by Kevin B. O’Reilly/amednews

Chicago – A severe earache awakened Ron Clearfield, MD, at 2 a.m. one night last spring. In search of a quick solution to the pain, the Bonita Springs, Fla., radiologist queried the Internet and found a service that offers a physician’s diagnosis after users type in their symptoms.

Dr. Clearfield gave up on the idea of online medical help only when he was asked to enter his credit card information and told he would be billed $39.95 for the service. It turned out that Dr. Clearfield, who later went to see a physician in person, had a blockage of the eustachian tube in his right ear. After his first dose of cortisone, the earache disappeared.

He could have been misdiagnosed with an infection, Dr. Clearfield told delegates gathered at the Council on Ethical and Judicial Affairs open forum at the AMA Annual Meeting. “The Internet doctor may well have prescribed me an antibiotic.”

The lack of an in-person exam is not the only ethical concern posed by the remote practice of medicine sometimes known as telehealth, said Dr. Clearfield, a member of CEJA.

Patients are eager to use technology, says Monique Spillman, MD. [Photo by Peter Barreras / AP Images for American Medical News]

“Patients may overuse or abuse the system by scouting for physicians who will more readily issue prescriptions, especially for controlled substances,” he said. “There is a potential conflict between the ethical and legal practice of medicine on the Internet. Although doctors may be legally permitted to engage in online consultation, it doesn’t mean that they ethically should do so.”

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