Patients want to use tech to avoid seeing a doctor for repeat prescriptions
Babalwa Mazwi has been on chronic medication to treat her hypertension for the past 18 months.
She considers herself lucky as her medical condition stabilised early on after she started treatment.
She says there is one downside to being on chronic treatment though. She has to see her doctor every six months for a check-up and to get a new script.
“I don’t mind the check-up part as I think it’s for my own good to know the status of my health, but at times I feel like I only consult with my doctor for the sake of getting a script, especially after the blood pressure stabilised.
"Not only is doing this expensive as I have to pay a consultation fee of R450 to get the script, but it’s a bit of an inconvenience as I’m working full-time and it can be challenging to manage doctor appointments and work demands,” she said.
Mazwi says she is keen on using new technology that can give her the convenience of getting a script without necessarily visiting a doctor.
But this Cape Town mother and many others who want to use technology feel stuck at the moment, as telemedicine that doesn’t allow face-to-face contact between a doctor and patient is forbidden by the Health Professions Council of SA, which regulates doctors in South Africa.
A law expert from the University of Pretoria, Avi Barit, has warned that while technology has advanced in the past few years and saw the emergence of electronic wearable devices which could help doctors obtain important medical information on patients remotely through built-in sensors, HPCSA’s “outdated” guidelines unfortunately prevented this.
He said by insisting on “face-to-face” consultation, the council effectively banned any consultation where a doctor is at a distance from a patient and is linked via technology.
The council states that treatment, including the issuing of a prescription based solely on a questionnaire, is not deemed an acceptable standard of care. The guidelines also state that a medical examination must be done, and a relevant medical history must be taken before treatment or a prescription is provided.
Writing in SA Medical Journal, Barit who is a PhD candidate at that university’s Faculty of Law, said while some high income countries such as the US seem to have moved with the times and regulators such as the US Food and Drug Administration were investigating how telemedicine technology could add convenience to patients and allow them to obtain prescriptions online after completing questionnaires via an app, but SA has remained behind.
But the HPCSA defended its stance, arguing that its mandate to regulate healthcare provisions need to ensure that services are provided by qualified and skilled healthcare practitioners.
Spokeswoman Fezile Sifunda said: “This regulatory mandate applies to healthcare practitioners in both state and privately-owned healthcare institutions. The HPCSA is not against technology but in order to protect the patient it believes telemedicine services should involve a healthcare provider where there is an actual face-to-face consultation and physical examination of the patient.”
Barit said the case of the “Hello Doctor” telemedicine concept for instance – which was later offered a “phone-a-doctor-service”, “shows that the (current) guidelines can’t be ignored”.
The service discontinued in 2011 after it came under fire from HPCSA. The council labelled organisations which offer a consultation with a doctor over the telephone as unethical, arguing that these breached the practitioner-patient relationship, patient confidentiality and the principle of informed consent.