Over the weekend the American Osteopathic Association (AOA), which represents the country's more than 100,000 osteopathic physicians (D.O.) and medical students, passed a resolution at their annual meeting in Chicago instructing their physician members to "actively educate patients on the importance of seeing a physician when ill or injured and in need of a medical diagnosis, and that patients not allow recommendations from these medical websites or applications to be used as a basis for delaying, or as a substitute for, evaluation and treatment by a physician."
As part of the resolution, the AOA also encourages its physician members "to recommend the best evidence-based resources available to their patients so that they may continue to encourage patients to be actively engaged in their own health care."
The concern that online health tools might displace professional health providers is not a new one, but the AOA cites trending adoption of digital health tools as the basis for the resolution and the need to encourage these kinds of conversations now.
How might these tools cause users not to seek care?
The digital health tools listed in the AOA's resolution include WebMD and iTriage. These apps might encourage smarter utilization of emergency room and finding the proper treatment facility based on a set of symptoms, but they don't directly discourage users from seeking care altogether. Based on the information a user enters, a symptom navigation may steer them to a seemingly mild affliction as a likely diagnosis, which may cause them not to seek out a medical professional. They don't make that leap for them though. And a friend or spouse may offer advice that leads a person to similar inaction.
Unsurprisingly, disclaimers from both iTriage and WebMD emphasize that their apps are not replacements for medical care: This concern isn't news to them either.
The language in WebMD's iPhone app disclaimer closely mirrors the language the AOA used in their resolution: "WebMD does not provide medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on the WebMD mobile application."
Then again who reads disclaimers? Physicians should discuss proper use of these and all digital health tools with their patients.
At some point health tools will become sophisticated enough and personalized enough that they may put a patient's mind at ease and suggest they don't need to contact a medical professional for certain medical concerns. The AOA points out that today's tools don't know what medications a user is on or what's in their medical record. That's true, but tomorrow's digital health tools will.
It's not the only (or even necessarily the primary promise) of digital health, but one of its many promises is to help patients self-manage their own health conditions. These tools will help them become (even better) partners in their care, alongside their professional care team. These tools will help patients make (even better) informed decisions on their own. And sometimes those decisions might be not to call the doctor.
The road to that digital health-enabled future will almost certainly be paved with disclaimers, but above all else it will require many conversations between physicians and patients. Kudos to the AOA for encouraging more.