Patients have a crucial need to reach health providers. A health provider needs to understand a complaint and be familiar with the patient. Traditionally, this required a face-to-face encounter between a patient and a health provider. There are circumstances when rendering an opinion face-to-face is not feasible or may be too time-consuming, or simply involve unnecessary expense. Face-to-face encounters require discussion, scheduling, traveling and office time that is wasted for a condition that could be solved with remote discussion and possibly a transmitted prescription.
Phone treatment of a person whom the health professional knows is often a good way to give care. Care rendered to an unknown patient might well lead to trouble. This Texas decision is apparently designed to eliminate such evaluations for patients who do not have an ongoing relationship with the health professional. As described, this decision sounds valid.
I often deal with patients by phone or with other forms of discussion. The other day, I discussed the physical complaints of a long-term patient using FaceTime. I prescribed medication based on what he showed me on the phone. He emailed back a few days later with good results. I have often used camera-phone JPEG pictures for assisting with rashes or suspected insect bites. I assessed the swollen legs of a patient who was calling from her Paris hotel room overlooking the Champs-Élysées. Skype is another reasonable means of communication. Email communication is appropriate where verbal description is adequate. At times, appropriate treatment requires lab testing, such as getting a urine culture at a lab just before beginning treatment, in case symptoms don’t improve. Such lab tests and prescriptions can be arranged remotely.
At times, phone call can discriminate between a cough, mild asthma, and life-threatening asthma. Recently, a patient in Bayside, Queens called me. Whereas she was able to speak, but was quite short of breath, I immediately had a private ambulance (Hatzolah) go to her apartment and bring her to her pulmonologist at a Manhattan hospital. They were at her apartment in five minutes, giving her oxygen and transporting her. I have known her for a few decades and could discriminate her needs appropriately. Using a conventional 911 ambulance would have been ok, but she would have to deal with a whole new set of physicians who would not have been familiar with her unique condition.