Medical Misinformation

Social media isn’t the only source of bad medical advice these days. There’s a new source of problems, one that the health insurance industry is pushing on consumers — telehealth.

There are two problems with relying on telehealth, both of which you can find with urgent care facilities and even some emergency rooms:

1. The medical professional doesn’t have a comprehensive view of your health situation or clear knowledge of changes in your health over time. At least not at the level that a primary care physician should have.
2. You don’t know going in how well trained and knowledgeable that medical professional will be.

Of course, if you’re talking to your PCP over the phone, these concerns don’t apply. Healthlines take you to someone you have never seen before.

This concern was illustrated in a current Medscape column on the drug, Paxlovid. What you need to know about this drug is

1. It’s the first line of defense at present for people at high risk of a Covid infection becoming a serious or even fatal medical event. High risk is defined as anyone over age 65 and those with illnesses depressing the immune system.
2. For Paxlovid to be effective, it has to be started within 5 days of the onset of Covid symptoms and before a serious complication has had time to develop.

Unfortunately, that’s not necessarily what patients are being told.

“Every day, I hear from people who are misinformed by their physicians or call-in nurse lines. Generally, they’re being told you can’t get Paxlovid until you’re seriously ill — which is just the opposite of what’s recommended. Why are we not doing more to educate the medical community?”

Dr. Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota(1)

In the case of Paxlovid, there’s a drug interaction with blood thinners typically used to treat cardiovascular disease. In the experience of the author, a telehealth doctor or nurse will use this interaction to deny the use of Paxlovid. However, the PCP, knowing the patient’s situation better, may (and did) reverse that recommendation, ordering the patient to suspend the use of the blood thinner in order to take Paxlovid. It really a question of considering which issue poses the greater immediate threat to the patient. Simply going by the book may not be the right answer.

That raises the annoying question: what else are telehealth advisors getting wrong? Who’s auditing the quality of the advice being given to consumers. In fact, healthcare in the US functions largely without oversight. There can be loss of license or criminal prosecution, but usually only when extreme errors or abuses occur. Doctors lack quality ratings, except for the often unreliable ratings that show up on social media.

We simply don’t have something comparable to a Good Housekeeping or Better Business Bureau rating or seal of approval for medical professionals. With a PCP, the patient builds trust over time, and if confidence fails, changes PCPs. With a nurseline or telehealth doctor, someone you have never spoken with and may never talk to again, what’s the basis for trust?

Sources:

1. https://www.medscape.com/viewarticle/987197?src=WNL_trdalrt_pos1_230121&uac=446438BR&impID=5104457#vp_2

Source: Found online

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