Commercial telehealth doctors may be placing profit over patients: regulator

The nation’s health regulator has warned some doctors working for commercial telehealth clinics may be putting profit ahead of patient welfare, sidestepping obligations to provide safe care.

The Australian Health Practitioner Regulation Agency will set up a dedicated unit to monitor ­single-disorder online clinics that often dispense as well as prescribe drugs. Picture: Joel Saget/AFP

The nation’s health regulator says some doctors working for commercial telehealth clinics may be putting profit ahead of patient welfare and sidestepping obligations to provide safe and appropriate ­patient care.

The Australian Health Practitioner Regulation Agency will set up a dedicated unit to monitor ­single-disorder online clinics that often dispense as well as prescribe drugs. It is concerned that clinicians working for these telehealth start-ups are capitalising on huge consumer demand in particular for weight-loss drugs and medicinal cannabis, and simply providing patients with access to predetermined medicines after superficial consultations, in the process compromising clinical care.

Doctors and industry insiders exposed the dangers of the often private equity-backed business models of some telehealth start-ups in The Australian in May, criticising their business model based on e-commerce that aimed to get as many people as possible on to a subscription-based drug prescription. The profit-driven model was described as “the antithesis of good clinical practice”.

In an update on AHPRA’s website designed to place doctors on notice, agency chief Martin Fletcher said some emerging telehealth practices were “dangerous­ly disrupting the traditional therapeutic relationship between a patient and their practitioner”.

“Good prescribing must balance safety and access,” he said.

“While the delivery of telehealth services is supported by AHPRA and the national boards, we do not support practitioners or health services taking advantage of patients or ignoring their obligations to provide appropriate care and follow-up when needed.

“We remind practitioners of their duty of care when providing prescriptions of any kind, whether it be in-person or via telehealth.

“We also encourage consumers to be aware of questionable practice models prioritising money-making over your health.”

The comments follow a crackdown on telehealth companies providing patients with compounded salt semaglutide, which is a replica made in a special pharmacy lab of the wildly popular drug Ozempic. The nation’s drug regulator was alarmed that some 20,000 patients were being supplied the copycat drug, which had not been through the rigorous ordinary approvals process and was not subject to any post-market surveillance.

Federal Health Minister Mark Butler. Picture: NCA NewsWire/Martin Ollman

Federal Health Minister Mark Butler has ordered a legislation change to carve out semaglutide from drugs allowed to be supplied via compounding pharmacies to consumers. The change will take effect from October.

Reforms to enable widespread Medicare funding of telehealth consultations were pushed through during the Covid-19 pandemic out of necessity and online and phone consultations with GPs are now a standard, popular way of delivering healthcare.

Normalisation of telehealth, coupled with high gap fees to see local GPs and difficulty obtaining appointments, at the same time ushered in a wholly commercial online and app-based healthcare industry.

The Medical, Nursing and Midwifery and Pharmacy Boards of Australia, together with AHPRA, are all now alarmed that some elements of that industry are “cashing in on rising demand for the prescription and use of med­icinal cannabis, bulk-produced compounded medicines, or soon to be banned compounded semaglutide and related products”.

The health regulator and the boards said they were “aware of reports of potentially vulnerable practitioners, particularly inexperienced or early career practitioners, who are being misled that their practice is acceptable when it is not”.

“AHPRA and the national boards are all seeing evidence that some health services have been set up specifically to cater for patients who contact them seeking to obtain access to a single pre-determined medication,” the news update said.

“AHRPA and the boards are reminding practitioners of their long-established responsibilities when prescribing and dispensing medicines, and how they continue to apply in the context of evolving business models.”