Texas Medical Board ruling strikes blow to telemedicine services

The Texas Medical Board has ruled that doctors must examine patients in person before they may order prescriptions for them, striking a blow to telemedicine provider Teladoc.

The board and Teladoc have wrangled in court since 2011, largely over the three-word phrase: "face-to-face," and Teladoc President and CEO Jason Gorevic says he will take the fight to the legislature, reports The Dallas Morning News.

The board, however, pushed back the effective date of the rule to June 3 to give lawmakers time to review it.

The board's rule requires a "defined" physician-patient relationship that requires  that physicians conduct a physical examination of the patient "as part of a face-to-face or in-person evaluation," held to the same standards of "acceptable medical practices." Questions answered by the patient through email, electronic text, or chat or over the phone won't do, according to Dallas/Fort Worth Healthcare Daily.

Board President Michael Arambula, M.D., said the decision would not end telemedicine in the state. 

"However, a telephone medicine scenario that allows a physician to treat an unknown patient without any objective diagnostic data and no ability to follow up with the patient sacrifices the patient's safety for convenience," he said.

Teledoc CEO Jason Gorevic says its physicians must review a patient's records before conducting a phone visit. He argues the new rule would prevent doctors from covering for one another's patients by phone, a contention the board rejects.

The rule follows the Federation of State Medical Boards' policy on appropriate use of telemedicine, which calls for doctors to establish a "credible patient-physician relationship."

Tennessee's Board of Medical Examiners has proposed similar rules. Teladoc Chief Medical Offier Henry DePhillips, M.D., opposed them last year in an opinion article for The Tennessean.

DePhillips said the proposed rules would negatively affect rural residents of the state, especially because Tennessee already faces hospital closures and a shortage of physicians in small towns, FierceHealthIT previously reported.

Last fall, Idaho's medical licensing board sanctioned a doctor licensed in the state who prescribed a common antibiotic over the phone while working for the telemedicine company Consult-a-Doctor.

To learn more:
- read the Morning News article

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