Can Smartphone Apps Really Replace GP Appointments?

I had a few too many Guinnesses last night. Now I’m at work writing this article with a throbbing headache and a pervasive anxiety about getting fired.

While normally a person who feels very unwell might book an appointment at their GP’s surgery, this has become increasingly unfeasible. With an ageing population causing extremely long waiting times, especially in London surgeries, most people who aren’t actually imminently about to die are just left to Google ‘weird-looking mole’ and hope for the best.

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Luckily for me in my time of need, the digital health industry is thriving. Estimated to be worth £25 billion by 2018, services such as Now GP, Push Doctor and GPDQ (GP Delivered Quick) are bringing NHS registered doctors to your smartphone – if you’ve got the money.

Babylon, another market leader, saw recent heavy investment from the Innocent Drinks founders and is about to put £19 million into its artificial intelligence symptom-checker. But it has also just got into some trouble for its sponsorship of the Royal College of GPs annual conference, after putting leaflets in their goodie bags and its logo on their website.

Accused of trying to steal GPs away from the NHS with promises of working from home, flexible hours and earning up to £90k a year, this app has caused more general concern over our dear public health system. Patient care watchdogs have also criticised the app for removing GPs from the NHS, and underhandedly creating a market-based system that prioritises the health of those who can afford to pay £25 a pop for an appointment.

Babylon actually claims to be removing strain from the NHS by creating an alternative system that runs parallel to the public health service. And maybe that’s true, because it means lazy people like me who have silly problems and a lackadaisical attitude towards personal finance won’t be clogging up waiting rooms. But how does it actually compare to GPs IRL? Am I getting the same treatment as I would if I waited 900 weeks for an appointment?

I decided to take one for the team and put this app to the truest test I know – can it figure out that I am very hungover indeed?

The phone app features a free symptom-checker and an ‘ask a question’ feature, as well as giving you the opportunity to book a phone or video call with a GP, a specialist or a therapist. I booked my GP appointment in for an hour’s time, and while I wait for my assigned doctor, I decided to see if the AI symptom checker could sort me out with a hangover cure. Here are my symptoms in order of severity:

A headache
I feel like I might maybe throw up on the other intern
Really want a nap
The overhead lights makes my eyes hurt
Thirsty and would really like a juice
A general sense of dread
I’m having trouble concentrating on writing this list

It asked some questions about how I was feeling, but never asked me anything about my looming sense of dread, which makes me think that this app probably isn’t so good at diagnosing mental health stuff. It ruminated for a bit about my low-level headache answer and then told me that ‘good hydration and avoiding excessive use of electronic screens (like this one) should help’. Does that count as a doctor’s note to stop work for the day?

Moving on to their ‘Ask a question’ service, I decided to hit them with the blunt and concise ‘why do I feel nauseous’. Three hours later and I still didn’t have a response, so it was lucky it was just my millennial self-indulgence and not anything more serious.

But then it was time for my video appointment. While I think the GP would be able to tell I’m hungover straight away if I was standing in front of him, he couldn’t diagnose me immediately over dodgy wifi. So running through some general questions, I recited my list of symptoms. He seemed quite bemused by such a sudden onset of illness when I woke up this morning, especially when I reported feeling fucking great last night.

Finally, he asked me if I had taken any recreational drugs last night. “I can see you are in your office though right now, and might not be comfortable answering that question around your colleagues.”

Feeling like this doctor’s 20 years’ experience in musculoskeletal medicine isn’t serving him well with solving my tricky case, I decided to help him along a bit. “I was drinking though,” I said.

At this point he realised I was hungover and said that my symptoms were “probably the result of a bit of drink and it being the end of the week”. He told me to just have a quiet night in tonight, and very reassuringly told me that the Babylon team are there 24 hours a day, so to just call back if my symptoms worsen. Thanks, Doc!

In case I missed any of our lovely chat, I got an email saying that a summary of my consultation has been stored in my app, as well as the recording of the conversation. At this and every other juncture, Babylon asks for a review of its services, reminding you that your positive experience is what their product is built on.

And it is a product – you can feel the smoothness of a whole team of graphic designers and focus group researchers on each page. Like Uber or Deliveroo, this app has been designed to fill a hole, and help us all on our way to a society devoid of any of the rough edges of waiting rooms or social interaction. Babylon is so 2016 that you can even do stuff like sync the app to your Apple Watch, and even create an account for your children so you never have to ask them how they are again.

So as long as the NHS is providing a hole to fill with its weeks-long waiting lists, the depersonalisation and privatisation of healthcare systems is as inevitable as me having another hangover.

More on the NHS:

Speaking to Junk Food Eaters and Smokers About the New ‘Unhealthy Lifestyle’ Bill

The Unhealthy Truth About Clean Eating

I Tried To Become a Surgeon in an Hour Using Only the Internet