Patients taking online docs to AHPRA

AHPRA has received 550 notifications about telehealth platforms over four years.

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The Medical Board has warned doctors prescribing without real-time consultations to prepare to explain any misalignment with the code of conduct and the board’s telehealth guidelines to avoid regulatory action.

Telehealth, and its potential misuse – particularly by single-indication marketing platforms (SIMPs) offering one-stop shops for the likes of vapes, weight loss drugs and cannabis – has been fueling growing tensions among regulators and doctors alike. 

According to AHPRA, as revealed by Guardian Australia, the nation’s regulator of health practitioner has received 550 notifications regarding telehealth consults or prescribing to date since 1 July 2020.

Around 30% of the concerns raised related to a practitioner “not adequately assessing a patient”.

“Interaction between a doctor and their patient is an important element in all consultations, including telehealth consultations,” a spokesperson from the Medical Board of Australian told The Medical Republic.

“AHPRA investigations have found some online models of patient care do not provide the same standards of care as we would expect in traditional face-to-face consultations.”

The notifications included references to the lack of an interaction with a prescriber, no request for medical history and no consideration for contraindications, prior to prescribing.

The Medical Boards has warned that doctors prescribing asynchronously – “without a real-time consultation” – should be prepared to explain any misalignment with the code of conduct and telehealth guidelines.

“[Health practitioners] would have to satisfy the board that their prescribing and patient management was appropriate and necessary in the circumstances,” said a spokesperson for the board.

“The board would address any gaps between the doctor’s conduct and good medical practice with proportionate regulatory action.”

Notifications were also raised with AHPRA regarding “prescribing processes that feel like they are managed by an algorithm, or AI process, as opposed to being undertaken by a prescriber only after carefully considering the clinical need for a medication”, said the board’s spokesperson.

Chair of the Medical Board of Australia Dr Anne Tonkin told TMR, “the Medical Board of Australia has made it very clear that algorithms are no substitute for consultations in good medical practice”.

AHPRA, when contacted by TMR, did not expand on the nature of algorithmic prescribing and other processes that were the subject of notifications.

Of the 454 telehealth-related notifications that were completed, 10% prompted regulatory action from the regulator.

“Where we have identified that this is the result of poor practice by a registered health practitioner, such as cases where a medical practitioner has prescribed to a patient who has not been adequately assessed, we have acted,” said the Medical Board’s spokesperson.

“In some cases, this has led to restrictions preventing practitioners from prescribing or conducting appointments via telehealth.”