Mohana Basu IN 2017 , telehealth website Qoctor

“ It looks like regulation is trying to catch up with the space , and there

“ I think there is a race to the bottom in terms of finding ways to be as cheap

a real-time conversation with the patient via phone or video .

was causing controversy among GPs .

is a lot of poor practice happening ,”

as possible by reducing time with the

“ I am not sure if the doctors are

Mailing out S4 antibiotics and

she says .

patient or reducing the proper , safe

aware they are operating outside

sildenafil , online questionnaires to

She says some patients get the

care that people should be getting .”

their insurance policies or turning a

assess eligibility for referrals — it

impression they are going to be

Despite the Medical Board of Aus-

blind eye .”

seemed so radical then .

assessed by a doctor , but when they

tralia making it clear that SMS or other

While Qoctor had critics , Dr Boylan

Today , telehealth has become a

receive a sick note , it is signed by a

asynchronous consultations are rarely

says she never took it personally .

widespread and lucrative market ,

nurse .

good practice , Dr Boylan claims they

“ We understood that new things

with estimated revenues of $ 440

“ There is nothing wrong with a

still occur “ in large numbers ” even

were always going to challenge the

million a year .

nurse ’ s signature , but you should be

when indemnity does not cover them .

status quo and people would question

However , Qoctor ’ s long-serving CEO , GP Dr Aifric Boylan , says the state of the industry now concerns her .

clear . If you are telling a patient that they are going to see a doctor , then they should see a doctor .

“ Providing a medical certificate is providing healthcare ,” she says .

“ Therefore , it should involve

them ,” she says . Poor practices , she says , risk eroding patients ’ faith in all GP telehealth .

Dr Aifric Boylan .

Mohana Basu A 61-YEAR-old woman developed

bilateral blurry vision

shortly after using hair dye

due to the aromatic amines

in the product , French

doctors say .

The patient , who had

no relevant medical history

and no exposure

to corticosteroids , used

a commercially available

hair dye containing

para-phenylenediamine .

According to the case in

JAMA Ophthalmology , doctors

found on examination

that her visual acuity was

slightly reduced in the right

eye ( 20 / 40 ) but normal in

the left .

Fundus examination

revealed multiple serous

retinal detachments , primarily

in the posterior

region , while optical coherence

tomography ( OCT )

imaging showed retinal

thickening .

Testing ruled out causes

such as sarcoidosis , lymphoma

and acute exudative

polymorphous vitelliform

maculopathy .

She was diagnosed with

retinopathy associated with

hair dye .

The presentation closely

resembled retinopathy

associated with MEK inhibitors

, with both conditions

likely involving disruptions

in the MAPK pathway

, which played a role in

the survival and function

of retinal pigment epithelial

cells .

After their patient

stopped using the hair dye ,

visual acuity improved over

four months , the serous retinal

detachments disappeared

and OCT showed subretinal

deposits without any remaining

thickening .

However , even after four

years , the patient ’ s OCT

showed some persistent

abnormalities , suggesting

long-term effects .

JAMA Ophthalmol 2024 ; 12 Sep .