We here at the Robert J. Waters Center for Telehealth and e-Health Law (CTeL) recently shared some thoughts on the blog, A Country Doctor Writes, pertaining to telephone medicine.
Is a practitioner diagnosing and treating a patient over the telephone practicing “telemedicine”, “telehealth”, or something else?
The blog’s author writes about how he received a postcard from a company “looking for physicians for telemedicine services.”
His thoughts on the company’s offering and its potential to provide healthcare were interesting.
But he went on to describe his personal experience with diagnosing and treating over the telephone, without the benefit of a physical examination.
The patient: his grandchild and a case of strep throat–and the diagnosis he missed over the telephone.
We shared with him that CTeL has undertaken extensive research with state medical boards throughout the country on what is required to establish a physician-patient relationship to meet the standard of care. Much of our research is found in 50 state surveys in our CTeL Members Library. Our 50 state prescribing requirement survey is the most popular.
Telephone diagnosing of strep throat would likely not pass the standard of care test in many states, from what we are told by state medical boards.
But more to the point of this blog post, many in the field of telemedicine would maintain that telephone diagnosing is not telemedicine in its truest form. By the definition of the Centers for Medicare & Medicaid Services, as well as many in the field of telemedicine, telemedicine requires audio-video real time communication.
So, the discussion goes on as to what is telemedicine. And the discussion continues on a proper physician-patient relationship and meeting the standard of care.
In the case of physician-patient relationships meeting the standard of care, though, there is only one “decider” that really matters. It’s not your in-house legal counsel, nor the law firm you hired.
It is the state medical board in that state that will be the decider whether your program or business model meets the appropriate physician-patient relationship and standard of care definitions in the state where the patient is located when the treatment occurs.