Increasing Interest In Telehealth From State Medical Boards
August 1, 2000
The Federation of State Medical Boards (“Federation”), which is composed of all United States Medical Boards and a number of foreign medical licensing entities, acts as a clearing house for licensure and discipline, and alerts licensing boards concerning any physician who has lost his license in one state and attempts to move to another state to continue to practice. Although only licensing bodies may be actual members, the Federation permits others to receive its publications and attend its meetings.
The Federation’s 88th Annual Meeting was held in Dallas, Texas during April 2000. While the meeting agenda addressed a broad range of topics, telehealth, which may be defined generally as the giving or receiving of some type of health advice or care when the provider and the patient are not in immediate physical proximity, emerged as the central theme of the meeting.
Many attendees at the annual meeting expect telehealth to spawn some sort of national licensure, which is viewed by some as a threat to the autonomy of state boards. Such state independence already seems to be weakening. New federal legislation permits military physicians to practice in private hospitals if the physician has one unrestricted state license, just as they now do in VA and other government hospitals. This was viewed by some attendees as opening the door to further federal licensure issues. The scope of this legislation is broad; it covers “medicine, osteopathic medicine, dentistry, or another health profession”. . . as long as the individual “ . . . is performing authorized duties for the Department of Defense.” While this universal authorization may take place “in any state, the District of Columbia, or a Commonwealth, territory or possession of the United States . . .” it must be “. . . in a health care facility of the Department of Defense, a civil facility affiliated with the Department of Defense, or any other location authorized by the Secretary of Defense.” Thus, the member boards are rightfully concerned about their role in the increasingly global health care marketplace.
Discussing telehealth also invariably leads to discussions of its use in traditional and alternative medicine, the problems that it may create through improper prescribing without adequate examination, and its role in outright Internet fraud. These concerns engendered debates over effective methods of protecting the health care consuming public from these telehealth-spawned problems. Many attendees felt that one of the best ways to protect the public is through the power of information. The Federation is expected to keep the public informed of the potential dangers of telehealth, and make certain that patients are always given full and complete information upon which to base their fully informed consent to any medical treatment.
Moreover, there is strong indication that there will be additional scrutiny on a nationwide level during the coming year in the areas of alternative medicine and informed consent. Since these two issues are closely linked to telehealth, the member boards will be looking closely at Web activity to uncover practices that are below the standard of care, unscrupulous, or outright fraudulent, regardless of the persuasion of the perpetrator. All indications are that the member boards will consider the lack of fully informed consent to be the basis for prosecution in any gray areas that arise. Heath care providers are forewarned to use care.