Document Type
Article
Abstract
With the widespread availability and use of the Internet in today’s society, physicians have started communicating virtually with their patients, even conducting online medical consultations. However, there are many barriers to using the technology of online medical consultations to its full capabilities.
First, many doctors are consulting with patients that they have no established relationship with and have never examined. These doctors are diagnosing ailments, providing a treatment plan, and in some situations, prescribing medication. Diagnosing and treating a patient that you have never examined can be very dangerous, and can place the doctor in significant potential for malpractice liability. In addition, because the liability issues in this area are unclear, some physicians are hesitant to engage in this activity, which creates a barrier to the use of online medical consultation.
The next barrier is lack of uniform laws governing online medical consultations. Because regulation of the practice of medicine is largely governed by states, there is no uniform law regarding the legality of online medical consultations. Hawaii and Texas have laws that are at the polar opposites of each other, with laws in Hawaii legalizing online medical consultations and Texas severely limiting online consultations.
Another barrier is with licensing requirements. Because of the nature of the Internet and the ability to easily practice medicine across state lines, it may require a physician to be licensed to practice medicine in every state that his online medical patients may be located.
The sparse reimbursement of online medical consultations further complicates the picture and creates an additional barrier. Although Medicare and Medicaid reimburse for telemedicine services in limited situations and areas, so far they have not allowed for reimbursement of online medical consultations and it is not clear whether they will do so. However, a few private insurers have offered reimbursement for online consultations during studies conducted to determine whether to continue such reimbursements.
In Part II of this Article, I will review the use of the Internet for medical consultations and provide an overview of telemedicine and cybermedicine and the difference between the two entities. In Part III, I will address the Federation of State Medical Boards (FSMB) and the American Medical Association (AMA) recommendations for online medical consultations, the applicability of federal law to online medical consultations and laws in Hawaii and Texas that govern this area. In Part III, I will also address problems with the regulations, examples of online medical services that are currently available, as well as potential problems with online medical consultations. In Part IV, I will address reimbursement of online medical consultation services by Medicare, Medicaid, and private insurance. In Part V, I will discuss the ethics of providing medical services online. In Part VI, I will discuss the liability issues involved with the online practice of medicine, including a discussion of standard of care, the extent to which current malpractice insurance carriers cover online medical consultations, the applicability of disclaimers provided on medical service websites and their effect on limiting liability. Finally in Part VII, I will conclude that although online medical consultations may be a more cost-effective method of providing medical care, the risks of liability outweigh the benefits. Online medical consultations should only be allowed if the doctor and patient have an established relationship, and even then should only be allowed in certain limited situations.
Recommended Citation
Regina A. Bailey,
The Legal, Financial, and Ethical Implications of Online Medical Consultations,
16 J. Tech. L. & Pol'y
(2011).
Available at: https://scholarship.law.ufl.edu/jtlp/vol16/iss1/3