Dear Commons Community,

In a blow to the growing telemedicine business, the Texas Medical Board voted yesterday to limit telemedicine practice in the state.  As reported by the New York Times:

“Taking a stand against the rapidly expanding use of telemedicine, the Texas Medical Board voted Friday to sharply restrict the practice in the state, siding with organizations representing doctors over the objections of industry representatives who said the new rules would reduce access to medical care at a time of increasing demand.

The vote was the latest salvo in a four-year battle between the state board, which licenses and regulates doctors, and Teladoc, a national company based in Dallas that provides telephone or video consultations with doctors on its staff, typically for routine problems like urinary tract infections, sore throats and rashes.

It also comes as companies like Teladoc, helped by enthusiastic investors and rapid advances in technology, are seeking to expand around the country, promoting their services as a convenient, inexpensive alternative to the emergency room, retail clinics or doctors who do not work nights or weekends. Many states are loosening restrictions on telemedicine, and requiring insurers to pay for it, citing doctor shortages and pressure to increase convenient access to medical care, partly because of the Affordable Care Act.

Texas, however, is moving in the opposite direction. The Texas board already required doctors to establish a relationship with patients before giving a diagnosis or prescribing drugs.

But on Friday, it changed its rules to state that “questions and answers exchanged through email, electronic text, or chat or telephonic evaluation of or consultation with a patient” are inadequate to establish a doctor-patient relationship. The move significantly tightens rules that already preclude video consultations except under a narrow set of circumstances.

The Texas Medical Association and other groups representing doctors in the state strongly supported the new restrictions, citing concerns about patient safety. In a letter to the board, the association said it “supports the use of telemedicine that can provide safe, high-quality, timely care,” but that safeguards must be in place “to protect patients and ensure telemedicine complements the efforts of local health care providers.”

But Jason Gorevic, the chief executive and founder of Teladoc, said in a statement that the new restrictions were “a huge step backward for Texas,” eliminating “a safe, affordable and convenient health care option that many have depended on for more than a decade.”

The new restrictions do not outright ban telemedicine, however. Doctors will still be able to treat patients by phone or video from another location under certain circumstances. For example, patients will have to be at a hospital or clinic, with a second health care provider there to “assist.” The new restrictions do not apply to mental health visits, most likely because of a continuing shortage of psychiatrists.”

It seems to me that by its actions, the Texas Medical Board is putting quality health care ahead of the business of health care.

Tony