Texas Medical Board defends state telemedicine practices

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In an opinion piece submitted to the Austin American-Statesman, Michael Arambula, MD, president of the Texas Medical Board, wrote in defense of how the state views and handles telemedicine practices.

"The great news is there are very few telemedicine scenarios which are prohibited in Texas," Dr. Arambula wrote. "Telemedicine can occur at essentially any location where a state-licensed or certified medical professional is available, with diagnostic equipment to facilitate an adequate physical evaluation of the patient, while the physician is seeing and hearing the patient in real time."

Texas has recently come under scrutiny for its telemedicine practices, which many view as becoming increasingly restrictive at a time when other states are expanding telemedicine opportunities, according to The New York Times.

In January, Teladoc filed a lawsuit against the Texas Medical Board, which issued an emergency ruling limiting the use of telephones in practicing medicine. The rule requires a face-to-face visit or in-person evaluation before a clinician can give a patient a prescription.

"The rules, as they're written today, only allow a physician who has seen a patient in person to interact with them remotely," Jason Gorevic, Teladoc's CEO, told NPR. "That's basically saying you can't go shop anywhere else."

In his opinion piece, Dr. Arambula writes this is not necessarily the case. "Under the existing rules, telemedicine can absolutely be used to establish a physician-patient relationship without the patient having to see a physician in person. If the patient and physician are not at the same physical location, the patient can remotely interface with a physician via a hospital, clinic or locations such as a fire station or school nurse's office."

The second part of Dr. Arambula's statement — the list of places an individual must be to establish this type of relationship over telemedicine — is the key source of contention, as it limits where somebody must be located to receive care. Notably missing from the list is somebody's house, which means people still have to travel to receive care.

"The Texas Medical Board understands the need to expand access to care to underserved and remote parts of the state, and the rules allow that expansion to occur while maintaining the safety of patients," Dr. Arambula writes.

More articles on telemedicine:

Vast majority of family physicians would, but don't use telemedicine: 15 survey findings
Walgreens expands telemedicine offerings to 20 more states
3 lessons from UCLA's failed telemedicine study

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