Online Medical Consultations: Urgent Measures Necessary to Prevent Inappropriate Prescriptions

Editorial

16:57 JST, May 19, 2025

Inappropriate medical examinations and prescriptions have become conspicuous in online medical consultations, in which doctors examine patients via the internet.

It is problematic that a service intended to improve patient convenience is instead causing health hazards. The government must develop a system to prevent problems.

Online medical consultations became covered by the public health insurance system in fiscal 2018. Initially, the service was mainly for patients with lifestyle-related diseases who needed regular hospital visits, and the first session had to be done in person.

Following the onset of the COVID-19 pandemic, online consultations were subsequently permitted even from the first session as a special measure to prevent infections at medical facilities. The measure was formalized from 2022 onward, allowing patients to receive consultations online from their first session.

Normally, in-person consultations are ideal for detailed examinations. However, amid the declining population and the increasing number of regional areas without accessible clinics, it is significant to expand the use of online medical consultations.

But it cannot be overlooked that the relaxation of regulations has led to the occurrence of inappropriate medical examinations.

In its guidelines for online medical consultations, the government requires that doctors do not prescribe medication to be taken for eight days or more without understanding the patient’s underlying conditions. Prescribing psychotropic drugs in the initial session is also not permitted.

However, cases in which these guidelines have not been followed have become an issue.

For instance, a patient who received an online medical consultation for mental health concerns reportedly had a month’s supply of sleeping pills sent after communicating with a woman claiming to be a nurse, not a doctor. There was also a case where psychotropic drugs were prescribed to a first-time patient.

Also, in online consultations for cosmetic treatments, there has been a series of cases in which people who are not ill have been prescribed several months’ supply of diabetes medication for the purpose of losing weight, causing headaches and dizziness, among other health hazards.

According to the National Consumer Affairs Center of Japan, 159 complaints were made about online consultations for cosmetic treatments in fiscal 2024, three times the number in fiscal 2021.

Taking this situation into account, the government has submitted a bill to the current Diet session to revise the Medical Care Law. The bill aims to formulate new standards for online medical consultations and impose penalties such as the suspension of services in cases of violation.

However, the ruling and opposition parties in the House of Representatives’ Health, Labor and Welfare Committee remained at odds over the order of deliberation for this and other bills, so it is unclear when the bill will be deliberated.

The bill also includes other important issues, such as regulations for doctors to open practices to correct the uneven concentration of doctors in urban areas, and digitalization to enable information sharing among medical institutions to proceed. Deliberation should proceed without delay.

(From The Yomiuri Shimbun, May 19, 2025)