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Telemedicine

The number of telemedicine opportunities available to physicians is increasing on a daily basis.  The telehealth landscape is constantly evolving as organizations, retail outlets, insurance companies, startups, and others have been exploring how to incorporate telehealth into the current healthcare landscape.  For some physicians, telehealth is a side gig, for others it is an adjunct to their clinical practice, and for some, it is now a full time job.

 

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Quick Links

Resources

We have a telemedicine database in our free PSG Facebook group for when companies come to us seeking physicians. Please feel free to sign up to be notified when new opportunities (full-time, part-time, or side gig) arise.

Visit our salary and negotiation database, where some of our members who work in telemedicine have shared their datapoints.

The American Telemedicine Association can be a good place to drive deeper and learn more. In particular, we find the state policy resource center page helpful.

The Center for Connected Health Policy can also provide useful information.

 

Here's some of the equipment our PSG team uses that could be used in your telemedicine setup:

Introduction and Advantages

Telemedicine continues to increase in scope, but has become commonplace for follow up of chronic conditions,  conditions where a physician exam is less of a necessity, prescription refills, and low acuity situations.  Several telehealth companies focus on these spaces.  In some situations, they will oversee care being provided by non-physicians in settings where physicians are not available, such as tele-hospitalist, tele-ICU, and tele-stroke situations. Certain specialties are more amenable to telehealth, such as pediatrics, behavioral health, radiology, family medicine, and many internal medicine specialties.

What Hours Are Required?

This is going to depend a lot from job to job.  Some jobs will have a minimum number of patients you have to see within a specified time frame (weekly, monthly, quarterly, etc), while others will require you to be logged in for certain hours and see whoever comes during that time.  Some jobs allow you to do as much or as little as you want without committing to the hours you'll be working, while others have fixed hours to ensure the coverage that they advertise.

Advantages of Telemedicine

Many physicians like the opportunity to earn side income during their free time, the ability to practice medicine remotely, and in some cases, to set their own hours and schedule.  Telehealth also offers you the opportunity to serve patients who may not have access to a physician secondary to shortages of primary or specialty physicians in their area or a physical barrier to being able to make office visits.

Getting Started

Prerequisites

You are going to need a medical license, and many jobs will require being board-eligible or board certified.  You will need a license in the state where you are providing care, so many telemedicine jobs want you to have as many state licenses as possible.  Additionally, every state has different rules and regulations that you may have to meet in order to participate in remote care.  For example, in certain states, additional certifications may be present.  Things that will help you get a telemedicine job: 

  • Tune up your medical CV to be comprehensive, accurate, and focused, while staying relevant.

  • Figure out what additional trainings/certifications are necessary

  • Exhibit pleasant online behavior

  • Demonstrate a clean medical record without probation or negligence

  • Be able to work independently happily.

  • Have basic computer/technology competence.

  • Have your medical licenses ready in all states where your employer covers.

  • Membership in relevant professional organizations can help.

  • Necessary medical licenses in all applicable states in the employer’s purview

  • Membership in relevant professional organizations

Some training that could be helpful includes training in patient privacy and safety and ethical training.

Questions to Ask

  • Who your patients will be

  • What your role will be in their care (triaging acuity, providing prescriptions, creating treatment plans)

  • How you will be paid (W2 versus 1099, how often you'll be paid, and method of payment)

  • Are there benefits?

  • Is malpractice insurance offered?  If so, what type?  Is tail insurance covered?

  • How long are shifts are and what are the expectations during that shift

  • What type of technology do you have to learn?  How easy is charting and what requirements in reporting are there?

  • How long are shifts?  What is the policy for time off?  How are weekends, nights, and holidays handled?

  • What is your backup for support if you need it? If there is a technical problem, who can you reach out to?  If you want a second opinion for a clinical issue, who can you call now?

  • How do you follow up on patients? Who handles the follow up with the patients you see after you're gone?

  • Are there any special telemedicine regulations in the state where you work?

  • Are there regulations about how data is stored?

  • How long are the shifts and how frequently will they be available?  What are the expectations about less desirable shifts such as holidays, nights, or weekends?

  • Are the treatment options available to you limited by formulary or political concerns?

  • What is the business model?  

  • How long does the average consultation take?

Equipment Needed

You will most likely be using a HIPAA compliant video-conferencing tool.  Therefore, you will need a good webcam ideally in a location with good lighting, as well as a computer.  Nowadays, there are more and more tools, including portable telemedicine kits with special diagnostic tools.

 

Here's some of the equipment our PSG team uses that could be used in your telemedicine setup:

Webcam: Logitech C920x HD Pro Webcam

Microphone: Blue Yeti USB Microphone

Ring light: NEEWER Ring Light Kit

     Note the differences in size and stability of different ring light options, as you might want a different model best on your setup, space, and situation. (For instance, we've found this one is not the most Roomba friendly.)

Green screen: Elgato Collapsible Backdrop

Starting Your Own Platform

Depending on the opportunity, you may be getting patients who find your company online, patients who are seen within a certain medical system or corporation and offered telehealth as a benefit, or from your medical group/practice. 

If you want to bring your patients to your own platform, one of the first things to consider is whether you need to pay for a platform, whether your institution already has a built in telemedicine solution, or whether you can use a free platform.  If you have a patient referral source in place, there are several free or relatively cost efficient programs to consider. 

Finding Opportunities

Searching online will bring up lots of telemedicine companies - most will list on the website whether they are hiring.  Try and search for ones that apply to your specialty.  Additionally, we have a telemedicine database in our PSG group for when companies come to us seeking physicians.  Please feel free to sign up!

Pay for Telemedicine

Reimbursements are all over the place.  Full time jobs often make between $150,000 - $250,000 (of course outliers are present, especially if someone picks up a lot of shifts or takes a lot of patients). Some companies offer compensation per consult or per hour. The compensation per consult ranges quite a bit depending on the platform, the complexity and average length of the visit, expected volume, and the specialty of expertise.  We've seen platforms offering as low as $15-20/consult, or as high as $60/consult. Some companies give benefits while others do not. Obviously, anytime you work for a company, there is a middleman, and if you already have a patient base or brand which would generate consultations for you, you may want to consider starting your own telemedicine business/practice, where you would keep a higher percentage of the consultation fees.

Visit our salary and negotiation database (you must be a member of our free physician-only PSG community for access), where some of our members who work full-time in telemedicine have shared their datapoints for comparison.

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