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The prudence requirements for in-person appointments also apply to video appointments
The Norwegian Directorate of Health and the Directorate of eHealth write in their joint report that the prudence requirement is the same for video appointments as it is for in-person appointments. The requirements are stated in the Health Personnel Act, the Health and Care Services Act, and the GP and Emergency Medicine Regulations.
Has sufficient information been provided during the appointment?
In the case of video appointments, the physicians themselves must assess whether the information presented by the patient is sufficient enough to be able to provide sound health care. The directorates emphasize that such considerations are not very different from those made in a regular clinical practice.
If the doctor thinks that the information from the patient is not sufficient, the doctor must obtain more information or ask the patient to come in to the office for an appointment. The need for an adequate amount of information can also contribute to the consensus among may GPs that video appointments work much better with patients they know already and to whose health records they have access, than with patients they’ve never met in person.
Weighing all considerations
The directorates point out that what can be considered prudent in a given situation is often contingent on a patient's current state of health and which treatment options are available. Physicians are required to find the best possible treatment, but also consider that providing help quickly may be more or less important as being as thorough as possible in a given situation, as the alternative may be that the patient would not receive treatment at all.
The directorates also emphasize that the existing knowledge base does not indicate that medical assessments are weakened by the fact that the appointment with the patient is done over video rather than in person.
Do video appointments promote overuse of health services, or can it counteract underuse?
The option to schedule an appointment with one’s doctor over video can lower a patient’s threshold for contacting their GP. This raises the fear that such an option might encourage the overuse of health services by some patients. Concerned new parents of infants and people who have googled their symptoms to the point of creating unnecessary medical concerns are often pointed out as examples for those with potential to overuse.
On the other hand, there are some patient groups who tend toward underuse and who seek out health services too late. As Holly Ankjell from the Norwegian Cancer Society points out in the video below, men are on average less likely than women to make a doctor’s appointment when a concern arises. They have found that this often leads to late cancer diagnoses. People experiencing early symptoms of mental illness face a similar problem. For these patient groups, it will be a great advantage both for patients, their relatives, and the community if the threshold for contacting one’s GP is lowered.
It is difficult to quantify what will be the correct number of appointments to balance these considerations. When the patient contacts their GP rather than a private video doctor, it will nevertheless contribute to the continuity of their relationship, which in itself is a good thing for any later health issues.