Guest posting by Rachel Marren
On April 10, the Texas Medical Board voted in favor of measures that would limit telemedicine in the state of Texas. In order for a physician to use telemedicine to communicate with the patient, the physician must have either (1) previously examined the patient in person, or (2) made a face-to-face telemedical diagnosis in which a different medical professional was physically with the patient taking vital signs and performing a physical examination.
The medical community is very divided on the issue of telemedicine and its role in the future of healthcare. Significant points can be raised for and against each topic:
Pros:
Increased Access to Healthcare
For a number of people, telemedicine would allow them to access quality healthcare when they otherwise would not be able to. People living in rural areas would be able to speak with a physician without having to drive hundreds of miles. Those who are housebound or afraid of doctors’ offices would be able to get treatment from their own homes. People whose jobs require frequent travel or otherwise don’t allow for a potentially lengthy daytime doctor’s visit would be able to obtain care 24/7 from wherever they are located. Additionally, telemedicine would allow for patients to choose a physician based on the quality of care he or she provides instead of simply proximity, and allow physicians in different locations to communicate with each other about an individual case.
Decreased Cost
A number of studies have indicated that telehealth technologies can decrease the cost of healthcare. Telemedicine can reduce the need for patients to come into the doctors’ office for basic check-ins or medication refills. It can also ultimately reduce hospitalizations for patients with chronic illnesses by allowing patients to update medical professionals on relevant signs and symptoms. A consultation from Teladoc, the largest telehealth provider in the country, costs the patient less than $40.
Reduced Spread of Infection
Doctors’ offices and hospitals are often hotbeds of infectious disease, with patients regularly infecting each other and their healthcare providers. Telemedicine would allow sick patients to receive care without spreading their infections to others or putting themselves at risk for additional infections.
Cons:
Technical Challenges
Frequent issues with sound and image quality occur when using video chat software, which would be particularly problematic when trying to make a diagnosis. Additionally, underserved populations who would benefit the most from telehealth services are also the most likely to lack internet access or devices that allow for video chatting.
Loss of the Patient-Doctor Relationship
Most telehealth companies work by matching a patient in need with whatever physician is available, preventing patients from forming long-term relationships with their doctors. This means that doctors will be less familiar with their patients’ medical histories and also potentially feel less accountability for their patients’ well being.
Inability to Perform Tests
Having the doctor and patient isolated means that the physician will not be able to physically able to examine the patient, record vital signs, collect blood or urine for testing, or perform rapid tests for common conditions like Strep throat or Mononucleosis. This means that for many conditions, an accurate diagnosis cannot be made remotely.
There are clearly major potential benefits to implementing telehealth but significant concerns to be addressed. The Texas Medical Board’s latest rules about telemedicine are a step in the wrong direction, as they prohibit most practical applications of telemedical care instead of recognizing potential benefits and seeking to minimize drawbacks. Additionally, to my knowledge, there have been no significant, relevant data to support the Board’s decision.
The ruling by the Texas Medical Board reminds me of responses to the rise of Uber and other similar companies. Taxi companies and various government agencies tried (and, in some cases, are still trying) to fight their expansion. But Uber, which is often the better option for the consumer, is still growing rapidly in the transportation sector. Maybe telemedicine can combat these regulations and do the same for healthcare.
Sources:
http://www.nytimes.com/2015/04/11/us/texas-medical-panel-votes-to-limit-telemedicine-practices-in-state.html
http://www.tmb.state.tx.us/dl/DAD89645-F81F-CF51-6FF8-D0E20891625A
http://www.teladoc.com/
http://content.healthaffairs.org/content/33/2/194.full.html