GEMS’s online advice column called potentially illegal and as medically sound as Dr Google
The Government Employee Medical Scheme (GEMS) and a private public relations (PR) firm have been accused of using lay people to give incorrect medical advice to patients who think it is a doctor offering free online help.
Members of GEMS‚ the second-largest medical aid in the country‚ are led to believe a medical doctor is answering their health-related questions posed online.
In what experts describe as unethical and potentially illegal‚ the advice column "House Call with Dr Joe" was launched on www.gems.gov.za in April 2014 "after receiving a number of requests from GEMS members for a scheme-specific personalised healthcare advice column".
The advice column is being managed by Martina Nicholson Associates (MNA)‚ who handles public relations for GEMS‚ Netcare and Universal Healthcare.
Martina Nicholson‚ the owner of the firm‚ has denied any wrongdoing and insists all questions are answered by a medical doctor. She declined to send The Times proof of this‚ citing doctor-patient confidentiality.
But two former staffers‚ who spoke to The Times on condition of anonymity‚ revealed that they and Nicholson herself answered questions on cancer‚ fertility‚ depression‚ infections‚ medication use and treating children’s concentration issues‚ all by using "Dr Google".
The questions and answers were posted under the "House Call with Dr Joe" segment of the scheme’s website. The site says: "Dr Joe is here to answer all your questions‚ particularly those questions that you do not always feel comfortable asking your doctor."
GEMS‚ whose response was sent to The Times by Nicholson‚ said the replies were written and signed by two medical doctors.
The Times sent some of Dr Joe’s replies to three independent medical doctors and a pharmacist‚ who all agreed that a number of answers were incorrect‚ suggesting that if doctors had signed them off‚ they lacked basic medical knowledge.
A former staff member said: "As far as medical training [was concerned‚ we had] none. And I remember once or twice that [Nicholson] called a doctor. But Google was our friend.
"It was only on one or two occasions where I ever heard of her wanting to consult a doctor.
"[It was] not my proudest work‚ [it is] actually the work I want to forget I ever did. I still cringe when I hear the name Joe."
Another ex-employee said: "The ‘Ask Dr Joe’ segment … gives off impressions that it’s a real doctor that is answering the questions when it was just us‚ the staff of a PR agency."
Nicholson dismissed this‚ claiming one of the staffers was a disgruntled former employee.
She later said her staffers only wrote the top and bottom of the answers. "The work we do here at MNA is actually only a very small part of an extensive process."
Nicholson also forwarded a response from GEMS chief healthcare officer Vuyo Gqola‚ who said: "All content is approved by medical doctors‚ both prior to being sent on to the member by GEMS and also prior to being placed on the website by GEMS."
But the doctors approached by The Times pointed out problems in several answers‚ including:
- A reply to a question about the cancer risk associated with asymmetric breasts suggests the woman should go for a mammogram every year;
- A reply to a question about a child suffering from Attention Deficient Disorder suggests the child should be fed "brain food" such as eggs and fish;
- A reply to an HIV-positive woman‚ aged 39‚ wanting to fall pregnant cites statistics that suggest it is almost as easy to fall pregnant in your late 30s as in your late 20s;
- A reply to a patient seeking advice on chilblains on his fingers quotes a definition of the disease from WebMD almost verbatim;
- A reply to a question on diabetes and birth control is almost exactly the same as a paragraph on www.everydayhealth.com; and
- A child with recurrent pneumonia was only advised to "drink fluids‚ get the pneumococcal vax [vaccination]‚ and go to a different doctor to get different antibiotics".
A pharmacist said some of the answers were also problematic because they suggested treatments. Diagnosing and treating people over the internet is illegal without a full examination and medical history.
GEMS and Nicholson said the purpose of the column was "not to dispense medical advice but to educate and inform members and to make it easier for them to talk about issues of concern and to encourage them to share these with their family doctor".
Pretending to be a doctor to give medical advice "is illegal and unethical‚" said medical law PhD student and pharmacist Shafrudeen Amod from the University of KwaZulu-Natal.
Health Professions Council of SA (HPCSA) spokeswoman Priscilla Sekhonyana said that if true‚ the actions by Nicholson amounted to a "criminal offence".
The Health Professionals Ethics Conduct of 2010 reads: "Only practitioners who have been deemed competent and are registered in their respective professions are authorised to participate in telemedicine practice in SA either as consulting healthcare practitioners or servicing healthcare practitioners.
"Consulting healthcare practitioners and servicing healthcare practitioners are held to the same standards of medical practice as healthcare practitioners who conduct face-to-face consultations."