The Unbearable Carelessness of Dr. Digital

They advertise low costs, round-the-clock service, easy access, immediate appointment scheduling, professional healthcare and prescriptions available at short notice. We are talking about telehealth providers. In the US, they have sprung up like mushrooms against the backdrop of COVID-19 restrictions, when in-person visits to the doctor were made difficult. The expansion of their use is being vigorously promoted. In fact, telehealth services could be a useful addition to healthcare provision. In their current form, however, they offer pharmaceutical interests a welcome gateway to expanding the business with disease. In doing so, telehealth providers expose the real weakness in the current healthcare system: the lack of focus on cause-based treatment.

Medicine that transcends boundaries is no longer just a pipe dream. For a long time, providing treatment when the therapist and patient are physically apart was limited or confined to a niche existence due to insufficient technological capabilities. Today, it seems to have become part of everyday life. In the US in particular, online consultations have established themselves as an integral part of patient care. GPs, clinics and psychologists all offer these services. Telemedicine experienced a major breakthrough in the wake of the pandemic measures, when health authorities ‘flexibilised’ the access requirements and medical standards for telehealth providers.

Even back then, concerns were growing about a watering down of pharmaceutical legislation. Experts warned of a quasi-legalised form of ‘online drug dealing’ if prescription-only medicines were dispensed to patients without a direct consultation with a doctor. Looking at developments over recent years, these fears appear to have been realised. Numerous telehealth providers are now active on the market and are competing fiercely for patients. It is striking that, in virtually all areas of treatment, a focus on medication is paramount. The rapid availability of prescription medicines such as antibiotics, antivirals, anti-allergy drugs, painkillers and anti-rheumatic drugs, GLP-1-type weight-loss drugs, contraceptives and other hormonal preparations, antipsychotics and antidepressants is heavily promoted.

The intensive promotion of medicines by telehealth providers is reflected in their user base. Representative analyses from last year showed that patients who use telehealth services are at least 20% more likely to take prescription medicines. Among certain subgroups of people with chronic conditions, the proportion was even significantly higher.

At the start of the year, the US Department of Health and Human Services announced a fourth temporary extension of telemedicine flexibilities, whilst at the same time indicating that permanent regulations were on the horizon. The reason explicitly given for this move was that prescriptions issued via telehealth had become “a lifeline for millions of Americans”. This approach should be consolidated, not least to “protect patients” and “maintain strong controls against diversion”. The cynical double standards in these statements are plain to see. In any case, there is no mention here of a sustainable healthcare system that prioritises prevention over intervention. Rather, the formalisation of this increased flexibility seems like a red carpet being rolled out for the influential pharmaceutical industry. This sector’s ambitions have been considerable from the outset. It is no secret that telehealth is viewed as a lucrative marketing strategy. The role intended for the patient here is self-evident! It is equally obvious what a ‘disruptive factor’ the restoration or even the preservation of health represents.

Who benefits from online consultations?

In fact, models have become established in which pharmaceutical manufacturers address ‘end consumers’ directly on their websites and refer them telehealth services, where, conveniently, an appointment can be booked immediately and, ultimately – not entirely by chance – the ‘just right’ product for the patient’s particular condition is prescribed. Coupons or other incentives play their part in making this more likely. It is possible that this ‘consumer-friendly’ sales pitch began even a step earlier: through targeted advertising on social media platforms or an influencer’s ‘disinterested recommendation’. No one can seriously expect that, given this close partnership between pharmaceutical and telehealth companies, the patient’s or customer’s health is the primary concern. It is just as if, during a real doctor’s appointment, the pharmaceutical representative were sitting right there at the table, offering obliging assistance in writing the prescription. If you think that’s right – go ahead! But independent healthcare looks very different!

In this context, it is important to remember that prescription medicines are the third leading cause of death in the US, if not already the leading cause. – A problem that could easily be remedied! A particular issue is polypharmacy – the use of several medicines at the same time – which results in even more severe side effects because these do not simply add up or cancel each other out. With psychiatric medicines, polypharmacy is not the exception but the rule. In the case of other chronic conditions too, such as cardiovascular diseases, the negative effects are exacerbated by the long-term use of multiple medicines.

Cases of adverse reactions associated with the above-mentioned drugs that were reported to the FDA’s AEMS. Retrieved on June 16, 2026.

As can be observed, the increasing use of telehealth services goes hand in hand with a rise in the prescribing of medicines. It is obvious that this will have consequences – albeit with a certain delay. The expected increase in reported side effects can be seen, for example, in the class of medicines known as antibiotics. Beyond the immediate effects on patients, it is well known that the indiscriminate use of antibiotics carries the risk of resistance developing.

Overcoming health illiteracy

Despite all the promises, the telehealth trend offers no way out of the dilemma of spiralling costs in a system that only purports to deliver healthcare. As long as the root of the problem – the pharmaceutical industry’s investment business with disease – remains untouched, virtual interactions between patients and doctors will, at best, be a digital substitute for a genuine consultation.

The advantages cited in relation to telehealth services (saving patients from having to travel long distances; reducing the risk of infection from highly contagious diseases; shortening the time taken per patient, as healthcare staff with limited availability treat more people on average) cannot, under the current circumstances, outweigh the disadvantages. These include the obviously limited scope for assessment and examination during a video consultation. In many cases, not even these technical requirements are met, and contact takes place solely through conversation or even in written form (email, chat). How can reliable diagnoses be made with such serious limitations? How can the quality of medical treatment be guaranteed under these circumstances? As telehealth is currently structured, this technology primarily facilitates the prescription (or refill) of certain medicines.

On the other hand, there are data protection risks. How can security be guaranteed when sensitive data is transmitted and processed? Who has access to it, and to what extent? Who monitors this?

The key question remains: how can we prevent third-party interests from unduly influencing the doctor-patient relationship without objective justification? The independence of a telehealth provider is absolutely essential. This independence is inevitably compromised if there is also an incentive to sell medicines. Conversely, it must make anyone sceptical when, on the relevant product pages of pharmaceutical manufacturers, they are advised which telehealth service or doctor in their local area they can consult for more detailed ‘advice’ on that particular medicine.

We can achieve a sustainable healthcare system by freeing people’s health needs from the stranglehold of economic interest groups. Prevention and cause-oriented treatment based on scientifically proven naturopathic methods lay the foundation for this. Overcoming widespread lack of empowerment is crucial to its implementation. Everyone can and should play a part in this process of educating the public. From this perspective, online health education can make an important contribution.