Advice for Doctors and Nurses Diving into Telemedicine

Advice for Healthcare Providers and Medical Workers Diving Into Telemedicine and Telehealth Due to Changing Regulations, COVID19 and more.

Vasanth Kainkaryam is an internal medicine physician.

As we have literally overnight plunged into the world of telemedicine, I wanted to caution everyone to stop and think about something.

As an avid telemedicine provider, I truly believe in helping support our patients and the public. However, if anyone is an employed physician or medical provider, please keep reading.

If your practice did include telemedicine before, this may be a non-issue. But if it didn’t, you need to ask these critical questions.

Unfortunately, for many health care providers, there are restrictive covenants or non-compete agreements. Typically, if it’s a service that the employer doesn’t offer, there isn’t as much issue with moonlighting or performing that service should you leave your employer in the future.  However, literally overnight health care companies across the country are plunging into telemedicine, and providers are being asked to participate.

While doing the right thing for our patients (and I agree, this is the right thing), you need to know the consequences of how it affects you, so make sure you think about asking these questions:

1. When you started your job, telemedicine wasn’t a part of it. Now it is. Does your non-compete/restrictive covenant apply to telemedicine now if it wasn’t in your initial job description?  If so, this may significantly limit anything you may want to do on your own afterwards.

2. Many telemedicine companies are drastically hiring, and you see ads left and right. If your company is also providing telemedicine as a service, is moonlighting with other companies a violation of your contract (as you now may be competing for the same patients given sudden reimbursement changes)?  Does your contract require you to obtain permission to deliver a service that is potentially competing against one your employer company delivers?

3. Is your employer aware of the correct billing for Medicare and Medicaid (if you bill for it)? Remember, even if someone else is completing your coding and billing, as a provider credentialed to bill under Medicare and Medicaid, you are ultimately responsible for those codes, and any inappropriate billing will be your responsibility as a billing provider.  Is your billing team trained?  Are they aware?

Important things to think about.  All too often, physicians and other health care providers have tried to do the right things for our patients to ultimately have had our hand slapped.

So pause for a second, get the questions answered, know what future implications are for today’s actions. Make the right choice for your patient, and for yourself, especially if it means amending your contract before you start something that may limit your talent/potential as a health care provider.

We are taught to feel powerless, which is why our burnout rate is so high.  Words are disguised to mean another: patient volume/productivity disguised as patient access, EHR checkboxes that are clinically meaningless disguised as quality measures, your bedside manner, and ability to relate disguised as patient satisfaction surveys.  And yet, as we see, despite being made to feel powerless, at the end of the day, we are the only ones with the ability to provide medical care when people need it. An anesthesia machine, scalpel, laboratory, and stethoscope are all useless without the person with it.

So get out there and wear your warrior uniform and help your patients! But don’t have it be a disguise for being made to wear shackles tomorrow.


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