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Roman Telemedicine Review for Physicians

 

I can now talk about the Roman telemedicine platform because I just got fired by them yesterday. I’m collecting termination badges from various telemedicine companies as I’m dealing with my medical board license suspension.

Most telemedicine companies have decided to terminate me because of this silly license suspension, though some have remained loyal, which, I must say, is humbling.

I reported my medical license suspension to Roman and after having me do another background check I received a respectful email from their Clinical Director stating that my contract was terminated. Cheers.

I’m not mad at them, they have to do what’s right to preserve their appearance to the public since they are a growing company.

Hopefully this Roman Telemedicine review isn’t biased but it’s only fair for me to share that little tidbit with you.

 

Roman Telemedicine Platform

I can’t share any details about the platform since I don’t want to give away any company secrets even though others are doing so publicly.

I often get emails from telemedicine companies asking me to take down information because it’s part of their “competitive edge”. I’m happy to oblige.

What I can tell you is that a niche telemedicine platform is one of the better concepts in telemedicine. You have to spend a lot less time squeezing the same information from a patient.

Roman is a platform for male patients to get care for erectile dysfunction. What I like most about Roman is that it’s not a pill mill. They don’t seem to just push meds on patients but delve into the history and symptoms and have strict prescribing criteria.

Navigation

Navigating the platform is a bit cumbersome. It’s a clickathon just to be able to get to a particular virtual destination. And though their UI/UX needs work, you can eventually figure it out and make it work.

 

Patient Volume

I can’t tell you about the patient volumes either because Roman might claim that such information will risk their competitive edge. ?

But what I can tell you is that you earn less than a traditional telemedicine consult per patient. However, because it’s a niche telemedicine platform, you’ll also spend a lot less time per patient. On average I earned a smidgen under $5,000/month and I probably worked 10-15 hours per week.

Having multiple state medical licenses will help which is true on any telemedicine platform. From their website you can see that they have physicians in nearly every US state.

 

The Roman Team

The Roman team is one the better teams I have worked with. They are efficient and professional. Their clinical director is competent and communicates with the physicians regularly.

It seems that their mission isn’t to make the most money from pushing ED medications. Instead, they have built an great website for patients to get the necessary information about erectile dysfunction. [Not proprietary information, see this link]

The team matters a lot of you are truly dedicated to your work and want to make a difference as a clinician. If you’re in it only for the money, then you can work for any shitty telemedicine company and just rack in the Benjies.

 

Job Opportunities

I am not sure if they are hiring more clinicians but I suspect a company like Roman will always grow.

It’s less important if Roman is hiring but more important for my physician (and psychologist) readers to be aware that more and more niche telemedicine platforms are coming to healthcare.

Consider all the different categories in medicine such as STI’s, pain management, psychotherapy, chronic disease, URI’s, and family planning. This market is so untapped, it makes me excited to see what will happen next.

I have done telemedicine work for nearly every single telemedicine company out there. This has allowed me to gain a ton of knowledge which has allowed me to build my consulting business. I see the niche market growing and broader telemedicine companies slowly disappearing.

 

Niche Telemedicine

Niche telemedicine makes sense because the marketing is easier, you’ll have far less competition, and it’s easier to demonstrate expertise.

I am currently consulting for a psychiatry specific telemedicine company out of California and they growing their services quickly.

Companies like Doctor on Demand were vehemently against prescribing “lifestyle” drugs like Viagra. This is a ridiculous and discriminatory stance for DoD to take which is why they are now backtracking on this policy. Or maybe it’s because their profits haven’t been as high as expected. [Not proprietary information, see link]

Specialty Focus

I had a recent email conversation with a blog reader who expressed interest in doing telepsychology. There is a high need for this kind of care and I would love to encourage more psychologists to pursue this telepsych.

To make it easier, try to focus on a specific niche, such as postpartum depression or PTSD. Even pediatric focused or geriatric focused telepsychology would be better than just doing general telepsych.

 

Malpractice Risk

The way they do what they do decreases the risk of telemedicine malpractice for the physician. You’ll have to become a clinician on their platform to know what I’m talking about.

In general, I am convinced that the chance of risk is lower doing telemedicine than F2F visits. Even though the wording by the medical boards is trying to scare physicians, there are fewer things which can go wrong in a telemedicine visit.

 

Future of Telemedicine

Though we are seeing a lot of telemedicine trying to replace an office visit, the future will likely be telemedicine augmenting the clinic visit.

Companies like DoD are having to raise their prices and companies like Teladoc aren’t able to turn expected profits for their investors. But this is just part of the story. They have paved the way for patients to accept telehealth as an alternative to a face-to-face visit for simpler, non-clinical matters.

We are seeing pharmacies getting into the telemedicine space. They tried to get into clinical medicine with those minute-clinics but that wasn’t a profitable move.

Pharmacies are looking to collect that juicy patient data. I expect telemedicine to cross paths with pharmacies in the very near future. This might explain larger groups like Amazon looking at the pharmacy industry.

A Roman dick pill vending machine? I could see that happening.

 

Addendum – 3/2019

It was interesting to read this little bit by the California medical board which seems to be targeting the platforms such as Roman directly.

What stands out is that it is from a 2004 action report. I’m not sure if it has since been amended. But it’s worth paying attention to if you are worried about any kind of risk when practicing on a platform where you’re not really interacting with the patient and instead just prescribe a medication.

6 replies on “Roman Telemedicine Review for Physicians”

I am just amazed how well you handle things like this and really appreciate you being so candid about the situation.

A lot of doctors would have kept everything under wraps (how many doctors do you know go around telling colleagues or even the public about their involvement in malpractice cases? You know it happens but no one discusses it so no one knows how to handle it.

What you have done is a huge service to those reading it. And honestly I can’t believe the uproar over what the issue was. They have doctors practicing that have done fraud or substance abuse and there are likely so many more out there not caught yet they want to waste limited resources trying to make an example out of you.

Sorry you have to go through this. Honestly you should write a book and publish it and hopefully it becomes a financial juggernaut that more than makes up for the losses incurred now

Thank you for your incredible support – seriously means a lot. I’m glad others are reading it because just having a little extra knowledge takes the medical board’s edge away. As for the medical groups, they can react any way they like, it’s their prerogative. But when we are less reliant on them, it no longer is a skewed supply and demand curve.
It makes no sense to create a criminal record for doctors, that doesn’t help anyone. It’s how these proceedings are handled, however. We’ll see how it plays out.

Ditto, what Xraysvn said.

I think it is very refreshing to see such candid thoughts about what you are going through. Bravo.

I, also, have been doing exclusively telemedicine for 4 years. I feel a bit of a squeeze now from the companies wanting to steer their independent contract physicians into an employed position. I work from abroad and don’t want or need the benefits they push.

I like your ideas on niche telemedicine being more of the future. I would like to somehow create a niche TM site but don’t know where to start.

Keep up the good work and look forward to future post!

That’s great – nice to meet a fellow TM’er.
Thank you for your kind words, it means a lot and is very encouraging.
My approach to starting your own mice TM would be as follows:
1. focus on a niche you’re comfortable with or excited learning more about
2. imagine the worst case customer in that niche, would you be okay dealing with those on a daily basis
3. figure out disease prevalence of that particular patient niche (TM weight loss = 60% prevalence)
4. what’s your income need and how much time are you willing to commit
5. what will your customer acquisition costs be (the money you have to spend marketing)
6. what’s your overhead (TM platform + malpractice + CAC costs)
7. talk to a company like Vsee which should run you no more than $300/month and they offer everything from TM to EHR in one price
8. figure out your price and play around with it

I like erectile dysfunction and birth control as possible niche markets. Hair loss and skin care such as acne is very underrepresented. Anxiety, insomnia, depression are possible as well. Everyone is afraid of the risk but I don’t see how it’s different if the person is seen in person and there is no proof for the extra risk so far.
There are no herbal TM platforms for common stuff like back pain/URI’s/UTI’s/dyspepsia.
You can get super-nice – refilling only herpes medication for HSV1 and HSV2. Buy the pills in bulk 1,000 pills for $100 and package and ship out from your own pharmacy which is what Roman does.
Much of your CAC can be lowered by having your TM landing site also be the main expert topic site on the web. With a good SEO strategy your site should come up quite high; meaning, you’ll spend a lot less on Google AdSense or on social marketing strategies to get your service/product out there.

Good luck.
Happy to chat more if you’re interested.

Thanks so much for such great ideas you put out there in your post!

A lot to chew on. These opportunities that we have in TM have made me more optimistic about practicing in the future. After twenty years of in-office work, doing virtual medicine is SO refreshing.

I’ll have to contact you through clarity to pick your brain a little.

I look forward to more good posts and comments from our colleagues.

I am a board certified urologist seeking employment with your company. Please contact me for any job openings at [deleted]

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