Online Medical Advice
Online medical advice was set up in 1987 with 3615 Ecran santé, founded by Dr. Loïc Etienne. In 2010, the decrees implementing the HPST law on telemedicine were passed.
Online medical advice is a medical practice that engages the physician who performs it. Although not an integral part of telemedicine, it is a similar exercise since it is exercised from a distance.
The public, whether patient or not, has many questions about health. These questions carry different needs: reassurance, expression of suffering, need for understanding, need for advice, advice, etc. Faced with this, the doctor who answers online cannot shy away from the often embarrassing questions asked of him. He must be very vigilant because the answers he gives in a context of a singular conference can find it on social networks or in forums where the advice it has given to a person can be generalized and extrapolated excessively. So there are risks. We, therefore, need ethical rules and support tools.
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The Questions Asked
The presence that our team of doctors has been able to ensure since 1987 behind the Minitel,then the Internet, and by telephone, has enabled us to identify a set of typical questions. Here is the list is taken from a study of 2000 messages that I carried out in 1995 and published in La Mort du Sorcier (Ed Albin Michel).
- What to do? (19%): attitude to adopt when faced with a given symptom or situation, urgently or not.
- Is that bad? (13%): Severity of a condition or illness?
- Is this normal? (12%): most often compared to analysis results
- What’s your opinion? (12%): compared to diagnosis or treatment established by a colleague.
- Where to go, who to see? (11%): search for the best specialist or only a doctor who can solve the problem
- What is your diagnosis? (10%): an explicit request based on a statement of symptoms and also analysis results
- What do you advise? (10%): request for practical advice whatever the field
- Why? (8%): I need to understand a mechanism or a disorder.
- What is the risk of…? (4%): most often faced with medication or invasive explorations
- What’s this? (1%): request for information on an illness.
All of these questions are requests that can be grouped into a request for information (13%), a request for an opinion (37%), a request for advice (50%). Intelligence is simple information that does not require being a doctor but requires a reliable knowledge base. A doctor can only give the opinion; it commits him but does not lead to a recommendation. The advice saves even more because it results in a request and must be carried out by a doctor.
The 6 Stages Of Health Information
The search for information responds to needs which are very diverse but which can be grouped into different requests for help:
- to the understanding of these complex worlds of medicine and health
- to the decision
- at evaluation
- to the observance and also
- to self-medication
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