The Idaho Legislature this year overwhelmingly passed HCR 46, calling for the state to develop a new set of standards for telemedicine and “tele-health,” which it defines as using technology “to enable the diagnosis, consultation, treatment, education, care management and self-management of patients at a distance from health providers.” Telemedicine, the measure says, “can result in significant savings to patients and payors by avoiding travel costs, duplication of tests and loss of work time,” and “will play an increasingly important role” in Idaho, with its rural nature.
Yet, just as the resolution passed, the Idaho Board of Medicine was imposing career-threatening sanctions against a young doctor for prescribing a commonly used antibiotic to one Idaho patient through a telemedicine company without an in-person physical exam. “You want to have an established patient relationship – you want somebody that’s evaluated you, looked at you,” said Nancy Kerr, executive director of the Idaho Board of Medicine. Now the nation’s largest provider of telemedicine consultations has pulled out of the state.
For 38-year-old doctor Ann DeJong, who is licensed to practice medicine in nine states including Idaho, the board’s sanction has triggered reviews of her licensing in all those other states, and now threatens her board certification. “When you’re not board certified and you have restrictions on your license, your credibility burns out and nobody wants to hire you,” DeJong said. “I was the guinea pig, I guess, the precedent,” she said. “I’m like a mouse in some sort of horrible maze.”
Kerr said Idaho has long had telemedicine, in the form of doctors consulting with other doctors through electronic means. But the treatment of patients from a distance has drawn a no-go. In March, the chief of medicine for Teladoc, Dr. Henry DePhillips, requested to appear before the Idaho Board of Medicine. That’s the telemedicine provider that bought out DeJong’s former part-time employer. The board unanimously declined to give him that opportunity, according to its minutes, “due to existing Idaho Code prohibition on the model of practice described.” You can read my full story here at spokesman.com.