One of the greatest things about telemedicine is that you can technically do it from anywhere. You need a physician, an internet connection, and a phone or laptop. Doing online telepsychiatry from abroad should thus be simple, but here are a few problems to consider.
The US medical system is a big moneymaker. From policymakers to lawyers to private lobby groups. The intention is to channel a lot of money from the US healthcare system into private companies.
This isn’t a distorted or pessimistic view of US healthcare. It’s how any functional government generally operates. The problem we have as physicians is that the policies aren’t in favor of physicians or patients.
The US healthcare system is a top-down system, starting with large corporations, down to the government entities, to government-affiliated entities, to physicians, and finally the patient.
US Policy And Telemedicine
I chatted with a telemedicine doctor who has a roster of only VIPs and lives in Beverly Hills. He has been doing telemedicine since 1978 – that’s when I was born.
Telemedicine has been around for decades. However, structured reimbursement and legal coverage of telemedicine services is only a decade old. And medicine evolves very slowly – so a decade is nothing.
Over the past few years, US policy has tried to make sure that all US healthcare spending and related taxes stay in the US. This means US physicians won’t be able to practice abroad.
In this report from the Office of Inspector General (OIG), CMS paid out for visits that didn’t qualify. One of the items mentioned is that US physicians were not physically in the US when billing. This is a mandate by CMS and is included in their Medicare Benefit Policy Manual (chapter 16).
“For one claim, a physician residing and practicing psychiatry in Pakistan provided psychiatric counseling services through telehealth technology to a patient located at a rural medical center in the United States. The service was unallowable because the physician was located outside the United States.”
Who told us that we need to be in the US when practicing medicine? That’s not the agreement I had when I entered medical school or agreed to a residency program.
Check out this article I wrote which discusses this rule in more detail.
Practicing Online Telepsychiatry from Abroad
Practicing telepsychiatry from abroad is still possible but now we have to factor the current laws and whatever will come down the pipeline.
Whatever CMS (medicare, Medicaid) private insurance companies will inevitably adopt. It’s a matter of time before private insurers, too, won’t pay for services provided by physicians outside the US.
But nobody can keep you from taking cash – not yet. Meaning, you can have your own private practice or see non-CMS patients and still practice telepsychiatry from abroad.
Starting Your Own Telepsychiatry Practice
It sounds daunting to start your own virtual practice but it’s 2021 and doing anything online is far easier than ever before.
If you don’t want to undertake it yourself, you can hire capable people from Upwork or Fiverr.
You’re a psychiatrist and there are only so many of you out there. A patient can see you and bill their insurance separately. You can even provide them the necessary forms. All you’re have to worry about is collecting their payment.
If you’re worried about reimbursement rates, my course addresses that in detail and why it’s far less relevant than you think.
Seeing Telepsychiatry Patients for Private Offices
Lots of private practice psychiatrists have patients whom they cannot see. Maybe they are difficult patients or they have unique medical conditions.
It could also be because the practice is at max capacity. For a referral fee or a cut of the visit, you could see these patients. The best way to find these patients is to contact private practices and see what their needs are.
It’s not like telepsychiatry jobs aren’t available, but you have to look for them. And look for companies which are friendly to telepsychiatrists practicing abroad.
Consulting in the Telepsychiatry Space
Your talents as a psychiatrist span beyond your in-office clinical abilities.
Small companies and healthcare startups need psychiatrists to build out their products. They need such input in order to create something competitive in the marketplace.
I have been consulting in the healthcare space for some time and it remains profitable. In fact, I think it’s only going to grow in the future.
If you want to practice telepsychiatry from abroad, you have lots of options, but you have to create these opportunities. Just because they aren’t mainstream, it doesn’t mean they don’t exist.