Kate Harveston* –
The concept of telemedicine — or doctor’s appointments performed remotely over voice and video chat — is growing in popularity. It’s an invaluable tool for individuals who can’t get to their appointments, or for those who live in rural or underserved areas.
While they are no replacement for a trip to the doctor’s office, they can be very useful for simple maintenance appointments. This reduces losses for the practice in the form of missed or skipped appointments.
It sounds like a great option, but some professionals have become concerned about the legality of telemedicine, especially in the face of the opioid problem that the country is facing.
What does the legality of telemedicine look like, and how might it change as time goes on?
Traditionally, practicing doctors are limited to the state in which they are licensed. For a doctor who only sees local patients, this isn’t a big deal. Telemedicine greatly expands their borders, though, potentially making it easy and feasible to treat patients from across the country and around the world.
However, the doctor is still technically only licensed to practice in his or her home state, which creates grey area.
The Interstate Medical Licensure Compact, which went live in 2014, makes it easier for doctors to practice in other states. Any doctor that possesses a full and unrestricted medical license in one of the member states can apply to practice in any other member state.
As of December 2016, 18 states have joined the compact and seven more have introduced legislation to join.
Participating in the compact means a licensed doctor can bypass the standard procedures required for licensing. It also reduces the costs associated with licensing, and makes the process faster.
This would help remove the licensing restriction for telemedicine doctors practicing across state lines. However, the future for doctors who don’t reside in these states and wish to expand their reach through the use of telemedicine is still unclear.
The Opioid Crisis
In October 2017, President Trump declared a public health emergency. The administration has since attempted to outline steps to address the opioid crisis, and one step introduced to combat the crisis is to allow the prescription of controlled substances via telemedicine appointments.
This allows doctors to not only care for and monitor their patients remotely, but also allows for the prescription of things like naxolone, an anti-addiction medication.
Telemedicine allows patients who are being prescribed controlled substances to contact their medical provider quickly, improving overall patient care.
Removing the face to face consultation restriction for these prescriptions might seem counterintuitive, but many posit that it could actually help combat the opioid epidemic by keeping doctors more involved with their patients on a regular basis.
Telemedicine and Malpractice
Telemedicine gets a bad reputation for creating higher liability problems, but healthcare providers have so far found that this is not the case. If anything, having documented and billable telemedicine appointments instead of off-the-record phone calls helps reduce liability.
Having that paper trail, even for low-liability routine appointments, helps protect both the patient and the medical provider.
Not all malpractice insurance providers will cover telemedicine yet, however, so it’s important to determine what is covered and what is not. Telemedicine malpractice insurance might increase premiums, but it may also be covered or included with an already established policy.
The Question of Informed Consent
Informed consent is an important part of medicine. It’s up to the doctor to ensure their patient completely understands any action they take before they can consent to the procedure. Informed consent laws vary by state. Telemedicine practices that are serving patients across state lines must adhere to both the laws of their home state and the laws of the state where their patient resides.
Telemedicine is a quickly growing field, and as more states join the Interstate Medical Licensure Compact, it is likely this field will continue to thrive.
The legalities of telemedicine aren’t as different from the legalities of traditional medicine as they may seem. For now, any doctor who chooses to leap into practicing telemedicine will have to be aware of state laws to ensure they are in compliance.
Kate Harveston is a young writer pursuing a career in journalism. She holds a Bachelors in English and minored in Criminal Justice, so she enjoys writing about anything related to politics, law and culture. If you would like to read more of her work, you can visit her blog, Only Slightly Biased