Telemedicine Is The Future Of Practice.

Telemedicine is the wave of the future if you like it or not. The COVID-19 health emergency is reshaping how people view healthcare delivery. So many people are staying at home in fear they will catch coronavirus. Well, people still need to be seen for various health issues. Where are they turning? Telemedicine!

Patients, right now as you read this, are seeing medical providers over their tablets, smart phones, and computers. Telemedicine businesses are BOOMING because the demand is so high. What’s going to happen is that patients will realize just how convenient seeing a provider online or over the phone is.

  • No commuting.
  • No sitting in crowded waiting rooms.
  • No waiting in a small exam room for 45 minutes waiting to be seen.
  • And it’s cheaper!

The convenience factor that patients are experiencing by utilizing telemedicine technology should not be underestimated. People have become more and more accustomed to on demand service. Online banking, Netflix, Spotify, Instagram, food delivery, drive thru, and shopping online are all on demand. Do you think healthcare should be different? It’s not, and people now realize this.

Medicare, Medicaid, and private payers are seeing this trend as well. During the COVID-19 health emergency, the section 1135 waiver granted under the President’s emergency declaration is expanding telehealth services with Medicaid and Medicare. Right now, telemedicine services do not require pre-authorizations, the restrictions on where the patient is located have been lifted, the use of non-HIPAA compliant communication technologies has been allowed, and reimbursement is the same as in-person visits. Private payers are also relaxing their rules with telemedicine.

I predict the changes will carry over once the public health emergency is lifted. Will it be immediate? I doubt it, but it will happen over a short period of time. Patient demand for telemedicine services will drive regulatory change across our healthcare system. Even if it does not, this is still an opportune time for the astute nurse practitioner entrepreneur to take advantage of.

I believe patients are going to be willing to pay cash for more and more services if they can be delivered via telemedicine. Patients want convenience and on demand service, and that is exactly what telemedicine delivers. Why go to an urgent care or primary care office, pay a $50 deductible, have their insurance billed, and spend 2 hours out of their day for a medical visit when they can just spend $45 cash and be seen within 15 minutes utilizing telemedicine? It only makes sense to go with telemedicine for various medical issues. It is more VALUABLE to the patient.

Patients can obtain lab work from a distance. Prescriptions can be sent into a pharmacy down the street or even delivered to their door! The days of having to drive to a medical office, wait around, and then drive to the pharmacy are going to become fewer and fewer.

Don’t get me wrong, there will still be a need for in-person encounters. Physical examination and the power of touch are still necessary for a wide range of medical issues, but for a common cold, rash, simple prescription refill follow up, etc., it is not.

The prescription of controlled substances also requires at least one in-person encounter per DEA regulation. During this health emergency though, that rule has been waived. Once the declaration has been lifted, the in-person requirement will take effect once again.

The Special Registration for Telemedicine Act of 2018 grants the DEA the authority to start issuing telemedicine specific DEA licenses. This will change how certain services are delivered, predominately opioid addiction treatment and testosterone replacement. We have no idea when these licenses will be available though, so it is a waiting game. Regardless, I see many of my men’s health and testosterone patients one time in person during the initial evaluation, and then I see them via telemedicine after that. It is convenient for the patient and me and is totally permitted via current regulation.

The main benefit for nurse practitioners utilizing telemedicine is the ability to practice in full practice authority states even if you live in a restrictive one. You can live in Georgia and practice 100% independently in Oregon. Very few nurse practitioners realize this, but it is true.

Another advantage nurse practitioners have utilizing telemedicine is the low overhead of a telemedicine practice. You don’t need to pay rent, payroll, utilities, general liability insurance, and other various expenses that come along with a brick and mortar practice. All you need to have to practice telemedicine is a phone, internet service, and a computer. What does this mean for the practice owner? More money in their pocket.

Telemedicine is changing the game for patients, providers, and practice owners.

If you are looking to start a niche side practice, right now is the time to seriously consider a telemedicine practice. Telemedicine is exploding with growth. I believe those that can get in on the ground floor now, will profit significantly.

If you are serious about starting a part-time side business that will increase your professional freedom and financial security, then consider opening a telemedicine practice. You do not need to pick up extra shifts for a lousy $60 an hour, you can earn real money working for yourself! Check out the “How to Start a Telemedicine Practice” course HERE if you are ready to take the next step.

20 Responses

  1. I already have a few side businesses. I do long term care and hospice. Are you in Texas? My question is this, with the recent legislation passed, NPs can start and recert home health visits. Can NPs sign 485s as well? Can you show this in writing, I am in Texas.

    1. I cannot give you an answer about NPs signing 485s in TX as I do not practice in TX nor do I want to because of the restrictions. TX is a horrible state to practice in as a NP. This is one of the reasons why NPs should focus on obtaining licenses in FPA states outside of restrictive states like TX. The thought of working as NP in a state like TX honestly makes me nauseated.

  2. Agreed with you. We are seeing huge demands for it in FL right now. Definitely buying your telemedicine course!

  3. I am a new NP , can a new NP start a telemedicine business? I feel like I don’t know enough of the treatment protocols to do that.

    1. If you follow the education in one of our niche clinical focused courses and focus on low liability service lines, then I do not see why a new NP cannot start a simple telemedicine practice.

  4. Now that the pandemic is becoming endemic and the writing is on the wall that the waivers etc are going to start ending, would you still recommend starting a telehealth practice at this time? I was thinking about starting a telehealth weight loss multistate; but the having to see a patient in person to be able to put them on a controlled substance (phentermine etc) has me rethinking whether this might not be a good idea after all.

    1. We have no idea when the restricitons will be put back into place if at all. COVID will spike again in the fall and we will be back to square one. I still recommend doing it, but just be aware it can change, but when, NO ONE knows….. I think the DEA will extend it as they have seen nothing really adverse has happened.

  5. Hi. I am a psychiatric nurse practitioner living in Tennessee and am interested in the idea of licensing in FPA state. Do you know any specifics on whether or not I would still be bound by the restrictive laws in TN if I am providing telehealth care across state lines? For example, if I serve patients in an FPA state, could I still be required to have a physician collaborator since I am located in TN? I have received conflicting answers to this, with some saying no and others saying I am bound to the statutes of both the location of my patient AND the location of my practice.

    1. Teresa,

      As explained in our telemedicine course, you are only bound by the laws of the state you are seeing the patients in and have a license in.

  6. Hi! Your blog is very informative! I have just started my own professional nursing corporation in the state of California. It is nauseating how restrictive it is for NPs. I am considering a telehealth side business. I am licensed NP in ca, and my business is being registered in Ca. Can I still practice across state lines via telehealth , like Arizona that has FPA, even though my business was set up in California?

  7. I have an S-corp in California, although I am not practicing with this business, but I am also licensed in FL as an autonomous NP. Will I need to start a new LLC in Florida to practice telemedicine in Florida? I will continue to work as a W2 in California.

    1. You could use the s-corp if you want. You only waive your right to bring on legal action in a state if you don’t have an LLC in it.

  8. Hello. I am a newly boarded certified PMHNP residing in Texas. I am interested in beginning my own telehealth/telepsychiatry medicine. I know Texas is very restrictive. What does FPA mean? Please pardon my ignorance. I am highly interested in taking your course.



    1. Full practice authority. Basically operating a practice in another state that is independent. All discussed in the telemedicine course and the starting a psych practice course.

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