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Grinberg: The Shrinking Limits of Telemedicine

  • State: California
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Odds are pretty good that you’re getting at least some reports reflecting primary treating physician visits through telemedicine. Sometimes it’s a phone conversation. Sometimes it’s a videoconference.

Gregory Grinberg

Gregory Grinberg

I suspect that, sometimes, nothing happens at all but the shadier members of the medical community just can’t help but routinely bill. Hopefully, the diligence of the defense community and the zeal of our prosecutors will keep that to a minimum.

Telemedicine, as vital as it is during this period of shelter-in-place, has its limitations. While a psychiatric qualified medical evaluation examination might very well be done over videoconference, a physical exam is not so readily performed. Perhaps the PTP can prescribe medication, but probably can’t administer an injection, right? 

So, about that.

Inverse.com has an article about an experimental “surgery” performed on a cadaver by Italian physicians from 9 miles away. Assistants set up the cadaver and the robots, and then surgeons wearing 3-D headsets controlled the robots over the internet to perform the surgery. The lag between command and response was negligible and did not appear to affect the performance of the surgeons. Pretty cool, huh?

What does this mean for us in the workers’ compensation world? 

Well, the advantages of telemedicine are many. A doctor in one geographic area can provide service to many geographic areas. The Workers' Compensation Appeals Board already uses remote judges and court reporters as necessary. When one location is overwhelmed, a less-congested venue can fill in and help.  

Could this approach be used for more invasive procedures? Can an injured worker report to a clinic and have epidural injections remotely controlled by a doctor? Could chiropractic manipulations be controlled and guided by a remote chiropractor?

Fee schedule issues are an ongoing point of contention within our beloved workers’ compensation system. Physicians naturally want to be paid more for their services, and carriers naturally want to pay less. What if the fees stayed the same but this approach significantly reduced provided overhead and increased capacity for more services?

Laugh all you want, but it doesn’t look like California’s shelter-in-place approach is going away before the flu season, and we’re likely to be hit by the perfect storm at that point: kids returning to school, businesses reopening out of desperation, and influenza resurging, as is tradition. Technology may, yet again, be the answer.

Gregory Grinberg is managing partner of Gale, Sutow & Associates’ S.F. Bay South office and a certified specialist in workers’ compensation law. This post is reprinted with permission from Grinberg’s WCDefenseCA blog.

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