An additional influential person who we should forward our letters of concern about Telemedicine and HR 3880 should be:
Dr. James N. Thompson, M.D
Federation of State Medical Boards of the United States
PO Box 619850
Dallas, TX 75261-9850
phone: (817) 868-4000 / fax: (817) 868-4099
I couldn't find an email address for him, but this appears to be his AMA listing, has the same PO Box and phone # as FSMB:
http://dbapps.ama-assn.org/iwcf/iwcfmgr206/SESSION_ID=2134416/SESSION_AR=63/frm_name=aps_result?action_detail.x=hello&row=0&key=1&amap=N&form_type=r&mem=N]Dr James N. Thompson AMA Listing
Of those who testified before the House, he is about the only one willing to consider phone consult Telemedicine as a viable practice of medicine. Dr. Thompson is the CEO of FSMB.
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Back in April 2002, Dr. Thompson designed the following guidelines for the practice of Internet Medicine:
Quote:
Federation of State Medical Boards of the United States
The recommendations contained herein were adopted as policy by the House of Delegates of the Federation of State medical Boards of the United States, Inc., April 2002
Model Guidelines for the Appropriate use of the
Internet in Medical Practice
Section III. An Appropriate Physician-Patient Relationship
The health and well-being of patients depends upon a collaborative effort between physician and patient.[2] The relationship between physician and patient is complex and is based on the mutual understanding between physician and patient of the shared responsibility for the patient’s health care. Although the Board recognizes that it may be difficult in some circumstances, particularly in an online setting, to define precisely the beginning of the physician-patient relationship, it tends to begin when an individual seeks assistance from a physician with a health-related matter for which the physician may provide assistance. However, the relationship is clearly established when the physician agrees to undertake diagnosis and treatment of the patient and the patient agrees, whether or not there has been a personal encounter between the physician (or other supervised health care practitioner) and patient.
Evaluation of the Patient
A documented patient evaluation, including history and physical evaluation adequate to establish diagnoses and identify underlying conditions and/or contra-indications to the treatment recommended/provided, must be obtained prior to providing treatment, including issuing prescriptions, electronically or otherwise.
Treatment
Treatment and consultation recommendations made in an online setting, including issuing a prescription via electronic means, will be held to the same standards of appropriate practice as those in traditional (face-to-face) settings. Treatment, including issuing a prescription, based solely on an online questionnaire or consultation does not constitute an acceptable standard of care.
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Excerpts from Dr. Thompson's testimony before the House on 03/18/04:
Statement of the Federation of State Medical Boards of the United States Committee on Government Reform
United States House of Representatives
Presented by James N. Thompson, M.D. President and CEO
Internet Pharmacy Consumer Protection Act March 18, 2004
http://reform.house.gov/UploadedFiles/FSMB%20-%20Thompson%20Testimony.pdf
Early Interest in Use of Internet for Practice of Medicine
As I indicated at the hearing this Committee held in March 2003, the Federation has been actively involved as a national leader on the use of telecommunications and the Internet in the practice of medicine for a number of years. In 1996, the Federation published A Model Act to Regulate the Practice of Medicine Across State Lines. In 2000, it published guidelines for Internet prescribing. In 2002, it published Model Guidelines for the Appropriate Use of the Internet in Medical Practice, one of the first national standards established for Internet medical practice.
Those guidelines, which the Federation recommends be adopted by state medical boards, include a key provision: “A documented patient evaluation, including history and physical evaluation adequate to establish diagnoses and identify underlying conditions and/or contraindications to the treatment recommended/provided, must be obtained prior to providing treatment, including issuing prescriptions, electronically or otherwise.”
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My take on this is the Dr. Thompson is open to the methodology used by the finer practicioners of Telemedicine, the folks who we most desperately need to preserve.
patient2all
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patient2all
It's a sad world, getting sadder by the day....
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