As technology advances, so too does healthcare. Think about changes in just the last few years. No one in the 1990s had access to their test results on their Smartphone just hours after a blood test! We have had a lot of new gadgets that have seamlessly integrated into the healthcare industry. They’re needed and wanted, and in a lot of ways, make life easier.
Beyond file-sharing and information access, the medical world has also benefited from advances in screening technologies, “smarter” medical devices, and the development of new techniques. Just think, prior to 1971, we didn’t have computed tomography (CT) scans, and by 2012, we had the ability to “3-D print” artificial limbs.
It seems technology and healthcare go hand-in-hand. Tech has made it easier for us to reach our doctors and for our doctors to test, diagnose and prescribe to us. But not every change is for the better. Just because we CAN do something, doesn’t mean we HAVE to. Perhaps you’ve read my thoughts on the use of Artificial Intelligence (AI) in the field? The more AI we rely on, the more disconnect we have from the human touch.
But, today, my concerns are based in the still “young” tech of Telehealth, and the risks it can pose for all. Much like AI, the removal of so much human touch in the process may lead to greater risks than rewards.
Browse This Article
Tech Comes to the Aid When Needed Most
Technology stepped in during the pandemic. While the entire globe was shuttered indoors, wearing masks when they ventured out, and avoiding any human contact, telehealth really took shape.
Not only were there times when we truly could not head out into public comfortably, but the thought of sitting in a doctor’s waiting room amongst other sick patients was terrifying. People were dying, suffering life-long effects, and in no uncertain terms afraid of an illness we knew so little about overall.
Telehealth to the rescue! No longer would you need to bundle yourself up, mask up, Purell-up, and venture out into the scary, germ-filled world when the slightest cough caused you and everyone around you worry. Instead, you’d call your doctor’s office, get a timed appointment, and hop on a conference call.
What could go wrong? This communication method, developed through decades of tech advancements, allowed patients and healthcare workers to stay safely isolated, but still connect. It was perfect. Or was it?
Benefits of Healthcare on Your Phone
As COVID slowed from a global pandemic to treatable, though still potentially deadly, the world has calmed. Vaccines became more effective. Treatments and prevention methods began to work, and fewer people were hospitalized or dying from the disease. Careful patients continued to wear masks. “Social distancing” became the norm. And, we all learned to wash our hands more and touch our faces less. The methods were working.
Still, it seemed telehealth was here to stay. Due to its convenience, added safety, and ease-of-use, many patients continued to request, and doctors continued to accept, appointments by telehealth. We became used to working from home, ordering food (and nearly anything else we’d ever need) from a phone, and staying in more often than going out. Now into 2024, we still feel the economic impacts of this contagious pandemic, and it isn’t the only thing seemingly forever changed.
A Safer Option
Telehealth, like anything else, isn’t all bad. The spread of illness is reduced, as patients with communicable disease, such as colds, flus, and other easily-spread germs remain home and get care from the comfort of their own beds.
Easy Access
Accessibility certainly increased. Not only could infirmed or disabled folks who typically might have relied on a series of bus routes, public transport services, or friends and family to gain access to doctor’s appointments, now “travel” with ease, so health care deserts that lack quality care could virtually be eliminated.
Living in a rural community that feels every bit of its remoteness when it comes to healthcare, I understand first-hand how telehealth could help such areas access quality healthcare professionals. I have, myself, visited the emergency room on a Friday evening (the only one in the entire county) to find there is only ONE physician’s assistant (PA) available to offer care. We waited over 13 hours to find out a urine test showed a urinary tract infection. Being able to speak to a professional via a Smartphone could have saved us plenty of time, effort, and exhaustion.
Additionally, in rural spaces we lack access to specialist care. Beyond your basic emergency needs, you are typically sent to the nearest large city (two, two-and-a-half, or three hours away, mind you) for more specialized care. My son jokes that our local healthcare is the approximate equivalent to a school nurse. They can offer you a Band-Aid, a cough drop, or a Tylenol, and then recommend you see someone more capable to care for you.
Financial and Better Health Outcomes
Some studies have shown that telehealth may offer cost savings for the industry (for patients, doctors, and healthcare), not to mention better health outcomes.
It was difficult to find information on what I’d imagine to be the largest benefits, those that seem to come in remote areas, like mine, that otherwise would lack access to such care. My fear, however, is this tool created for the good of man, may become quite the opposite. Trends are showing I have reason to be wary.
An ‘Abuse’ of Telehealth: Online Drug Dispensing
Where there is good, so too will you find evil. And in some cases, this negative aspect of telehealth is its use in, what I certainly hope, were unintended ways. Today, access to medications is becoming a bit TOO easy, which is scary, especially to someone like me. Why me? I am an employee of and dedicated believer of MedShadow Foundation. Our mission is to notify all about the potential risks and benefits of medication. We educate you on ways to consider improving your life, symptoms, or conditions through wellness, diet, and lifestyle changes that allow you to avoid the side effects and harms of medication.
Yes, of course, medications can heal and help! Some are completely necessary to sustain life, not to mention vastly improve the quality of life. However, there are times when medication is the “easy out.” It is the quick fix far too many of us seek for our troubles, but that might cause new problems down the line.
It is difficult, myself included, to do things the “hard way.” Why work to lose weight, go to the gym and sweat every day, pay more for healthier food choices, and feel hungry so much of the time, when a constant stream of weight loss drugs are bombarding us daily? I know firsthand. Diet and exercise are hard. Jumping on a telehealth call would be easy. If it weren’t for my fear of unknown and untested side effects, I may be more tempted. Let’s explore some of today’s top dispensers that offer online access to medication.
Noom Med
As a person who has struggled with her weight all of her adult life, I know a thing or two about weight loss programs. Friends of mine have tried “Noom,” a program that approaches weight loss with a psychological perspective. They attempt to teach you why you overeat, not just how to eat better. I think that’s a great starting point and that the psychological approach has merit. Afterall, we all probably have reasons for our actions, whether we are conscious of them or not.
However, in its latest attempt to stay relevant in the industry, Noom has launched “Noom Med,” a prescription-writing arm of the program, which allows patients to visit with a telehealth prescriber, and thereby access psychiatric and weight loss drugs, ranging from Zepbound, Saxenda, Wegovy, Mounjaro, Contrave, Metformin, Bupropion/Naltrexone and Topiramate, drugs to help you lose weight, slow a resistance to insulin, or help mood, anxiety, or depression
On the surface, that sounds great, right? More access to help. But, my personal concern would be the lack of follow-up and aftercare. Are these patients closely monitored? Many aforementioned medications listed come with very serious side effects, such as suicidal ideations. These are not meds that should be handed out without a careful or watchful eye.
LillyDirect™
In what is, in my opinion, the absolutely grossest of uses, pharmaceutical giant Eli Lilly has launched its own online direct pharmacy. With a quick telehealth appointment, this drug maker can connect you with a prescriber, and easily disperse its – and at times, its competitors’ – medications directly to you. How wonderful, right?
Wrong. This is wrong for oh so many reasons. Firstly, do you think that a doctor offered through a pharmaceutical company directly is likely to recommend lifestyle changes or diet or exercise to cure all that ails you? If so, it seems likely that the doctor will not receive any future referrals from Lily. The doctor you speak to through that program is making money from referrals from Lily.
Even if the doctor attempts to stay independent from pharmaceutical influence, studies show that doctors who accept gifts from pharmaceutical companies are much more likely to recommend drugs from that company. There is no reason to expect a different outcome when the offering isn’t a dinner but a stream of patients.
In a technical sense, the doctor would be able to prescribe any medication and should act in the best interest of his or her patient, whether a drug is made by Eli Lilly or not. But, it is hard to imagine they won’t be swayed to stick with those that sign their paycheck.
Secondly, there is not one shred of evidence you can offer to me to prove Eli Lilly have patients’ best interests in mind. The company had an annual revenue of $28.54 billion in 2022. By nature, it is beholden to shareholders first and patients second. Pharmaceutical companies do not make money unless you are taking their drugs. The longer you use them, the more money they make.
hers, his, Nurx and More
These telehealth operators are not alone. Today’s market is flooded with options just like these two: “hers” offers women access to healthcare professionals who can write prescriptions for everything from PMS to shinier hair. “hims,” which offers men erectile dysfunction drugs with the simple filing of a healthcare questionnaire.
Nurx, which began offering birth control to those who lacked access, now offers prescription medication for your skincare needs, too. Talkiatry offers psychiatrists that can prescribe drugs for stress-reduction and anxiety, to depression treatments and even antipsychotics.These are serious drugs that come with significant side effects. They should not be a “first line” option. These tough decisions should, instead, be discussed with a knowledgeable healthcare professional, preferably who has a patient’s full medical history.
Yes, these websites promise a “licensed healthcare professional” will review your case and prescribe if that seems the best solution for you, though I am personally skeptical if they truly ever focus on lifestyle or diet changes, instead of offering a medication prescription, especially knowing that if a medication is what you had in mind, you could switch to a new telehealth platform in minutes until you find someone willing to prescribe it to you.
Take this site, which offers to get you medications OVERNIGHT! Or perhaps review this site, which offers a compounded semaglutide that you put under your tongue. This method of delivery has not even been evaluated by the FDA yet!
In one example, a close family member of mine, we will call Sally, as she has asked that her name not be used, said it took her all of about 15 minutes to complete a verbal questionnaire, and be prescribed a compounded drug, which included semaglutide, for weight loss. At age 23, she was not offered a diet plan, discussion, or a review of potential lifestyle changes she could try. She reported to the online service she has tried dieting and been unsuccessful in the past. She was prescribed an injectable drug, she is now on the third month of, and has not had a single follow-up appointment. She was approved for a 90-day supply, which she’s pleased to report has helped her to lose 20 pounds. She has not been scheduled for any follow-up care.
Accessibility Does Not Equal Quality Care
You may be confused how someone who is very pro accessibility could be against programs geared toward just that. Afterall, what are these precedent-setting avenues if not easier access to medications?
Here’s the worry, and maybe it’s one I have only since I started working with MedShadow. I’ll be the first to admit, I didn’t know half of the things I’ve learned about medicines before I began my work with MedShadow. I’ve learned a lot, and it is high time all became educated!
The bottom line is that no weight loss program, quickie telehealth, and certainly not a pharma-run “doc” is going to be able to guarantee continual quality care. They are not designed as such, and could not, even if you requested it, offer your routine exams and medical care like a primary physician would. My personal fear is, in the convenience of telehealth and easily accessible medications with online consultations, routine primary care will diminish. I worry that quick calls for a hot new drug will replace quality medical care, which includes screenings, check-ups, communication about all medical histories and daily routines, and a frequent review of your medicines. Maybe my concerns are unfounded, and top quality docs will simply change WHERE they give care, and not how they give care. But, quick fixes often mean corners are cut, and I worry that, in the case of telehealth, it will mean less notification of side effects, less discussion of overall health, and even less discussion of lifestyle alternatives to prescription drugs.
The Choice Is Yours
Like all aspects of your body, healthcare is a choice. You choose your doctors. You choose the method in which you receive your care. Those are freedoms in our country that allow us to decide on the way we will manage our own bodies, our own health.
Telehealth itself clearly offers benefits. From remote, rural areas suffering from healthcare deserts, to those unable to get to their physicians due to transportation, cost, or physical barriers, access to such professionals can clearly be a plus.
Increasing the access to specialists, mental healthcare providers, and even basic primary care is always a good thing. Every person deserves access, no matter where they live, their income, or their background.
However, calling in for a quick erectile dysfunction medication, a skincare prescription, or a drug for your anxiety is not the best use of telehealth. These sites can only increase the risks of adverse effects as patients log-on to obtain the drug, and may never be seen nor heard from again.
Even those sites that MAY require a patient to return at some frequency for refills are, in my opinion, not ordering routine blood tests, monitoring weight loss, or tracking interactions of other medications or conditions. Instead, I fear they are writing scripts at a dangerous frequency, to patients they never see, and never follow-up with again afterward.
It is a scary precedent in my opinion, and one that makes me worry that this trouble with telehealth is just beginning.
