By Dr. Latisha Rowe
When it comes to telemedicine the Primary Care Physician is wholly screwed. After spending years to establish relationships with their patients, any overnight telemedicine startup can sign a contract with a private insurer and shut the patients Primary Care Physician (PCP) out on telemedicine. Even if the doctor is credentialed with the said insurance provider the insurance company can deny reimbursement to the physician for seeing their patient virtually since they have signed a separate contract with a large telemedicine network. The employers pay the telemedicine company month over month for this “benefit” whether the patients use it or not. That’s why telemedicine companies are being sold for 100s of Millions of dollars despite 1-5% utilization. The young telemedicine CEO is laughing his way to the bank and the struggling doctor, buried in medical debt, is working a side job to make ends meet. Sounds crazy and surreal but its exactly what is happening today.
The craziest part is the doctor may have to sign up with the same corrupt, monopolizing telemedicine company that stole their business for $25 per patient (no good doctor comes that cheap) just to make ends meet. And if you are thinking “well this is good for the patient”, it isn’t. The patient would be better served being seen online by their own doctor. However, a GOOD provider can be accused of violating the anti-kickback statute if they partner with the wrong tele-health partner and are found to be being “enticed to refer”. For example, if a dermatologist pays for telehealth equipment to placed in the office of a Primary Care Physician (PCP) the equipment is an incentive. Its ok for the insurance companies to entice their members to see one telehealth provider but it’s NOT ok for a company to put a telehealth kiosk (for Free) in a doctor’s office.
So it may seem the doctors have their hands tied; the patients have NO CHOICE in who they see and the telemedicine machines are in bed with the insurance companies. It’s a win-win for them and a lose-lose for US... “Us” being doctors and patients. As a primary care doctor who fights and advocates for my patients daily, I see the frustration when they are torn between me, the provider they know and trust, and some RANDOM doctor they have never met online. They can see me but thanks to the deal the insurance companies made with… dare I say “the devil” … they would have to pay me cash. Telemedicine is supposed to provide better ACCESS to care but you don’t have access to the docs you need. These companies are handing out prescriptions like candy, and they couldn’t care less about evidence-based medicine, this isn’t good for anyone. If we don’t put a halt to the virtual pill mills and sanctioned contracted kickbacks, healthcare will be more disconnected than ever. If telemedicine continues to boom while shutting out the largest providers of primary care; when you need a good doctor good luck finding one. The GOOD NEWS is, physicians can compete against the corporate practice of medicine and win. All they need is someone walk them through the process and teach them how easy telemedicine can be. That’s exactly what we plan to do at the Virtual Physicians Summit, the first telemedicine conference for physicians by physicians. So, there is hope, but like musicians who took their music back from the record labels and invested in TIDAL, its time doctors take medicine back and invest in US.
Learn more about best practices in Telemedicine at our website, www.virtualphysicianssummit.com.