How telemedicine challenges the medical profession


Telemedicine offers significant promise—including increased access to care and better health outcomes—but challenges remain to sort through. The December issue of Virtual Mentor, the AMA’s online ethics journal, considers this issue from a variety of angles.

Skeptics worry that the benefits of telemedicine may be outweighed by diminished privacy and security of medical information and loss of the therapeutic value tied to hands-on encounters between patients and their physicians.

Many contributors to this month’s issue believe that the innovative uses of telemedicine draw attention to the ever-present need for improving access to care, patient privacy, security of medical information and quality of the patient-physician relationship.

Articles in this issue include:

  • Telepsychiatry as part of a comprehensive care plan.” In this commentary, authors Nicholas Freudenberg, MD, and Peter M. Yellowlees, MD, write that telepsychiatry treatment ideally should include collaboration with patients’ primary care physicians. One way to facilitate the collaboration is for patients to have videoconference appointments with their psychiatrists at their primary care clinic.
  • Telemedicine: Innovation has outpaced policy.” Authors Karen Rheuban, MD, Christine Shanahan and Katherine Willson write that health care policy needs to advance beyond the 20th century if telemedicine is to be integrated properly into health care of the 21st century.
  • Privacy and security concerns in telehealth.” Contributors Timothy M. Hale, PhD, and Joseph C. Kvedar, MD, review a key article focused on the ethical-legal issues that telemedicine can generate. Transmitting patient data through institutional networks can add privacy risks unless security safeguards are put in place.
  • Telemedicine use in international relief efforts.” In this piece, authors Eseosa Asemota, MD, and Carrie L. Kovarik, MD, write that the future of global medicine will see telemedicine enhance the capabilities of physicians in the field during epidemics or disasters and extend expertise in such specialties as dermatology into underserved regions of the world.
  • “The success of telehealth care in the Indian Health Service.” Contributors Howard Hays, MD, Mark Carroll, MD, Stewart Ferguson, PhD, Christopher Fore, PhD, and Mark Horton, MD, explain that telehealth is increasingly important for closing gaps in health care that have existed for decades in the American Indian and Alaskan Native communities and other ethnic groups.

Don’t forget to participate in this month’s ethics poll and listen to the latest podcast.