Virtual Doctor Appointments Might Miss Vital Diagnoses, Endangering Patient Lives: BMJ Study
A study was published in BMJ Quality and Safety that examined data on safety-related issues reported from virtual GP (general practitioner) appointments in the UK between 2020 and 2023. 95 incidents were filed, which included complaints received, claims and settled compensations, and so on.
According to the findings, doctors are not at fault. In their clinical evaluation of patients, they rarely make mistakes. However, the possibility of an underdiagnosis for a patient still exists.
According to the study, several of the mistakes were connected to serious illnesses, which would likely have been readily identified through a face-to-face assessment. The statement in the report indicated that clinicians had mistakenly considered a diagnosis delivered during an internet-based appointment as final, rather than provisional, during multiple safety events. Because once a diagnosis is missed in a remote appointment, subsequent schedules with the same case may be misleading and lead to an unfortunate event.
A telephone appointment resulted in a patient's death due to a receptionist's failure to attend to the patient's breathing trouble. Other incidents include the misdiagnosis of a pregnant woman with membrane rupture, a 16-year-old girl with sepsis, a child's congenital heart condition, and a new mother with pulmonary embolism. These incidents highlight the importance of proper communication and patient care.
The study found that the main issue with over-the-phone or virtual consultations was poor rapport building with patients, and the complete details and history may not be adequately gathered. Parents or caregivers may underemphasize symptoms, leading to misleading diagnoses. Anecdotal evidence from a GP revealed that, although a parent casually mentioned his son's presenting symptoms, a video call exposed the child's intercostal recession, necessitating immediate medical attention. Without the video call, the situation would have turned unfavorable.
The study found that young people, old people, or individuals with pre-existing conditions proved to be particularly challenging to assess via remote consultation. Treatment paths and patient education initiatives were intricate and multi-layered, necessitating the management of numerous clinical and non-clinical staff members. Doctors should ensure patients are informed about their care stages, while patients should express any worsening conditions.
According to Professor Greenhalgh of the University of Oxford, staff caution and attentiveness make the majority of distant clinical consultations in general practice safe and sound. However, inadequate communication and corporate pressure frequently lead to safety mishaps. Specific challenges had been uncovered by the research, along with steps to further mitigate them.
The Nuffield Trust's Dr. Rebecca Rosen stressed that doctors need to be alert to high-risk symptoms that call for in-person consultations, pay close attention to patients who request in-person appointments, and schedule in-person consultations if their condition has not improved following prior remote consultations.
(Input from various media sources)
(Rehash/Bharkhavy K V)
