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Posted: Fri Oct 14, 2016 8:44 am
by fishdoc
Be careful with Skype and other such services as they may not be HiPPA compliant. There are free HIPPA compliant video chat services available, though.

Posted: Fri Oct 14, 2016 8:44 am
by jmosby1469
One of my colleagues departed the practice and took with him a set of patients whom he manages via skype for clinical contact, then escribes or calls in their bupe prescriptions. Made a big gap in the clinic schedule here in LaGrange. Not sure that passes muster, either.

Posted: Fri Oct 14, 2016 8:44 am
by Jeremy K
Again, thanks all for the comments. Dr Passer: I appreciate your concern. In my case, I won't be doing any 'online' practice myself, I'm just wondering about my patients using it to access counseling. However, for a physician using 'online' to 'remotely' evaluate and treat patients, I would agree: check with your malprac insurance to make sure you're covered.

Posted: Fri Oct 14, 2016 8:44 am
by drpasser
Check with your malpractice insurance about anything like this.

Posted: Fri Oct 14, 2016 8:44 am
by Jeremy K
Thanks everyone for the input.

Posted: Fri Oct 14, 2016 8:44 am
by robertsonjon
In my area (Michigan's Upper Peninsula) there aren't a lot of psychiatrists available, so many patients (addiction and other) see a psychiatrist by Skype (many through the VA) and it seems to work well. I'm sure there are sketchy drug counselors out there who do it, but plenty of good ones, too. If it works for the patient, and they feel they are making progress and getting their needs addressed, I don't see a problem.

Posted: Fri Oct 14, 2016 8:44 am
by mack86
I have been doing this for prescribing. I call or fax Rx to their pharmacy. North Carolina medical board accepts this as a way to reach people in rural, remote, or otherwise underserved areas.

There is also a format for online counseling, but I have not used it yet.

Posted: Fri Oct 14, 2016 8:44 am
by fishdoc
Many of my patients will supplement local 12 step programs with online meetings. We have found no problems with these meetings, but we have no experience with counseling as you describe. Some of my colleagues are experimenting with telemedicine for well established patients.