AcuteCare Telemedicine Blog


Restrictive Rules On Use Of Telemedicine – Is It To Protect Or To Preserve?

The Tennessee Board of Medical Examiners (TBME) recently issued proposed changes to regulations governing the delivery of medical care through telemedicine technology. Patients in that state who seek care through telemedicine may soon be faced with new, complicated and restrictive regulations. Proponents argue the new rules are necessary to ensure that every patient in Tennessee has a primary care physician.

One of the most controversial rules mandates that patients have a face-to-face visit with a primary care doctor prior to receiving telemedical treatment. In addition, the new rule requires the patient to receive an in-person appointment with a physician annually or on the fourth consecutive time the patient receives care. Vaughn Frigon, chief medical officer for TennCare, the state’s Medicaid program, explains, “We want every patient in the state to say, ‘I have a primary care doctor,’ and that their initial access is through the primary care provider.”

In a time when general practice or specialized care physicians are in short supply, particularly in a state with large rural communities whose residents often do not have access to much needed healthcare, it is difficult for telemedicine advocates to understand how such restrictive regulations will provide rural Tennesseans with better or easier access to either general or specialized healthcare. It is as if the residents of geographically challenged rural areas had the opportunity to utilize a new state-of-the-art super highway to deliver better, less expensive life sustaining benefits offered by the outside world, only to have new restrictions levied to frustrate its use.

Applying the TBME logic to this scenario would mandate that anyone using the new improved highway would first be required to take the old path, slowly winding through the mountains on the old, more dangerous narrow roads so as to ensure the traveler has the opportunity to have the appreciation for the longer travel time and the abundance of beautiful scenery. To be certain that no one misses the experience, once each year, or every fourth trip, each traveler must repeat the more difficult journey.

This analogy may be over-simplified due to the fact that face-to-face medical care is important and will always have an important role in the delivery of quality patient care, but the comparison emphasizes that telemedicine is not a different or a lesser valued form of healthcare, only a different, and in most cases, less expensive and efficient means of delivering healthcare that improves access and availability to patients in rural and outlying communities.

Meaningful regulation across all industries is necessary to ensure the safety and protection of all people and communities. But excessive, though well-meaning, regulations often counter the promises of new technology to improve our lives. Expanding access to efficient, quality healthcare to all people is a worthy goal.


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