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New challenges for virtual visits with doctors emerge for Washingtonians

A medical physician stares outside of an entrance at the Houston Methodist Hospital on July 16, 2021 in Houston, Texas. (Photo by Brandon Bell/Getty Images)

During the COVID-19 lockdown, virtual doctor visits and telemedicine appointments became more popular. But now, some insurance companies seem to be having second thoughts about the practice.

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“Telemedicine isn’t really new. We’ve had increased awareness of it in the general public and certainly increased usage of it in medicine amongst multiple specialties. And it was really highlighted during COVID,” Mercer Island MD Dr. Gordon Cohen explained to Seattle’s Morning News on KIRO Radio. “But in fact, when I started working at Seattle Children’s in 2002, we actually used telemedicine to build our practice in congenital heart care, it was used beyond just that specialty as well.”

“Suddenly with COVID, doctors weren’t going to their offices, we were all social distancing,” he continued. “People didn’t want infected patients in their office. So the insurers suddenly said — well, [the Centers for Medicare and Medicaid Services], who ultimately makes the decisions about reimbursement, made the decision that it’s OK to bill for telemedicine visits, so telemedicine took off like crazy.”

Dr. Cohen says of the physicians he spoke to, 80% of their practice was telemedicine during COVID-19.

“Those are just people I spoke to,” he said. “I suspect there were probably physicians whose practices became 100% telemedicine based. But there were numerous challenges that occurred with it. For example, licensing — suddenly, you could see any specialist you wanted to across the country. So if you had a child that had a series of complex problems and you wanted to see the best specialists in the world or in the country, you might have a telemedicine visit with a cardiologist in Boston, and maybe a geneticist in California, and so forth.”

You could then have three or four doctors, in or outside of Washington.

“What happened was a lot of states lifted the requirements for licensing because the emergencies of the pandemic,” Cohen said. “But what’s happened now is the pandemic has sort of slowed down and now that states are reinstituting the limitations on licensing, for example, a doctor in Boston can’t necessarily see a patient in Missouri, say, because they don’t have a license to practice where the patient actually is.”

Instead, people are driving across state lines but not all the way to the doctor’s office, then sending a screenshot of their location to prove they’re in the state so the doctor can offer a telemedicine visit.

“These have essentially been referred to as ‘truck stop telemedicine visits,'” Cohen said.

“I think there has been discussion about creating a national or federal telemedicine license so that you would have a license that would cover you for just telemedicine practice across the country,” he added. “But I also think that there’s probably concern that it can be a little too accessible and it’s not well controlled or well regulated at this point in time, and that probably does need to happen.”

Listen to Seattle’s Morning News weekday mornings from 5 – 9 a.m. on KIRO Radio, 97.3 FM. Subscribe to the podcast here.

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