Amid soaring patient demand for GLP-1 weight loss medications such as Ozempic and Wegovy, primary care physicians (PCPs) are raising concerns about patient safety risks associated with third-party telehealth prescriptions of the new drugs. According to a recent survey conducted by the San Francisco-based healthcare consultancy Omada Health, those concerns are growing as telehealth services play an increasing role in prescribing these medications, often without the involvement of the patient’s primary care physician.
The report notes one in eight Americans has used a GLP-1 medication, while an estimated 129 million currently qualify for semaglutide-based treatment.
Patient Safety Concerns
The report, Primary Care Perspectives on GLP-1 Prescriptions, found that slightly more than two-thirds (67%) of the 2,000 primary care physicians (PCPs) surveyed believe GLP-1 prescriptions by third-party telehealth providers pose a significant risk to patient health. These physicians cited concerns such as inadequate reviews of a patient’s medical history, insufficient patient monitoring, and the potential for overprescription.
Among the respondents who report patients asking about third-party telehealth prescribing, almost two-thirds (64%) actively advise patients against it. Only 18% are comfortable with their patient engaging semaglutide-based treatment from a telehealth prescriber, while 57% indicate they caution patients against accessing GLP-1 treatment through third-party telehealth providers.
Disruptions in Care Coordination
PCPs identified the inherent potential to disrupt care coordination as their second most significant concern. Half of the surveyed PCPs believe continuity of care is compromised when patients obtain GLP-1 prescriptions from telehealth providers without informing their primary doctor. Additionally, 61% reported patients often fail to disclose when they receive GLP-1 prescriptions from alternative platforms, making it more difficult for PCPs to monitor potential side effects and adjust existing treatment plans.
The report warns that without transparency, PCPs cannot provide the necessary support for managing lifestyle changes, monitor potential side effects, or ensure the treatment aligns
with a patient’s overall health needs.
PCPs Cautious with GLP-1 Prescriptions
Despite increasing patient demand, PCPs remain generally cautious when prescribing GLP-1 medications. The survey revealed that, on average, 29% of patients request GLP-1 prescriptions, and PCPs approve these requests 53% of the time. However, 77% of PCPs reported conducting a thorough physical evaluation before prescribing, assessing for comorbidities such as diabetes, cardiovascular disease, and hypertension—conditions that telehealth prescribers may not be capable of evaluating.
More than half (56%) of surveyed physicians require patients to attempt non-pharmacological interventions, such as diet and exercise, before considering GLP-1 prescriptions. An overwhelming majority (87%) agree or strongly agree that GLP-1s need to be paired with an improved diet to drive healthy weight loss, while 79% emphasize the importance of exercise.
GLP-1 Prescriptions and Liability Risks
With new indications for GLP-1 medications in areas such as sleep apnea, substance use disorder, and chronic kidney disease, the demand for semaglutide-based treatments is expected to continue rising. While telehealth might enhance accessibility to this type of care, without proper PCP oversight, the likelihood of an increase in adverse outcomes and medical liability claims related to semaglutide-based treatment is high.
If patients begin experiencing adverse outcomes from improperly prescribed GLP-1 medications, both the telehealth providers and uninformed PCPs are likely see a spike in medical negligence claims for inadequate medical oversight, failure to monitor comorbidities and side effects, improper patient selection, drug interaction, or inappropriate discontinuation of treatment.
This article first appeared in the March 2025 edition of Medical Liability Monitor.