Thinking About a Telehealth Practice?

Cliff Ennico on

"I am a young (mid-30s) physician who has just completed his residency and recently bought a suburban general medicine (internist) practice.

Your column last week about building a successful medical practice struck a chord with me, and I hope you won't mind a related question.

My practice is in a rural area, and, while I have enough patients to keep my head above water, there isn't a lot of room for growth.

I've been reading a lot lately about telehealth -- offering medical services online -- and am thinking about setting up a telehealth service for patients around the country with a particular condition I'm especially well-qualified to treat.

Can you put something in a future column about this?"

Absolutely. Before the COVID-19 pandemic, I used to speak around the country to organizations of doctors, lawyers and other professionals, and my message to them was always the same: A professional practice (while heavily regulated and subject to strict ethical rules) is, to some extent, a small business like any other. In trying to succeed and grow a professional practice, you will face many of the same challenges as any other entrepreneur. Looking for creative ways to reach new patients is certainly a way to grow, especially in an environment where "organic" patient growth is extremely limited.


When it comes to the law, telehealth -- offering medical services remotely via Zoom meeting or another online platform -- shares some similarities with marijuana (cannabis) regulation: There is no comprehensive federal law regulating telehealth. Instead, there is a patchwork of state regulations, and, as with cannabis regulations, they are all over the place.

Complicating the picture is that many states (including my home state of Connecticut) have enacted "temporary" telehealth laws that will expire (or "sunset") as soon as the COVID-19 emergency is over. When seeking guidance online, be sure to check the "last updated" information on an article or blog. Some websites that purport to summarize COVID-19-related laws around the country have not been updated since 2019 or early 2020 and so cannot be relied upon as competent legal advice.

Here are some of the questions you will need to ask before setting up your telehealth website:

What Type of Telehealth Practice is Permitted? Most states define "telehealth" or "telemedicine" as the use of synchronous (live) two-way electronic audiovisual communications between a patient and a doctor for the purposes of receiving health care treatment. There are additional communications that qualify as telemedicine, including:


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