Physician-Patient Relationship

In the realm of telemedicine, each state has its own laws and regulations regarding the establishment of a practitioner-patient relationship. While all states allow physicians to form such relationships via telemedicine, there may be certain variations and conditions to consider. Some states impose specific requirements on the patient's location, or the modalities used for establishing the relationship. To gain a better understanding, it is advisable to review the specific laws and regulations of each state.

According to the American Medical Association (AMA), a valid practitioner-patient relationship should be established before delivering telemedicine services. This can be achieved through one of the following methods:

  • If an in-person encounter is typically required for the service in question, a face-to-face examination may be necessary before commencing telemedicine services.

  • Another option is to have a consultation with a physician who already has an ongoing practitioner-patient relationship with the individual seeking telemedicine services. The physician who has established the relationship must agree to supervise the patient's care.

  • The establishment of a practitioner-patient relationship can also align with evidence-based clinical practice guidelines on telemedicine developed by prominent medical specialty societies. These guidelines, often created by societies like radiology and pathology, outline the standards for establishing such relationships.

Exceptions to the general rules exist, including on-call situations, emergency medical treatment, and other scenarios recognized as meeting or improving the standard of care. In cases where a medical home does not exist, telemedicine providers should help patients identify suitable medical homes and coordinate physicians who can provide in-person services in conjunction with telemedicine services.

For more detailed information on each state's specific laws and regulations, it is recommended to explore the relevant statutes pertaining to telemedicine.