Direct-to-consumer teledermatology platforms may have inherent conflicts of interest

Ranpariya, Varun; Lipoff, Jules B.

doi:10.1016/j.jaad.2021.04.102

Cited by 8 publications

(4 citation statements)

References 2 publications

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“…Concerns about conflict of interest (COI) were raised about healthcare providers who work for DTC companies (16%; n = 14); these worries arose most frequently in the context of DTC telemedicine. Arguments were made that providers have a financial COI with DTC prescription platforms since prescribing medications that increase the company’s profits is essential for the platform’s survival [ 25 , 26 , 97 ]. The issue of COI was also raised with stem cell therapy clinics [ 53 ], providers of neurostimulation [ 55 ], telemedicine [ 39 ], and digital health tools [ 68 ] who all have a financial interest in profit maximization.…”

Section: Resultsmentioning

confidence: 99%

“…Neurotechnology-related publications were most prevalent, likely due to multiple commentaries accompanying a relevant journal article (n = 13) [23] and chapters (n = 9) in a neurotechnology book [24]. Other publications from special issues included five related to dermatology and telemedicine [25][26][27][28][29] and four related to DTC lab testing [7,[30][31][32].…”

Section: Plos Digital Healthmentioning

confidence: 99%

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Ethical issues in direct-to-consumer healthcare: A scoping review

Nagappan,

Kalokairinou,

Wexler

2024

PLOS Digit Health

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An increasing number of health products and services are being offered on a direct-to-consumer (DTC) basis. To date, however, scholarship on DTC healthcare products and services has largely proceeded in a domain-specific fashion, with discussions of relevant ethical challenges occurring within specific medical specialties. The present study therefore aimed to provide a scoping review of ethical issues raised in the academic literature across types of DTC healthcare products and services. A systematic search for relevant publications between 2011–2021 was conducted on PubMed and Google Scholar using iteratively developed search terms. The final sample included 86 publications that discussed ethical issues related to DTC healthcare products and services. All publications were coded for ethical issues mentioned, primary DTC product or service discussed, type of study, year of publication, and geographical context. We found that the types of DTC healthcare products and services mentioned in our sample spanned six categories: neurotechnology (34%), testing (20%), in-person services (17%), digital health tools (14%), telemedicine (13%), and physical interventions (2%). Ethical arguments in favor of DTC healthcare included improved access (e.g., financial, geographical; 31%), increased autonomy (29%), and enhanced convenience (16%). Commonly raised ethical concerns included insufficient regulation (72%), questionable efficacy and quality (70%), safety and physical harms (66%), misleading advertising claims (56%), and privacy (34%). Other frequently occurring ethical concerns pertained to financial costs, targeting vulnerable groups, informed consent, and potential burdens on healthcare providers, the healthcare system, and society. Our findings offer insights into the cross-cutting ethical issues associated with DTC healthcare and underscore the need for increased interdisciplinary communication to address the challenges they raise.

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Section: Resultsmentioning

confidence: 99%

Section: Plos Digital Healthmentioning

confidence: 99%

Ethical issues in direct-to-consumer healthcare: A scoping review

Nagappan,

Kalokairinou,

Wexler

2024

PLOS Digit Health

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“…The parallel growth in the direct-to-consumer telemedicine industry serves as another indicator of the increased acceptance of nontraditional physician-patient relationships. 49…”

Section: Next Steps For Teledermatologymentioning

confidence: 99%

Synchronous and asynchronous teledermatology: A narrative review of strengths and limitations

et al. 2022

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The policy changes prompted by the COVID-19 pandemic caused synchronous models (primarily video visits) to supplant asynchronous models (store-and-forward or shared digital photographs) as the default and predominant modality of teledermatology care. Here, we call attention to the unique strengths and limitations of these models in terms of clinical utility, accessibility, and cost-effectiveness. Strengths of synchronous visits include direct physician-patient interaction and current reimbursement parity; limitations include variable video image quality, technological difficulties, and accessibility barriers. Strengths of asynchronous visits include greater convenience, especially for clinicians, and potential for image quality superior to video; limitations include less direct physician-patient communication, barriers to follow-up, and limited reimbursement. Both synchronous and asynchronous models have been shown to be cost-effective. Teledermatology is positioned to play a prominent role in patient care post-pandemic. Moving forward, dermatologists are challenged to optimize teledermatology use in order to improve outcomes, efficiency, and workflows to meet diverse patient needs. Future directions will depend on sustainable reimbursement of both teledermatology formats by government and private payers.

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“…As discussed, significant concerns exist, including conflict of interest, treatment by nondermatologists, and prescription of medication absent a thorough history. 1,2 Such deficiencies are countered by the presumption that these services provide increased access to care. Here we examine if the features of popular DTC teledermatology platforms are structured to accommodate underserved populations.…”

mentioning

confidence: 99%