While some physician organizations fight the proliferation of telemedicine, the American College of Physicians, representing internal medicine, is embracing it for primary care — while still also trying to protect its turf.
In a position paper appearing this week in the Annals of Internal Medicine, a peer-reviewed ACP publication, the Philadelphia-based medical society acknowledged that telemedicine can increase access to care and patient satisfaction while delivering care that often is more efficient and less costly than in-person encounters. Still, though, the ACP raised some issues with remote care, “including the absence of the physical examination, variation in state practice and licensing regulations, and issues surrounding the establishment of the patient-physician relationship.”
The organization said that telemedicine should be “a component of a patient’s longitudinal care,” and is most effective and “professionally responsible” as part of an established relationship.
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Consumer-facing telemedicine companies clearly represent a competitive threat to the traditional business model of internal medicine. “ACP believes that episodic, direct-to-patient telemedicine services should be used only as an intermittent alternative to a patient’s primary care physician when necessary to meet the patient’s immediate acute care needs,” the organizational policy stated.
Regardless, the medical society wants to see more spending on telemedicine infrastructure and reimbursement. “ACP supports the ongoing commitment of federal funds to support the broadband infrastructure needed to support telehealth activities,” according to the paper.
Similarly, the group asked for continued federal investment in research on the efficacy, safety and cost of remote care, as well as a loosening of Medicare telemedicine payment rules. “ACP supports lifting geographic site restrictions that limit reimbursement of telemedicine and telehealth services by Medicare to those that originate outside of metropolitan statistical areas or for patients who live in or receive service in health professional shortage areas,” the organization said.
The ACP’s Board of Regents approved the policy in April, though the position paper did not appear until Tuesday.
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