You shouldn’t even treat a dog that way

There was an interesting item reported over the past few days regarding the disciplinary action taken by the Texas State Board of Veterinary Medical Examiners against the license of a Texas veterinarian, Dr. Ronald Hines. Here is a link to one of many reports on this story.

Before I go any further, let me lay out the standard cautions about believing only a little bit of what you read (especially on the Web), and hardly anything of what you hear. But psychiatrists need to heed the lesson here.

We at PRMS get many questions about “telemedicine” in psychiatry, which until a few years ago meant speaking to people on the phone. Now it includes “skype-iatry,” youtube videos, texting, interactive chat, blogging, and an ever-growing array of ways to connect instantly with anyone anywhere in the world.  The main points we make to every psychiatrist we speak to is ‘remember the licensure laws’ and ‘just because you can do it doesn’t mean you should do it’.

Professional licensure in the US is still the purview of the individual states. Lawyers, physicians, veterinarians, pharmacists, psychologists, public accountants, real estate agents, electricians, cosmetologists – you name it – practice under a grant of authority from the state government. For example, a lawyer expert in US constitutional law, who may have argued cases before the Supreme Court and written treatises quoted in every legal textbook used today, can’t automatically act as an attorney for anyone in a state where she’s not licensed, even to challenge a simple speeding ticket.  She would have to comply with that state’s rules on admission to the bar.

Our second point is also critical: the standard of care doesn’t change because you’re treating someone remotely versus the old-fashioned, face-to-face office visit.

Our advice is simple: practice only where you are licensed, and practice in keeping with the rules of the state(s) where you are licensed.  As an example, here is a link to the Texas Medical Board’s FAQs on Telemedicine. More and more states have addressed this issue, but not all take the same approach. 

It’s a simple matter of a few clicks on your keyboard to learn what your state has to say on this important topic.