Intended for healthcare professionals


Proliferation of private online healthcare companies

BMJ 2016; 352 doi: (Published 23 February 2016) Cite this as: BMJ 2016;352:i1076
  1. Jessica Watson, academic clinical fellow1,
  2. Chris Salisbury, professor in primary health care1,
  3. Helen Atherton, assistant professor2,
  4. John Campbell, professor of general practice and primary care3,
  5. Brian McKinstry, professor of primary care e-health4,
  6. Sue Ziebland, professor of medical sociology5
  1. 1Centre for Academic Primary Care, School of Social and Community Medicine, University of Bristol, Bristol BS8 2PS, UK
  2. 2Division of Health Sciences, University of Warwick, Coventry, UK
  3. 3University of Exeter Medical School, Exeter, UK
  4. 4Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
  5. 5Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
  1. Correspondence to: J Watson Jessica.Watson{at}

Should the NHS try to keep up?

With an app for just about everything, why not one for contacting your doctor? In the United Kingdom, private companies offering primary healthcare are proliferating, with Dr Morton, a website offering email or telephone consultations, and Dr Now, a smartphone app offering video consultations. Companies in the United States are offering an Uber-type experience, where instead of a car, a doctor appears at your door.1

These companies operate in a climate where patients want convenience, flexibility, and speed of access, features which overstretched general practitioners in the UK are struggling to provide. Meanwhile, new companies are appearing regularly, with the UK digital health market currently worth £2bn (€2.6bn; $2.8bn) and expected to grow to £2.9bn by 2018.2 What are the implications for the NHS?

Safety of online consulting

Online consultation methods, although widely used in countries such as Denmark,3 are relatively untested, with recent Cochrane reviews concluding that insufficient evidence exists to make recommendations about their use,4 and doctors and patients voicing safety concerns.5 UK professional bodies advise that emails should be reserved for “appropriate matters” such as scheduling appointments, repeat prescriptions, and test results.6 7 The American Academy of Family Physicians supports online consultations …

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