In early 2014 I decided to use the six state licenses I had obtained as a locum tenens physician to start practicing telemedicine. Since then I have worked with several telemedicine platforms. I use telemedicine to keep up my outpatient skills. I have found that telemedicine companies differ dramatically in their overall ease of use for the provider.

Here are my top 7 tips for deciding which telemedicine company to work with.

1. Technology support. Telemedicine is dependent on technology. If it is difficult to get help from tech support, do not credential with the company. Tech support is your lifeline to your patients. Make sure you can get help right away if you are having problems finishing or starting a consult. I find the companies that send automatic emails saying they will get back to you within 24 hours the most difficult to work with.

2. Nurse support. All of the telemedicine companies that I have worked with have amazing nurses. Some are overwhelmed with work. Telemedicine nurses can connect to your patients via direct call back numbers in a way that you cannot. They are also able to call in prescriptions to pharmacies if the platform is down or if the patient put in the wrong pharmacy information. Make sure that the company you work for has a nurse that can call you back right away. A few telemedicine companies are understaffed with nurses, and it can take hours for a callback. If the key to telemedicine is volume, this is frustrating to deal with.

3. Chief complaints. I’ve noticed a trend in telemedicine companies moving away from making the chief complaint visible by providers before choosing to take the consult. For me, this is a big red flag. It can be as simple as, “I have a cold.” I like this because if I see a patient that says, “I have abdominal pain,” I know to triage them first because they may be wasting precious time to get an intervention if needed.

4. Volume. Telemedicine is great for staying connected to outpatient medicine. If you are looking to work on a telemedicine platform for your main source of income, then volume is key. A lot of telemedicine companies will tell you how many calls they get per day; the key question is how many calls they get for the states that you are licensed in and how many providers they have licensed in those states. If you want higher volume, then ask if they will pay for your license in states with higher needs. Some do, and some do not. If you are willing to pay to be licensed in additional states, then make sure the volume is high enough to make that extra out of pocket payment worth it.

5. Malpractice coverage. Many companies provide malpractice coverage as part of their credentialing package. If they do not make sure your malpractice coverage covers you for telemedicine.

6. Documentation. Documentation during your telemedicine consult is arguably even more important than in an outpatient visit. Everything is on the phone, or by video, so make sure in the subjective area you are quoting what the patient is telling you. You are not able to do a physical exam so your recommendations will be based on what the patient is saying.

7. Have fun! Telemedicine has been enjoyable for me. I like being able to have the time to educate my patients about antibiotics and when they are and are not necessary. I enjoy the technological aspect of telemedicine and understanding all of the different platforms. Telemedicine gives you a unique opportunity to practice your outpatient skills from the comfort of your home.

Geeta Arora is a physician and can be reached at her self-titled site, Geeta Arora, MD.

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