e-med (e-Med Private Medical Services) is an online medical site based in the UK, staffed and owned by doctors. [1] It is notable for being the first [2] web portal to offer consultation, diagnosis, referral and prescription services [3] to remote patients via email and Skype video conferencing, and for a controversial General Medical Council case. [4]
In the UK, e-med (e-med Private Medical Services Ltd) was the first [5] online health site to offer both diagnosis and prescriptions over the internet to patients without the time or proximity to visit a doctor. It was established in March 2000 [6] by Dr. Julian Eden, drawing on his remote medicine experience as a doctor serving the world traveller, [7] [8] SCUBA and dive population (between 2002 and 2004, he was The Guardian newspaper's "Flying Doctor"). [9]
At the time, e-med's instant popularity (with six hundred patients signed up in the first month) was criticised [10] by the medical establishment, including the BMA (British Medical Association). Dr Paul Cundy, a member of the BMA's IT committee, argued: "When it comes to online consultation or diagnosis, then I think the internet is simply not robust enough. There are no regulations to protect patients, and they are completely and utterly at the mercy of internet doctors." [11]
In 2011, e-med had logged over one million consultations and was serving 500,000 patients worldwide annually. [12] e-med was also the first medical practice to use Skype, [13] a videoconferencing service, to conduct "face-to-face" consultations between doctors and patients in different locations.
The model established by e-med and other UK online consulting sites [14] is not only being adopted in other European countries, but also by the UK's state medical service. Professor Sir Bruce Keogh, the medical director of the NHS (National Health Service), mandated the implementation of new plans that would introduce online consultations via Skype, noting that IT will "completely change the way [doctors] deliver medicine". [15]
The website publishes the open access case report journal Grand Rounds.
In 2007, complaints were registered with the General Medical Council (GMC), the body overseeing British doctors, alleging "misprescription of dangerous drugs" by Dr. Julian Eden. [16] Two of the complaints were made by national newspaper reporters listing false details with e-med [17] [18] [19] and another by Ian van Every, a company director of Dr. Thom.com, a medical website run by his brother, Thomas van Every. [20] As a result, Eden was removed from the medical register in 2009. [21] His case is currently under appeal.[ needs update ]
General practice is the name given in various nations, such as the United Kingdom, India, Australia, New Zealand and South Africa to the services provided by general practitioners. In some nations, such as the US, similar services may be described as family medicine or primary care. The term Primary Care in the UK may also include services provided by community pharmacy, optometrist, dental surgery and community hearing care providers. The balance of care between primary care and secondary care - which usually refers to hospital based services - varies from place to place, and with time. In many countries there are initiatives to move services out of hospitals into the community, in the expectation that this will save money and be more convenient.
In the United Kingdom, junior doctors are qualified medical practitioners working whilst engaged in postgraduate training. The period of being a junior doctor starts when they qualify as a medical practitioner following graduation with a Bachelor of Medicine, Bachelor of Surgery degree and start the UK Foundation Programme. It culminates in a post as a consultant, a general practitioner (GP), or some other non-training post, such as a specialty doctor or associate specialist post.
Professor Sir Bruce Edward Keogh, KBE, FMedSci, FRCS, FRCP is a Rhodesian-born British surgeon who specialises in cardiac surgery. He was medical director of the National Health Service in England from 2007 and national medical director of the NHS Commissioning Board from 2013 until his retirement early in 2018. He is chair of Birmingham Women's and Children's NHS Foundation Trust.
The General Medical Council (GMC) is a public body that maintains the official register of medical practitioners within the United Kingdom. Its chief responsibility is to "protect, promote and maintain the health and safety of the public" by controlling entry to the register, and suspending or removing members when necessary. It also sets the standards for medical schools in the UK. Membership of the register confers substantial privileges under Part VI of the Medical Act 1983. It is a criminal offence to make a false claim of membership. The GMC is supported by fees paid by its members, and it became a registered charity in 2001.
General medical services (GMS) is the range of healthcare that is provided by general practitioners as part of the National Health Service in the United Kingdom. The NHS specifies what GPs, as independent contractors, are expected to do and provides funding for this work through arrangements known as the General Medical Services Contract. Today, the GMS contract is a UK-wide arrangement with minor differences negotiated by each of the four UK health departments. In 2013 60% of practices had a GMS contract as their principal contract. The contract has sub-sections and not all are compulsory. The other forms of contract are the Personal Medical Services or Alternative Provider Medical Services contracts. They are designed to encourage practices to offer services over and above the standard contract. Alternative Provider Medical Services contracts, unlike the other contracts, can be awarded to anyone, not just GPs, don't specify standard essential services, and are time limited. A new contract is issued each year.
Health and Social Care (HSC) is the publicly funded healthcare system in Northern Ireland. Although having been created separately to the National Health Service (NHS), it is nonetheless considered a part of the overall national health service in the United Kingdom. The Northern Ireland Executive through its Department of Health is responsible for its funding, while the Public Health Agency is the executive agency responsible for the provision of public health and social care services across Northern Ireland. It is free of charge to all citizens of Northern Ireland and the rest of the United Kingdom.
The National Health Service (NHS) is the publicly funded healthcare system in England, and one of the four National Health Service systems in the United Kingdom. It is the second largest single-payer healthcare system in the world after the Brazilian Sistema Único de Saúde. Primarily funded by the government from general taxation, and overseen by the Department of Health and Social Care, the NHS provides healthcare to all legal English residents and residents from other regions of the UK, with most services free at the point of use for most people. The NHS also conducts research through the National Institute for Health and Care Research (NIHR).
Healthcare in England is mainly provided by the National Health Service (NHS), a public body that provides healthcare to all permanent residents in England, that is free at the point of use. The body is one of four forming the UK National Health Service as health is a devolved matter; there are differences with the provisions for healthcare elsewhere in the United Kingdom, and in England it is overseen by NHS England. Though the public system dominates healthcare provision in England, private health care and a wide variety of alternative and complementary treatments are available for those willing and able to pay.
The National Health Service (NHS) is the umbrella term for the publicly funded healthcare systems of the United Kingdom, comprising the National Health Service in England, NHS Scotland and NHS Wales. Health and Social Care in Northern Ireland was created separately and is often locally referred to as "the NHS". The original three systems were established in 1948 as part of major social reforms following the Second World War. The founding principles were that services should be comprehensive, universal and free at the point of delivery—a health service based on clinical need, not ability to pay. Each service provides a comprehensive range of health services, provided without charge for people ordinarily resident in the United Kingdom apart from dental treatment and optical care. In England, NHS patients have to pay prescription charges; some, such as those aged over 60, or those on certain state benefits, are exempt.
Julian (Jules) Christopher Paul Eden is an author, journalist, businessman and former doctor with specialisms in remote medicine and dive medicine. He was the founder of the UK's first online medical clinic, e-Med in 2000.
Online doctor is a term that emerged during the 2000s, used by both the media and academics, to describe a generation of physicians and health practitioners who deliver healthcare, including drug prescription, over the internet.
DrThom is a UK-based commercial online doctor service, also operating in Ireland and Australia. It is 100% owned by LloydsPharmacy, which is in turn owned by a leading international wholesale and retail company McKesson Europe.
Chaand Nagpaul is a British doctor who works as a general practitioner and was Chair of the Council of the British Medical Association 2017-2022. Nagpaul took over as chair from Mark Porter in June 2017.
Electronic consultation is an aspect of telemedicine which involves remote communication between patients and clinicians, or between clinicians and specialists.
Dr. Fox is an online clinic launched in January 2010 by Tony Steele and Dan Broughton. The service is owned by Index Medical Ltd and was the first UK online consultation service to allow patients to check their eligibility for treatment without first completing a registration process.
EMIS Health, formerly known as Egton Medical Information Systems, supplies electronic patient record systems and software used in primary care, acute care and community pharmacy in the United Kingdom. The company is based in Leeds. It claims that more than half of GP practices across the UK use EMIS Health software and holds number one or two market positions in its main markets. In June 2022 the company was acquired by Bordeaux UK Holdings II Limited, an affiliate of UnitedHealth’s Optum business for a 49% premium on EMIS’s closing share price.
Aseem Malhotra is a controversial British cardiologist, health campaigner, author, and, contrary to public health consensus, an anti-mRNA vaccine activist. He contends that people should reduce sugar in their diet, adopt a low-carb and high-fat diet, and reduce their use of prescription drugs. He was the first science director of Action on Sugar in 2014, was listed as one of The Sunday Times 500 most influential people in 2016, and was twice recognized as one of the top fifty black and minority ethnic community member pioneers in the UK's National Health Service by the Health Service Journal. Malhotra is co-author of a book called The Pioppi Diet.
Jack Adcock, a 6-year-old child, was admitted to Leicester Royal Infirmary (LRI) on 18 February 2011. He died later that day, in part because of failings in his treatment. Dr Hadiza Bawa-Garba, the junior doctor who treated him and a nurse, Isabel Amaro, were subsequently found guilty of manslaughter on the grounds of gross negligence. Both were subsequently struck off their respective professional registers, although Bawa-Garba had that decision overturned at appeal. There is an ongoing debate about the judgements against Bawa-Garba, partly around Bawa-Garba's personal culpability versus a context of systemic failures, and partly around the possible use of her reflective notes about her own practice as evidence.
Livi is a digital healthcare service by Kry International AB, a Swedish online healthcare company based in Stockholm. Kry International was established in 2015 and operates as Kry in Norway and Sweden. In France and the United Kingdom, it operates as Livi.
ZAVA is the brand name for an online doctor service and online pharmacy Zavamed.com run by the London-based Health Bridge Ltd. Launched in 2011 as DrEd, it was re-branded to ZAVA in 2016.