Personal Health, Telemedicine and Access Collide

Props to HISTalk for coverage of the San Francisco Telemedicine case. There is no doubting the tragic loss of a young life to suicide (19 year old Stanford Student committed suicide) but the background to the case and in particular the telemedicine element emphasizes the archaic nature of laws and practice of medicine which may be nominally one country but behaves as though it were 51 states (I know 50 states plus a district but that behaves like a state albeit without “representation”). This is not a commentary on the treatment choices but about the surrounding legislation for the practice of medicine across state lines.

A lot of medication is prescribed over the Internet…..Can California regulate it in this fashion? … No out-of-state telemedicine provider has ever been jailed for practicing medicine in California

Best practice aside the litigation does not address the fundamental problems and why a 19 year old would be accessing an on line pharmacy for prescription drugs and even the reasoning behind such a choice. That aside the basis of the lawsuit is the Colorado doctor’s lack of license to practice in California….. he is licensed to practice in Colorado. Seems a license to practice in Colorado should be sufficient unless there is some disease, condition or drug that is unique to California that requires additional testing, licensure and validation to ensure that the doctor meets the necessary quality standards in ANOther State. It is bad enough that the International possibilities that used to be associated with a career in medicine have diminished over the last 50 years but it would seem that we are now placing artificial barriers up to the practice of medicine across state lines…..why?!

Current laws allow for:

…state law allows out-of-state doctors to practice “telemedicine” through the Internet or interactive audio or video transmissions, as long as they act in consultation with a licensed California physician.

Again this is archaic regulations and the only reasonable explanation must require that we “follow the money”… this is not about safety, quality of care or any other mantra.

Like Mr HisTalk I agree – we should be focusing on streamlining the regulations, standards and privacy requirements rather than creating a web of complicated and artificial reasons to prevent the application of technology to allow for telemedicine and remote treatment and diagnosis.

Lets hope this will be a part of any reform packages proposed – time for the US States to step out of the dark ages and catch up with the times and at the same times addresses some of the disparities in cost (and quality) that exists across state lines (some quality reports suggest better value for money paid in one state vs others) and even international borders (drug costs that are 77% higher in the US for comparable drugs).