Wednesday, October 19, 2016

Texas Physicians Threatened by TeleMedicine

It seems that the Texas Medical Board had tried to keep patient care via the Internet from competing with traditional medicine. As reported by the Texas Standard, they required physicians to meet with patients in person before they were allowed to treat them remotely. Since 35 rural Texas counties have no physicians at all, this regulatory entry barrier all but kills the main benefit of telemedicine. Even in urban areas, telemedicine would likely generate serious competition to traditional health care providers.

This requirement primarily affected Teladoc, a company based here in North Texas. But Teledoc sued that the requirement violated antitrust laws and won in lower court. The Texas Medical Board appealed but recently dropped their appeal, perhaps because Teledoc was backed up by the FTC and DOJ. Since the Texas Medical Board is made up of incumbent physicians, this is not unlike the teeth whitening case in North Carolina.


  1. In a world where convenience is king, where we can order groceries online and pay for goods through our smart phones, traditional medicine has finally met its match, telemedicine. I believe you could view traditional medicine as a monopoly; untouched for years. Yes, we have improved technologies that have enhanced traditional medicine, but as Froeb et. al, (2016), note “even monopolies are not permanently protected from the forces of entry and imitation” (p.120). Telemedicine may be seen as a complement to traditional medicine, or a competitor, especially if physicians see it as taking business away from them.

    At the end of the day, doctors are here to help people, and if telemedicine makes it more convenient for patients to receive treatment, then why wouldn’t you want to support its success? Doctors aren’t losing patients or business, they are just being asked to connect with patients in a new way. Traditional medicine was bound to change, and I know I am looking forward to being able to using telemedicine. Instead of having to take time off from work and wait in a long line at a walk-in center, I can connect with a physician within a matter of minutes, talk with them about my symptoms and if needed, have a script for an antibiotic called in to my local pharmacy.

    No barrier to entry lasts forever, and the Texas Medical Board’s requirement that physicians are required to meet with patients in person before they are treated remotely is no different.


  2. I work in a rural area at a 25-bed hospital. We are considered a physician shortage area. We actually have a telemedicine stroke program in our Emergency Room through a hospital an hour away and it’s been incredibly successful. It’s incredibly difficult to attract physicians to our small community; so having telemedicine for certain services has been a true asset and allows us to better care for our patients. Patients shouldn’t suffer and it’s our responsibility to provide them with quality care.

    This sounds to me that these physicians are more concerned about business rather than providing care to their underserved patients. In addition, physicians can only see so many patients a day, so in reality, they can’t be that selfish. I understand they have to be business-savvy, however, if they don’t have another plan as to best serve their patients, then ultimately this is best solution.

    There are several pros and cons of telemedicine though. Pros include convenience, less time in waiting rooms, it’s cost-efficient, and assures privacy. Cons include electronic glitches, inadequate assessments, and as mentioned above, physician resistance. (Harper, 2012).

    Certainly physicians would rather see their patients in person, especially because of liability issues. Medical liability insurance is ridiculously expensive. It’s ultimately a physician’s license on the line. So there are pros and cons, but from what I’ve seen, it’s been very beneficial in my rural area.


    Harper, J. (2012, July 24). Pros and Cons of Telemedicine for Today’s Workers. Retrieved November 16, 2016, from US News and World Report,