[Inside Chodong] Half-Hearted Telemedicine: What It Takes to Take Root Properly

Jo In-kyung, Content Manager of the Industry Division

As respiratory illnesses such as seasonal colds, influenza (flu), and Mycoplasma pneumonia infections are spreading again, especially among young children, pediatric and adolescent clinics in neighborhoods are experiencing “open runs,” where patients flock even before the doors open. When colds spread in kindergartens or schools, infections easily spread, and once sick, it often requires prescription antibiotics for at least three to four days, sometimes up to nearly a month. Clinics known for good care typically have a minimum two-hour wait, and if you arrive even slightly late, the day’s appointment slots are often already full. With the increasing use of paid mobile applications (apps) that allow appointment reservations, patients who visit clinics in person for on-site registration complain that their consultation order is pushed back.

Will the expansion of telemedicine starting from the 15th provide some relief to these sick children and their anxious parents? Until now, telemedicine for initial consultations during holidays and nighttime was only allowed for patients under 18 years old for consultations without prescriptions. Now, the eligibility has been expanded to all age groups, allowing anyone to request telemedicine for any illness at hospitals or clinics where they have had an in-person consultation within the past six months. Telemedicine is also available during holidays and nighttime regardless of prior visits. Forty percent of residents nationwide in cities, counties, and districts are classified as medically underserved and can always receive telemedicine. This significant relaxation of eligibility criteria comes after criticisms that the telemedicine pilot program, implemented since June after the COVID-19 pandemic, was ineffective due to various restrictions.

However, some disappointing aspects are noticeable even before full implementation. In most regions, medication delivery is still not possible, and it remains difficult to find pharmacies open during late-night hours or weekends. Except for a very small number of people such as those with disabilities, patients who receive telemedicine during nighttime or holidays still cannot take prescribed medications if there are no open pharmacies. Complaints include, “Even if I manage to get telemedicine late at night, I have to drag my sick body to find an open pharmacy or wait until the pharmacy opens the next day to get my medicine.”

Concerns about the safety of telemedicine, such as misdiagnosis or negligence, as well as worries about abuse of medical services or excessive commercialization, also deserve attention. The president of the Korean Society of Pediatric and Adolescent Medicine argues, “In children, symptoms are ambiguous and difficult to diagnose, and conditions can progress rapidly. Can acute appendicitis or intussusception be diagnosed through telemedicine?” This is not an unfounded concern. However, over the past three years during the pandemic, among 14 million telemedicine users and 36 million consultations in Korea, there have been no significant medical accidents, and public satisfaction reached 78%. To prevent inappropriate medical use aimed solely at obtaining prescriptions without consultations, it is reasonable to prohibit the prescription of post-coital contraceptives, which have high side effect risks, and to withhold judgment on some medications. Discussions and improvements will continue regarding which medications can be prescribed and symptoms that require in-person consultations when telemedicine diagnosis is deemed difficult by physicians.

The medical community and pharmacists’ associations should consider improving medical services and expanding patient benefits rather than opposing changes or disadvantages outright. The surge in demand for telemedicine due to an aging population was already anticipated. Above all, in a reality where difficulty in making pediatric and adolescent clinic appointments is cited as one of the challenges of raising children, the voices seeking quicker access to doctors’ consultations and prescriptions should not be ignored.