'online' counseling

[sambrayfield]

I have practiced in rural Missouri 34 years. 'Rural' general practice has it's unique challenges. Having a one on one with a another human is best but I fully agree with the practitioner from the UP that you often have to go with what you have to work with. Samuel 'Buddy' Brayfield, DO

[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.

[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.

[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.

[drpasser]

Check with your malpractice insurance about anything like this.

[Jeremy K]

Thanks everyone for the input.

[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.

[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.

[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.