The Texas Medical Board on Friday adopted new rules governing the practice of telemedicine, mandating that physicians be physically present when diagnosing an ailment or prescribing drugs.
The Texas Medical Board has spent nearly four years attempting to adopt amendments to its guidelines that require a “defined” physician-patient relationship before diagnosing an individual, which would require an in-person consultation. It tried to impose an emergency rule change, and also threatened to discipline physicians who practiced telemedicine through Dallas-based Teladoc, the largest provider of telehealth services in the U.S.
This triggered a flurry of lawsuits and appeals that ultimately led to the board following its defined process for passing amendments: Publish the changes, allow for public comment, hold a hearing, and pass or deny the amendments during a scheduled meeting.
On Friday, the board approved the rules. The Texas Medical Association stood in support, arguing that it is important to maintain the physician-patient relationship by requiring an in-person meeting. But that effectively guts the business model for many telehealth companies—if the state is requiring the presence of at least a nurse practitioner or physician assistant, the access granted through a telephone or video consultation no longer exists with as much freedom.
Many doctors, like family physician Dr. Doug Curran of Athens, says a phone call just isn’t enough to properly diagnose a condition. He spoke of a patient of his who was prescribed antibiotics for a sinus infection during a telephonic consult. Three days later, he sought care and learned he really had pneumonia.
“You know, I’ve been doing this over 30 years and I don’t feel comfortable—even with my own patients—seeing them over the phone if I can’t see them the next day,” he said.
Teladoc has defended its practices, saying all its physicians are board certified and citing that it has never had a liability claim filed against it over the course of more than 700,000 consults. Bill Hammond, the CEO of the Texas Association of Business, told the board on Thursday that the rules “will drive a stake right through the heart of telehealth,” The Austin American Statesman reported.
The company’s chief legal officer, meanwhile, told the board that the rules would cause Teladoc to lose $15.5 million, largely because it will affect large-scale accounts with insurance providers like Aetna and employers like Pepsi-Co and Domino’s.
The rule change goes into effect on April 30.
Below is Teladoc’s full statement:
Unfortunately, the Texas Medical Board’s decision to adopt a new rule takes away Texans’ access to a safe, affordable and convenient health care option that many have depended upon for more than a decade. As Texas’ population booms, health care expenses climb, and the shortage of primary care physicians grows, telehealth is a solution for patients dealing with common, non-emergency issues. This rule change only serves to intensify these problems without providing any benefit to Texans.
As written today, the new rule also outlaws the longstanding practice of physicians providing traditional on-call services for one another, affecting every physician and patient in the state. One of many unintended consequences of this change.
If the rule change takes effect this summer, it will represent a huge step backward for Texas. California, Colorado, North Carolina, Kentucky, Virginia and dozens of other states have found solutions that embrace telehealth, and all of its benefits, while ensuring patient safety.
We are hopeful that legislative leaders in Texas see the urgency in protecting patients and physicians and will be similarly forward-thinking and take action to deliver the benefits of telehealth in Texas.
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Autor(en)/Author(s): Matt Goodman
Quelle/Source: D Healthcare Daily, 10.04.2015
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