Lloyds online doctor

kingofbeers

Hey,
Just wondering has anyone used lloyds online doctor prescription. Are they genuine.

ainecaine

kingofbeers wrote:

Hey, Just wondering has anyone used lloyds online doctor prescription. Are they genuine.

Hi, I have, they posted a prescription to me and I gave it to my local pharmacy with no problems. They give an explanatory note for you and the pharmacist also with telephone numbers.

kingofbeers

Has anyone ever used prescriptions issued by Lloyds online doctor www.lloydsonlinedoctors.ie in Irish chemists. If so where was it you used it and did they query about it been uk.

Ken.

Mod-Moved to health sciences. Please read the local charter before posting. Thank you.

Alun

Also note that the URL given is incorrect, it should be www.lloydsonlinedoctor.ie, i.e. no 's' after 'doctor'.

Kurtosis

Mod note

OP I've merged this latest thread with your recent thread on the same topic.

Just to remind posters, as per the forum charter we don't allow recommendations of specific doctors so please keep any responses to factual information about this service.

palmcut

I think online prescribing has great potential for misuse, abuse and forgery.

Vorsprung

Have been involved in a few discussions about such services. For me, the main issue with this particular service is that the GPs involved are in another country. Call me protectionist if you will!

Admittedly if this service finds a large demand, the onus will be on Irish GPs to change how they operate to compete.

palmcut

Do they check BP online?
Respiratory check?
Oedema?

Mental assessments?
Blood tests?
Urine samples?

Breath test?

I have more faith and trust in a face to face live interview rather than a remote discussion or a remote Q&A session with a machine.

Tree

My local pharmacy reckons lots of women are using it for renewed pill scripts. The pharmacy gives them a printout of bp for submitting to the service, and no one seems to be having any particular problems. Given that GP's in Ireland charge a full consultation for most women every 6mo, there's a huge appeal to using a much cheaper online service for long term meds like that.

Kurtosis

Tree wrote: »

My local pharmacy reckons lots of women are using it for renewed pill scripts. The pharmacy gives them a printout of bp for submitting to the service, and no one seems to be having any particular problems. Given that GP's in Ireland charge a full consultation for most women every 6mo, there's a huge appeal to using a much cheaper online service for long term meds like that.

That's interesting. So are the pharmacy checking BP after the script has already been issued? If so, I'd be curious where the responsibility would lie between the pharmacy and doctor if a patient did go on to have a VTE as a result of taking the pill.

Tree

Part of their terms for a combined oral are:

If your blood pressure and weight are outside safe limits for use, you will need to send the prescription back to us and you will receive a full refund.

They're not part of the mini pill terms.

As I said, my pharmacy seem very happy to take those scripts for oral contraceptives, not sure if they see many ppl presenting other scripts.

And given how the usual full consultation for a pill repeat has been "anything changed?" (with bp measurments), I'm not sure how different it is to the online (apart from price)

palmcut

penguin88 wrote: »

That's interesting. So are the pharmacy checking BP after the script has already been issued? If so, I'd be curious where the responsibility would lie between the pharmacy and doctor if a patient did go on to have a VTE as a result of taking the pill.

In such a case the pharmacy should refuse to dispense until the prescribing doctor has checked the BP.

Vorsprung

My understanding is that the BP has to be noted on a particular form and then stamped, there are BP machines in some Lloyds branches and these measurements are accepted.

With regard to VTE risk, it's a well documented complication and assuming the patient has no family or personal history, it's just one of those things. Pregnancy carries a higher VTE risk!

echo beach

Vorsprung wrote: »

My understanding is that the BP has to be noted on a particular form and then stamped, there are BP machines in some Lloyds branches and these measurements are accepted.

In that case what is the need for a doctor at all?

Kurtosis

It just strikes me as odd that a doctor would be happy to issue a prescription for something before confirming if it is suitable for the patient and telling the patient to go and get things checked by a third party that the doctor has no direct relationship with.

Ah yeh I know the risk of VTE is small but if that's why women are being instructed to get their BMI and BP measured, I'd have thought a prescriber would want to know about this before issuing a valid prescription.

Tree

No stranger than when I move houses and move GPs and just tell them I'm on $pill and they issue it on my word.

Vorsprung

echo beach wrote: »

In that case what is the need for a doctor at all?

To go through a history, identify issues and risk factors and finally provide a script. Other health professionals are not, as it stands, trained to do that. I presume they do this?! It it is a box check form?!

As I said initially, I don't think the model is sound, and I'd have major issues with a family member using this service.

locum-motion

For what it's worth, I have received two diifferent types of prescriptions from a GP practice that according to its headed notepaper is located in Wigmore Street, London. The doctors involved specify their Irish Medical Council registration numbers on the forms, and the phone number is a Dublin one (presumably diverted to London).

The first type of prescription I've seen from this practice is, as far as I'm concerned, the same as any other prescription apart from the London address. As with any other prescription, I work on the assumption that the doctor has examined the patient to determine the appropriateness of the medicine. These prescriptions pre-date the setting up of the "Lloyd's Online Doctor" service.

Since then, I've seen a second type of prescription from the same practice: same doctor, same address, same phone number. The only difference was that there was a little bit of additional information typed on the prescription too, which specifically stated that the prescription was issued via Lloyd's Online Doctor, and that the doctor had NOT examined the patient, and (IIRC) asking the pharmacist to follow the instructions on the accompanying postcard. These instruction basically said: please measure the patient's BP and BMI, write it on this card, decide if you want to dispense, and ask the patient to send the card back to us. If you don't want to dispense, please give the prescription and card back to the patient so they can try another pharmacy. The final instruction was to the patient; if you can't find a pharmacy willing to dispense it, return the prescription and card to us for a full refund.

I refused to dispense this prescription.

As far as I'm concerned a prescription is a legal document that says "I have examined this patient and in my professional opinion this treatment is safe and appropriate for this patient."

If the doctor includes a disclaimer on the document that says "I have not examined this patient and I am happy for the pharmacist to examine them in my stead and exercise their own professional judgement to decide whether to supply or not." (or words to that effect) the document is rendered null and void.

At this moment, in this country, it is not legal for a pharmacist to examine a patient and independently decide that they will supply a Combined Oral Contraceptive Pill, except in certain specified emergency situations (and even then, the law requires that the pill has previously been prescribed by a physician).

If and when the law is changed to allow me to do so, then I shall do so. And at that time, I will charge a fee commensurate with the time and professional input involved. And I shall pay professional indemnity insurance premiums commensurate with the service.

But until that change in the law occurs, the responsibility, the liability, the insurance premiums and the larger fees remain with the doctor.

Any "doctor" that charges the fee (albeit lower than his colleagues), while at the same time attempting to wash his hands of any potential liability and pass said liability onto another person who is prohibited by law from accepting it, does not deserve the title.

huskerdu

Tree wrote: »

No stranger than when I move houses and move GPs and just tell them I'm on $pill and they issue it on my word.

I have done that too, but the Doctor checked my blood pressure and weight before prescribing.

If you have gone to a doctor who has handed you a prescription for the combined oral pill without BP and BMI being acceptable, I would walk away from that doctor very fast.

Nonoperational

locum-motion wrote: »

For what it's worth, I have received two diifferent types of prescriptions from a GP practice that according to its headed notepaper is located in Wigmore Street, London. The doctors involved specify their Irish Medical Council registration numbers on the forms, and the phone number is a Dublin one (presumably diverted to London).

The first type of prescription I've seen from this practice is, as far as I'm concerned, the same as any other prescription apart from the London address. As with any other prescription, I work on the assumption that the doctor has examined the patient to determine the appropriateness of the medicine. These prescriptions pre-date the setting up of the "Lloyd's Online Doctor" service.

Since then, I've seen a second type of prescription from the same practice: same doctor, same address, same phone number. The only difference was that there was a little bit of additional information typed on the prescription too, which specifically stated that the prescription was issued via Lloyd's Online Doctor, and that the doctor had NOT examined the patient, and (IIRC) asking the pharmacist to follow the instructions on the accompanying postcard. These instruction basically said: please measure the patient's BP and BMI, write it on this card, decide if you want to dispense, and ask the patient to send the card back to us. If you don't want to dispense, please give the prescription and card back to the patient so they can try another pharmacy. The final instruction was to the patient; if you can't find a pharmacy willing to dispense it, return the prescription and card to us for a full refund.

I refused to dispense this prescription.

As far as I'm concerned a prescription is a legal document that says "I have examined this patient and in my professional opinion this treatment is safe and appropriate for this patient."

If the doctor includes a disclaimer on the document that says "I have not examined this patient and I am happy for the pharmacist to examine them in my stead and exercise their own professional judgement to decide whether to supply or not." (or words to that effect) the document is rendered null and void.

At this moment, in this country, it is not legal for a pharmacist to examine a patient and independently decide that they will supply a Combined Oral Contraceptive Pill, except in certain specified emergency situations (and even then, the law requires that the pill has previously been prescribed by a physician).

If and when the law is changed to allow me to do so, then I shall do so. And at that time, I will charge a fee commensurate with the time and professional input involved. And I shall pay professional indemnity insurance premiums commensurate with the service.

But until that change in the law occurs, the responsibility, the liability, the insurance premiums and the larger fees remain with the doctor.

Any "doctor" that charges the fee (albeit lower than his colleagues), while at the same time attempting to wash his hands of any potential liability and pass said liability onto another person who is prohibited by law from accepting it, does not deserve the title.

I often disagree with you, but this is a good post.

El_Dangeroso

The NAGP announced recently they will be launching their own telemedicine service. Seems like they want to angle it towards seeing your own doc, but in an online capacity.

I think the days of free telephone follow ups are over, patients will be directed to the online service for discussion for a fee.

Private patients already subsidise high users of GMS services, seems with the introduction of the under 6 contracts, this is due to increase.

OR

The babylons and LODs of the world will cream off all the low hanging fruit (pill Rxs, ED pills) and then refer everything difficult back to the already strained and under-funded primary care sector.

I think that the ICGP are due to issue some guidance for safety in telemedicine soon, be interesting to see what they come up with.

echo beach

El_Dangeroso wrote: »

The babylons and LODs of the world will cream off all the low hanging fruit (pill Rxs, ED pills) and then refer everything difficult back to the already strained and under-funded primary care sector.

That seems to be their model. They will look after healthy people but as soon as you are sick they don't want to know. The evidence is their policy of giving refunds to women whose pharmacist makes the professional decision not to dispense the pill the online doctor has prescribed, potentially putting a patient's health at risk. Surely in that case the doctor should review the woman's history and discuss other possible options, but that would take time and time is money, which is much more important than ethics or professionalism.

Tinkerbell.123

ainecaine wrote: »

Hi, I have, they posted a prescription to me and I gave it to my local pharmacy with no problems. They give an explanatory note for you and the pharmacist also with telephone numbers.

Hi, I'm using Lloyds online doctor for the first time, does the prescription take long to come? Did you have to get blood pressure checked in the pharmacy?