Telemedicine seems to be everywhere these days – press conferences, social media, podcasts, etc. It isn’t a new concept by any means; services like Doctor on Demand have been around for a while, and even many insurance providers have rolled out their own versions of telemedicine apps.
The concept has been poised to disrupt current healthcare practices for quite a while, but the current world situation is accelerating its integration exponentially.
There’s a lot to keep up with in modern medicine, and utilizing telemedicine can seem like just another layer of complexity. However, it can also be a powerful tool, and a way to get ahead of the next wave of tech-based medicine.
Whatever your thoughts are, though, the current need for social distancing and remote assessments brings an opportune time to look into the pros and cons of telemedicine for both patients and providers.
What is Telemedicine?
Well, to begin, let’s contrast two popular terms right now: telehealth and telemedicine. While the terms are similar, they are actually very different things. “Telehealth” is the use of online and digital services to promote patient health and education. Examples of this include websites and apps designed to teach people about basic health and nutrition.
“Telemedicine” is the use of digital communication in the form of apps or video-conferencing software to treat patients clinically. It involves what would normally happen in a typical doctor visit, including diagnosis and treatment.
Pros and Cons for Patients
For the patient, the pros are obvious: simple accessibility, speed, and lower cost. The ease with which patients can hop on and use a telemedicine platform to see a doctor is far easier than getting in the car and, for some, driving an hour to visit their doctor.
For example, I had a friend who wanted to see a dermatologist for a simple skin issue. She tried to set an appointment with a dermatologist and was told it would take three weeks. Instead of waiting that long, she jumped on a telemedicine platform, was able to speak to someone within thirty minutes, and was given a treatment plan.
The cost for patients can also often be far less than the cost of a typical doctor's visit.
Of course, there are also obvious cons to this scenario. So much of what physicians do requires not only a history, but a physical as well. There’s a huge difference between seeing a rash in person and over a two-dimensional screen.
There are many conditions and diagnoses that cannot be assessed on a video call and need to be deferred to a “live” physician visit.
However, for things that don’t require physicals, there’s a lot about telemedicine that makes sense for patients.
Pros and Cons for the Physician
For the physician, one advantage for telemedicine is the ability to see a large number of patients at their convenience. Physicians get to decide when they log in and see patients on these platforms. They can do it from their own home, or even in their downtime at work.
For many physicians, telemedicine has been a way to have control of their work hours and gain a ton of flexibility. For physicians looking to work part-time, these opportunities have been perfect.
Physicians are often constrained to finding patients within a very specific geographic boundary. Now with the ability to consult online, these geographic barriers have been removed. Especially if you have some additional level of expertise, you can easily attract patients from all over your state.
On the other hand, compensation is handled much differently, and so is billing. It can be difficult to integrate payments into your existing billing system, and the payments themselves are unpredictable.
Utilizing telemedicine also presents a learning curve for both the providers and staff, and at times it can seem like more trouble than it’s worth.
Lastly, there’s the risk of becoming even more of a commodity than we currently are, as telemedicine prioritizes convenience over a physician’s expertise. As more patients utilize these platforms, they may begin to place less value on a physical, thorough examination and more value on getting results and prescriptions done quickly.
How to Get Started
Currently, using telemedicine platforms is a necessity for many physicians. Many patients and physicians simply cannot leave their homes, and with good reason.
Still, the steps are largely the same as ever.
First, you should decide whether you want to be a provider on an established platform or integrate it into your practice.
Signing up with an established provider is as simple as visiting their website, filling out forms, showing proof of licensure, and going through a basic credentialing process.
What used to take six to nine months in terms of credentialing is now being fast tracked due to changes in regulations. I’ve heard of physicians getting credentialed in as little as a week because of the demand.
Here are what some of those physician entry points might look like:
Getting signed up is pretty straightforward. Many platforms will ask you for information very similar to any credentialing process. Every platform is different, though, and they’re looking for particular specialties.
Primary care has the most opportunities, but there are also opportunities for dermatologists, allergists, psychiatrists, and more.
You’ll usually be asked to fill out a basic application, including your license number, education, where you’ve worked, and any sort of judgments in the past.
They’ll then give you an independent contractor agreement along with a W9 form. They’ll also want a CV from you.
Some platforms are nationwide, while others are confined to certain states or regions. So to be a provider on the site, you need to have a medical license in that particular state.
In the past, these national platforms they often only hired providers with multiple state licenses but with today's demands, they're looking for physicians in nearly every state.
I've also heard of situations in today's environment where certain states will allow physicians with other state licenses to practice telemedicine in their state. Please see each state's current policies.
List of Telemedicine Platforms
This group seems to be growing daily but here are a list of some ones you might want to check out. Most of these links will take you directly to their provider sign-up form. (I have no financial interest or association with any of these companies.)
Compensation varies widely from platform to platform, and it depends on the nature of the visit/consultation. Some are for simple refills, while others involve in-depth questioning.
Some of these platforms compensate per visit, while some billed per hour. I’ve seen compensation from $15 to $55 a visit. Of course, depending on length of visit, you can responsibly do three to four an hour.
I’ve even heard of situations where you get paid $2000 per shift admitting patients for a particular hospital. These latter types of jobs have to be negotiated specifically with certain hospitals, however.
Whatever the case, physicians need to still remember to be advocates for their own value. Is it worth your time? That's a question on you can answer.
How Do You Set Up Telemedicine for Your Practice?
These days, many physicians have already worked to figure this out. They’ve used platforms such as doxy.me and others. With the current regulations in place, regulations have loosened.
While this process can be complicated, it’s very doable–especially in today’s environment. It’s outside the scope of this post, but I’d encourage you to find information online (like this) or consider a course like the Telemedicine and Health Technology for US Physicians & Health Care Providers Course.
Telemedicine isn’t going anywhere anytime soon. In fact, what’s going on with this pandemic has greatly accelerated its adoption. Many practitioners who avoided joining telemedicine groups or have been thinking about converting part of their practices to telemedicine are finally taking steps to figure it out, mostly due to necessity.
For many, telemedicine is a great way to diversify your income and position yourself well for the future of medicine. For others, it’s a great vehicle to help create more of the ideal life in medicine. Once it’s set up for your office or practice, you’ll likely find it to be a useful tool and a good way to reach more patients.
How has your experience been in telemedicine? Are there any other platforms that you’ve been happy with?
By the way, I recently had Dr. Naya Sagori, MD on the Passive Income MD Podcast to talk about the ins and outs of telemedicine, how its adoption is accelerating due to COVID-19, and discusses opportunities for physicians to participate in this rapidly evolving technology. Take a listen to the episode here.