Telemedicine: Opportunity for Office-Based Physicians?

Thanks to a perfect storm of improved technology, governmental support, and increased cost of in-person care, telemedicine is evolving and expanding at the same time.

As a recent op-ed published in iHealthBeat noted, the American Telemedicine Association (ATA) estimates that more than 10 million Americans have directly benefited from some sort of telemedicine service this past year, probably double from just three years ago.

Perhaps most notably, while there have been insurer restrictions in the past, this year a growing number of them are changing their tune. Last year, UnitedHealth and ATA worked together to overcome a potentially harmful proposal to telemedicine that came before the American Medical Association's House of Delegates, iHealthBeat reported. In addition, as of 2013, online video visits will become a covered benefit by WellPoint and other private insurers.

But all of this expansion and evolution raises a few questions for physician practices: Is telemedicine a good thing for office-based physicians? Will it present more opportunities for practices? Or, will all the teledoc services take away business?

Doug Lawrence, who manages telemedicine services for the Indiana University Health Physicians in Indianapolis, told Physicians Practice he sees only great opportunities for doctors.

“With the large influx of new previously uninsured patients there will be more patients to care for with the same number of hours and physician's trying to maintain quality of life,” said Lawrence. “Physicians can see more patients in locations other than their traditional offices. Overhead will be reduced by potentially reducing their long-term costs even with the investment in telemedicine technology (this technology costs are being reduced each day). There will still be a need for the traditional physician offices, but when needed the space can be shared.”

In a recent blog on finding new revenue sources, one physician described how he supplemented his income by adding telemedicine visits to his schedule.

"It's especially pertinent for me to find new revenue sources because, for physicians in training, compensation tends to be more limited, just based on how the structure of our training is," internal medicine physician Robert Galamaga, who is based near Chicago, told Physicians Practice. "All it takes is a couple of minutes out of my day from doing whatever I might be doing, whether I'm home, traveling, sitting in a coffee shop, or somewhere where I can step aside and talk for a few minutes with a patient.”

But it seems not all physicians stand to benefit from non-office visits.

In a recent Practice Notes piece “Electronic Access to Physicians is Good, Fragmentation is Bad,” writers James Doulgeris and physician Nicholas Bonvincino point out that while there is a lot to like about using the proliferation of smartphones, e-mail, texting, and cameras to handle patient issues “ without clogging physicians’ offices and schedules,” there’s also a downside.

“One’s gain is usually someone else’s loss,” Doulgeris and Bonvincino wrote, noting that specialists who lose a few visits and primary-care physicians who are not networked might see non-office visits as lost fee-for-service revenue.

Also, there is a greater potential for fragmented care when patients choose to bypass their primary-care physician to connect with other doctors via virtual means, Doulgeris and Bonvincino suggest.