Law BY KARA NUZBACK
Medical board wages war over telephone treatment
TELADOC ARGUES FACE-TO-FACE MEETING UNNECESSARY FOR NEW PATIENTS A
case working its way through Texas courts could nix operations at a company that provides telephone patient consultations. Dallas-based Teladoc claims a phone call with a licensed physician can serve as a
convenient supplement when patients don’t have the time or money to see their primary care doctors. The Texas Medical Board (TMB) argues a physician must examine a new patient face-to-face before providing care remotely. Douglas Curran, MD, a family physician with Lakeland Medical Associates in
Athens and vice chair of the Texas Medical Association Board of Trustees, says he recently saw a patient — a school teacher with state health insurance benefits
— who told Dr. Curran he’d been treated by a physician through Teladoc, a com- pany that allows patients easy access to a physician, but one in which physicians can diagnose and prescribe treatments for patients after a phone conversation, without ever seeing the patient in person. The patient told Dr. Curran the Teladoc physician diagnosed him with a sinus
infection and prescribed antibiotics. But the patient was still showing symptoms of illness when he visited Dr. Curran’s office three days later. After a face-to-face examination and an x-ray, Dr. Curran says he diagnosed the patient with pneu- monia and saw the patient three days in a row to monitor his progress getting over the infection. “He ended up not being able to work for a full week,” Dr. Curran said. He says
if he’d seen the patient in the first stages of his symptoms — when the patient consulted Teladoc — he could’ve offered a higher level of care. “I think that’s going to happen a bunch,” Dr. Curran warned. According to its website,
www.teladoc.com, Teladoc offers member patients
access to their own medical records, 24-7 access to board-certified physicians, and same-day video or telephone consultations, depending on what the patient prefers. Teladoc’s customers include the commercially insured population of Aetna in
Texas, 800,000 patients covered by Texas Medicaid managed care plans, about 25,000 Medicare patients, and a number of children in foster care for the Texas Health and Human Services Commission, according to court records. Some physicians, including Dr. Curran, say a phone conversation is not
enough to properly diagnose and treat a patient with whom the physician is unfamiliar. “To be able to look at them and see them and touch them — that tells you what’s wrong with people,” he said. TMB agrees; in most cases, the board says, a physician must conduct a physi-
cal examination of a new patient before the physician can provide treatment via telemedicine.
April 2015 TEXAS MEDICINE 45
“I hope the one who comes out on top is
the patient.”
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