, a patient downloads a telemedicine app, creates an account and, after answering a few questions, will be connected to a doctor via video link on his device.
To obtain a teleconsultation, a patient downloads a telemedicine app, creates an account and, after answering a few questions, will be connected to a doctor via video link on his device.ST PHOTO: DESMOND FOO

Patients may now use their mobile phones to teleconsult a doctor for relatively minor illnesses (Telemedicine: Putting the 'app' in appointment, Sept 8).

It makes perfect medical sense in some common situations: When the diagnosis is beyond doubt to the patient (for example, fever and runny nose caught from a family member, or a recurrent migraine), when time is limited (a gout attack just before closing time on a public holiday), when leaving home would make him feel worse (the dizziness of recurrent vertigo) or when he would pose an unnecessary risk of infection to others in the clinic's waiting area (uncontrolled vomiting from gastroenteritis).

As a heartland family doctor, I urge the Ministry of Health (MOH) to allow all neighbourhood clinics to teleconsult with their patients.

These doctors already know the patient (including his or her other medical conditions and medication history), and so should be in a better position to offer sound advice than a doctor seeing the patient over a mobile phone link for the first time.

After all, an ill patient may not want to talk very much on the phone, or be able to fully recall his medical history.

For recurrent illnesses, such as migraine or menstrual cramps, the family doctor would know what medicine and its dosage had worked well for the patient in the past, and with minimal side effects.

This way, a patient will not need to download a dedicated app when ill, or even need to own a smartphone.

He can simply phone in, verify his particulars against the clinic records, discuss his problem, and request that the doctor issue medicine and his medical certificate (MC) to a family member who is able to collect them on the patient's behalf.

If the patient does not recover as expected, the doctor will already have on record both symptoms and medicine, and can thus review his illness more confidently.

I urge MOH to allow family doctors to remotely consult with their existing patients without needing to further register as a telemedicine provider.

We only ask to be formally allowed to diagnose, prescribe and issue an MC without physical examination of the patient for appropriate cases of minor illnesses, no different from telemedicine licence holders.

We can start making patients' lives easier in this way as soon as permitted.

Lee Pheng Soon (Dr)