The Guild-ed Age
Texas Doctors’ Guild Fights Progress

A doctors’ guild in Texas has just thrown up a major road block to better health care. The NYT reports on the decision of the state’s Medical Board to further restrict the practice of telemedicine in the state:

On Friday, it changed its rules to state that “questions and answers exchanged through email, electronic text, or chat or telephonic evaluation of or consultation with a patient” are inadequate to establish a doctor-patient relationship. The move significantly tightens rules that already preclude video consultations except under a narrow set of circumstances. […]

Texas is among a handful of states that still require an in-person exam before a telemedicine consult can take place, according to the American Telemedicine Association, a trade group in Washington. Other states have vaguely worded policies that are not clear on whether an in-person visit is needed first.

In a country in which health care is both very expensive and hard to access, permitting if not encouraging the use of telemedicine, at least for basic primary care, should be a no-brainer. Telemedicine is cheaper than in-person visits and can connect patients in areas with few health care providers to doctors they might otherwise travel miles to see, or not see at all. That doesn’t mean we should countenance a regulatory free-for-all, nor does it mean that patients with more serious and demanding medical conditions should be pushed to use telemedicine. But we ought to welcome new technologies that, when used appropriately, can help bring down costs and reshape our often-inefficient methods of health care delivery.

Unfortunately, doctor’s guilds don’t like changes that threaten to undermine their market power. In the name of protecting patient safety, medical advocacy groups have fought against reforms that ease restrictions on telemedicine or extend more autonomy to nurse practitioners. And when these opponents succeed, America, laboring under high costs and inefficient practices, loses out.

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