Since Covid-19, many people in need of routine care are preferring the convenience of remote appointments, having had to rely on them for many months.
MyClinic.ie is an online primary care service offering a range of medical services, all at the click of a button. It bypasses the need for an in-person appointment with your GP and ensures swift access to the care you need.
Established in 2015, it has consistently grown in popularity. As co-founder and GP Dr James Ryan explains, it is a patient-centric offering that prides itself on being accessible and affordable.
“When we established it, we saw a space for being able to communicate or consult remotely with patients for a variety of different reasons. From a patient perspective, we were trying to reduce the time burden and increase the ease of access to lots of different healthcare professionals in one go – like an online primary care centre.”
While initially it just offered GP consultations, the service soon developed so that patients could also access a psychiatrist and there are plans to add a nurse, physiotherapist, dietitian or other allied healthcare professionals online later in spring.
And as the service evolved, a platform was then built that created an individual health record for each client, one they could access as well as the doctors. “This is very different to the way normal practices work – they store our health records but you don’t have access to it. With this system it allows the patient to take control as they will always have access to their health records. Not only can they see the information we store on them, such as medication and their past medical and surgical history, they also have the opportunity to upload their own information and store it there as well,” Ryan explains.
MyClinic.ie offers a range of other services, from at-home STI testing to dermatology consultations, and unsurprisingly, demand for their services has surged since the pandemic began. "It's naturally increasing as people become aware of their ability to do some of these things from the comfort of their own home – when you are working, it is difficult to get time off during the day." He adds that MyClinic.ie also saw a deluge of requests for PCR referrals when they couldn't contact their own GP.
An online GP consultation on MyClinic.ie costs €35, while repeat prescribing via form fill is €25
Indeed, the country’s GPs have been under unprecedented pressure, as they deal with the huge surge in Covid-19 consultations as a result of the Omicron variant, coupled with their pivotal role in the vaccination and booster campaigns. Ryan says people have been finding it increasingly difficult to access their own GPs since Covid-19 came along. “We deal with more complex issues now compared to before the pandemic when it was more straightforward issues. Difficulty in accessing their own GP has been pushing them towards accessing an online provider for more complex issues when in the past they probably wouldn’t have.”
Partly in response to this, MyClinic.ie introduced a tele-psychiatry service in mid-2021. As co-founder and consultant psychiatrist Dr Daniel Clear explains; "A pandemic of mental health difficulties has been generated by Covid-19 and it has only emerging of late, and it's worrying because resources don't seem to be catching up to reality."
This is the first service of its kind in Ireland and Europe, and Clear says demand for the remote psychiatry service has been “remarkable”. He attributes this to the lengthy waiting times for specialist psychiatric care seen in both the public and private health services.
“The wait times for public services extend into months for non-urgent cases and even private psychiatry can surpass that in terms of wait times because of limited access points,” he explains. “Urgent cases tend to be seen quite quickly but if it’s a non-urgent case, it will be a long time. The feedback we get is that people are trying to access services for quite a while before they come to us, and they are just relieved to be seen within a reasonable timeframe.”
Essentially, the service is designed to operate remotely but very much in tandem with the patient’s GP, he adds. “We take referrals from the patient’s GP and liaise with them on an ongoing basis on the patient’s treatment plan and ongoing physical wellbeing – it’s a shared care agreement with the patient’s GP.”
Diagnosis in psychiatry can be a lengthy process. Clear explains that it is done over a number of one-hour consultations, after which a treatment plan is drawn up and communication is fed back to the patient’s own GP. “Depending on the treatment plan, there may be further follow-ups,” he adds.
Clear stresses that there is a limited set of case presentations that they can manage online. “We don’t manage urgent cases and we don’t manage psychosis, addiction, or severe mental health issues because we don’t have the multidisciplinary team – that’s the key difference. This is psychiatrist-led care and it’s remote.” Potential cases of anxiety or depression are a large proportion of their work, as are other conditions such as attention deficit hyperactivity disorder (ADHD).
“Often people will have had an assessment for ADHD and need to engage with a psychiatrist to explore medication options, or in cases of depression and anxiety where the GP has tried multiple options and patients are treatment-resistant, this is where we would come in,” Clear explains. The service has, unsurprisingly, seen demand increase significantly, but still has a much shorter wait time to public and private services which can take up to a year.
Ryan says people of all ages are using the service, and says it is particularly popular among people who are finding it difficult to sign up with a new general practice, if they’ve moved to a new area for example.
"There is of course lots of stuff that we can't do, we can't physically examine someone, and we have limitations to what we can prescribe online too, especially with controlled medications that might be addictive or have the potential for overdose." He also stresses that the MyClinic.ie doctors regularly liaise with the patient's regular GP to allow for continuity of care or further investigation if required. "We encourage people to have an online provider in addition to their own GP that they can use episodically, for example as an out-of-hours service, and we can communicate with their own GP so they still see the full picture." The service is also affordable – an online GP consultation costs €35, while repeat prescribing via form fill is €25.
Those unsure of using an online GP service but seeking the convenience and accessibility it offers can be reassured, Ryan adds. “A lot of it is gathering information and determining if you can gather enough and prescribe safely via an online consultation. If we can’t, we err on the side of safety and refer onto another GP or specialist.”