Does Letting Texas Doctors Regulate Telemedicine Pose a Conflict of Interest?

The state already has a doctor shortage – dozens of counties have none at all – so why would the state not want to allow Texans to meet with their doctors remotely?

By Laura RiceOctober 19, 2016 10:28 am,

The telemedicine trend – in which a doctor meets with a patient through video conference – has made its way to Texas. But Teladoc, a company based in North Texas, has faced some hurdles in the state, namely a conflict over antitrust laws.

The Texas Medical Board requires doctors to meet with patients in person before they’re allowed to treat them remotely. Teladoc says that violates federal antitrust laws and filed a suit against the state and its medical board. Texas dropped their appeal on Monday. But why?

Erica Teicher, the New York bureau chief for health news site Modern Healthcare, says the state is trying to regulate the way doctors interact with their patients.

“They’re saying that they want to make sure that it’s high quality by having doctors have personal relationships with their patients,” Teicher says. “In order to have a telemedicine appointment with a doctor, you would have to first meet that doctor in person… Teladoc is saying that that’s not necessary. They have enough controls for telemedicine where you’re able to get high-quality treatment.”

Texas has a physician shortage already – a 2015 report found 35 counties in Texas have no physicians at all – and Teladoc says they’re trying to bridge that gap, Teicher says. But telemedicine would mean less work for doctors who didn’t want to participate in telemedicine and the Texas Medical Board is made up of doctors who are regulated by the board.

“So there creates this conflict of interest,” she says, “and when they’re then narrowing telemedicine, it’s potentially creating a benefit for their members.”

The Federal Trade Commission and the Justice Department say the regulations on telemedicine should be “completely eliminated.” State medical boards across the country regulate doctors in their state and most states are allowing telemedicine to move forward. Only two – Texas and Arkansas – have curbed it.

“It’s really booming across the country,” she says. “For instance, Teladoc is actually able to have its physicians work and provide telemedicine visits in most other states, but Arkansas and Texas are the two that have particularly been fighting back against that.”

Going forward, the fight Texas is putting up against telemedicine isn’t looking good, Teichert says.

“The courts really haven’t been too keen on allowing Texas to scale back on telemedicine like this,” Teichert says. “…I think they’ll either have to completely redo these rules, redo their oversight, or they’re probably not going to be able to regulate medicine in this way.”

Post by Hannah McBride.