Considerations for telemedicine jobs

Nov 19, 2018

Telemedicine physician jobs are becoming quite prevalent as this mode of healthcare delivery becomes more accepted by patients, providers, and payers.

It’s an excellent activity for doctors in a variety of situations. As a part-time gig, it’s good extra income for those who already have a full-time job or as a sole source of income for physicians who can’t or don’t want 40+ hours of work each week. Full-time telemed jobs often appeal to physicians for their flexible schedule and ability to telecommute. Finally, it’s a great way for physicians in nonclinical roles to keep clinical skills sharp.

Despite its wide appeal, though, a lot of providers shy away from telemedicine since it’s unfamiliar. Some simply haven’t taken the time to explore how it might fit into their professional lives. And others feel lost trying to figure out what the best telemedicine companies for physicians are.

Whether you’re just starting to think about trying telemed, recently got contacted by a recruiter, or are ready to make the switch from an office-based practice, there are a lot of factors to think about to ensure the work is a good fit and that you’re signing a solid contract.

Here are seven important questions to ask yourself when considering a physician telemedicine job.

What is the company’s business model?

It’s not always clear up front how a telemedicine company earns their revenue. Some, such as HealthTap, charge patients directly for consults using a per-consult or monthly fee.

Others accept insurance or have partnered with a health insurer to offer consults to members in which the cost is shared between the two parties.

Some companies contract with businesses to offer on-demand healthcare to their employees. In this case, it’s typically at no (or low) cost to the patient while the employer bears the cost.

Any of these three options and derivatives of them can be good models from the provider’s point of view.

Others are not so great. For instance, certain platforms almost exclusively bill Medicare for specific services. Be wary of any organization that expects you to regularly prescribe braces or DME via telemedicine.

Oddly enough, multi-level marketing telemedicine companies exist. This means there is an incentive for you to recruit other providers to use the platform. Sales and recruiting takes precedence over patient care with this model, unfortunately.

When, where, and how will you carry out patient encounters?

Find out what your schedule will be. If you’re told you can work “whenever you want,” ask followup questions about how encounters are assigned to physicians. Ask about the volume of patients you’ll have per day or per shift.

$40 per consult means nothing if there aren’t any consults available when you’re working.

Additionally, find out what the expectation is for how quickly you respond once you’re assigned an encounter.

Along these lines, find out if you need a specific device to do the work or if there are any technological requirements, such as a certain internet speed.

Who are the patients and what are their expectations?

Having an appreciation for how the patients make their way to you will help you meet or exceed their expectations as customers and as patients. Learn how they typically find out about the telemedicine company – for example, through an online search or from their employer.

Some telemed companies have nurses or other staff who will be in touch with the patient before your encounter. Determine if this is the case and, if so, what history-taking or other steps will already be done by the time the patient gets to you.

Similarly, what does the patient need to do before they get to meet with the provider? They may need to call a triage line, fill out an online profile, or check off a list of their symptoms.

What does the work flow of a patient encounter look like?

You also want to having a solid understanding of how a consult is carried out from beginning to end. Getting a demonstration of the platform with an example of a patient encounter is probably the most efficient way to accomplish this. If that’s not possible, be sure you consider how you are notified of a consult, how you communicate with the patient, how you enter orders, and how you document your note.

Some platforms use real-time communication with a patient, such as a video consult or a phone call. Others utilize asynchronous communication, which is more like an exchange of text messages between you and the patient. The former is more personal and allows the physician to quickly ask questions and get the info needed for medical decision-making. On the other hand, asynchronous encounters offer more flexibility for the provider’s schedule.

What can you order and how do you follow up on results?

In addition to knowing how you enter orders, you should also consider what you’re able to order. Can you order any medication, or only those on a formulary? How about lab results? You’ll want to know if there are protocols you’re expected use, and if certain medication types or classes are off limits.

Gain an understanding of how the order is processed, how prescriptions are sent to the patient or the pharmacy, and what lab vendors are used.

The process for following up on results is equally important. Will you be automatically notified of the results? How quickly are you expected to review them, and how do you get back in touch with the patient to discuss them?

What are the telemedicine regulations in the state you’ll be practicing?

Every state has its own regulations that govern telemedicine. Some are vague and others are strict. Some state boards of medicine expend a great deal of oversight when it comes to telemedicine, and others take a very hands-off approach.

Opportunities to practice telemedicine are innumerable for doctors with multiple state medical licenses. Nonetheless, a physician practicing in multiple states needs to take extra precaution to confirm they’re practicing lawfully in each state.

A few specific types of regulations to be aware of include:

  • Special licenses for practicing telemedicine
  • Requirements for an initial face-to-face visit
  • Prescribing controlled substances
  • Obligation for an in-state physician to have “ultimate authority”

This consideration is less about the specific telemedicine company you’ll be working with, and more about the locality in which you’ll be practicing. That said, though, the extent to which the company is proactive about putting safeguards in place to ensure their providers are following rules and regs is something to consider. Although you always need to do your own leg work, it’s nice to work for a company who’s looking out for you.

How will you be compensated?

Last, but just as important as every other consideration, is how you’ll be compensated. Once you have an understanding of how your consults will work logistically, the types of problems you’ll be addressing, and how much time you’ll be spending per consult, you can figure out what compensation would make it worth your time.

Make sure you’re fairly compensated. You should be remunerated not just as an exchange for your time, but for the professional risk to you as a practicing physician.

Some telemedicine companies offer a standard rate per consult or per hour. If you’re offered a rate that is too low and the company is not willing to negotiate, have a low threshold for saying “no thanks.”

For part-time positions and moonlighting, you’ll likely need to sign an independent contractor agreement, which comes with its own considerations.

There are, of course, other things to think about beyond what what’s presented here. If you’re considering a full-time telemedicine job, then learn about the company culture, room for advancement, and benefits.

I encourage you to give telemedicine physician jobs a look if you’re looking for something more out of your career or want some additional income. You might determine that it’s not for you. But at least you’ll have asked yourself the right questions to make an smart decision.

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