Doctors weigh in on consulting online

Sick, but too scared to go to the clinic for fear of Covid-19? You can consult a doctor online using your smartphone through local digital healthcare platforms.

Although not a new phenomenon, telemedicine has never really caught on in Malaysia.

Most people prefer in-person consultations with a doctor when necessary, and indeed, physical examination by the doctor is an essential component to diagnosing disease.

However, the Covid-19 pandemic has resulted in many people reluctant to visit the doctor, especially due to the fear of catching the coronavirus that causes the disease.

Local digital healthcare platforms have taken advantage of this to amp up their presence, offering free consultations with doctors via an online forum, or private consultations via messaging, phone call or video call for a fee.

Some also offer medicines for delivery through their online pharmacy.

Obstetrician and gynaecologist Dr Tan Cheng notes that convenience is the main point of telemedicine, especially as it is suitable for issues a patient may be too shy to approach a doctor in person to talk about.

“For example, emergency contraception or the morning after pill can be dealt with by telemedicine conferencing.

“Other frequently seen cases include continuation of medication for chronic cases such as patients with hypertension (high blood pressure) or diabetes.”

However, he adds: “Most new cases would require physical examination or further investigation.

“If such cases cannot be managed solely from history-taking, the patient is then advised to approach the nearest clinic for further physical examination or an investigation (like blood tests or imaging).”

Telemedicine has its role, but it will not replace actual physical consultation entirely, he says.

General practitioner Dr Elizabeth Kurien believes that telemedicine is evolving to become the new norm and has an important role to play in non-acute cases.

On a personal level, the virtual platform allows her flexible timing.

“I usually try to see patients online during my working hours at the clinic, in between my regular or walk-in patients,” she says.

However, she notes that one downside to telemedicine is that there is no continuity of care.

“As much as I would love to embrace telemedicine, patients are usually attended to by different healthcare providers at each consult, so doctors are not able to get to know the patient well and treat them as holistically.

“In addition, there is no personal touch as compared to treating a physically-present patient,” she says.

“But patients should not be worried about visiting hospitals or clinics,” she adds.

“I believe that most clinics will change their style of consultation, for example, by giving staggered appointments to patients so that the clinic is not flooded with patients at any one time.”

Flexibility is also a factor for general practitioner Dr Rashid Khan.

He says that the fact that telemedicine consultations can be done via a smartphone means that he can be anywhere and still see a patient at any time.

“I had a patient with diabetes who experienced a sudden onset of sweating and headache.

“He did a sugar (blood glucose) test and it was within normal range.

“He came onto the online platform to clear some doubts, and the first thing I told him was to go to the emergency department to rule out a heart attack,” he shares.

Dr Khan notes that he always proceeds with caution whenever he attends to patients online.

“It may look as simple as a viral fever, but it could be dengue.

“Just like in the current scenario, the patient might be having a simple fever, but it could be Covid-19.

“Even online, we take the extra effort to make sure that the patient is followed-up post-treatment to check on their well-being.

“I always advise them to go to the nearest clinic or hospital for further treatment if their symptoms do not improve or if they develop new symptoms,” he says.