Do Virtual Patient Visits Increase Your Risk of Being Sued?

Neil Chesanow

Disclosures

October 22, 2014

In This Article

Major Virtual Networks Limit Liability

Physician concerns about the liability risks of virtual patient visits often arise from a misunderstanding of the ailments that these visits are primarily intended to address.

American Well, based in Boston, Massachusetts, hosts one of the nation's largest virtual physician networks, with insurers such as United Healthcare and WellPoint as clients. "A lot of telehealth programs, such as we operate, are often dealing with low-acuity-type conditions," points out Medical Director Peter Antall, MD. "It's hard to cause real harm when diagnosing a cold in a healthy host."

Common issues addressed by American Well's 200-300 board-certified physicians, most of whom moonlight in addition to their regular jobs, include acute bronchitis, cough, sinusitis, acute pharyngitis, acute cystitis, urinary tract infection, abdominal pain, diarrhea, fever, acute conjunctivitis, painful urination, influenza, respiratory infection, headache, strep throat, and smoking cessation.

"There are always exceptions," Dr Antall, a pediatrician, hastens to add. "It's when you have patients with chest pain or strokes—high-acuity situations—where you, of course, worry." However, network physicians are trained to refer patients with potentially urgent or emergency conditions to a local emergency department, their primary care physician, or an appropriate specialist, he says.

"We have a robust quality management program," he adds. "We give physicians feedback, audit their charts, and have resources to help them make the proper referrals, whether it's to a poison control center, a local ER, or a suicide hotline."

The network has been operational for about 2.5 years. "Not only have we not had any malpractice claims, we've not had any physicians brought before medical boards," Dr Antall says. "We haven't even had a chart claim to date."

Another major virtual network, with about 2000 board-certified physicians, is run by MDLIVE, based in Sunrise, Florida. Its clients include hundreds of self-insured employers and hospitals nationwide, as well as the insurer Cigna. Founded in 2009, "we haven't had a single documented claim," says General Counsel Justin Stone, JD.

On its website, MDLIVE explains that "while MDLIVE telehealth plans are not intended to replace your primary care physician for common or chronic conditions, a virtual consultation can sometimes replace a doctor office or emergency room visit. Communication with your primary care physician is important for continuity of care."

"There's actually a lesser liability risk in our telemedicine delivery model than in an in-person model of care, simply because we only deal with minor acute-care conditions," Stone contends. "We have the ability to limit the risk simply because we're not seeing chronically ill or very sick patients."

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