Monday, December 4, 2023
Physicians - maximum of 0.25 AMA PRA Category 1 Credit(s)™
ABIM Diplomates - maximum of 0.25 ABIM MOC points
This article is intended for physicians practicing or considering the practice of telemedicine.
The goal of this activity is to describe ethical issues faced by physicians practicing telemedicine and solutions for these issues, according to an American College of Physicians (ACP) case history and commentary.
Upon completion of this activity, participants will:
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The case and commentary were developed by the American College of Physicians.
Medscape, LLC designates this enduring material for a maximum of 0.25
AMA PRA Category 1 Credit(s)™
. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 0.25 MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.
For questions regarding the content of this activity, contact the accredited provider for this CME/CE activity noted above. For technical assistance, contact [email protected]
There are no fees for participating in or receiving credit for this online educational activity. For information on applicability
and acceptance of continuing education credit for this activity, please consult your professional licensing board.
This activity is designed to be completed within the time designated on the title page; physicians should claim only those
credits that reflect the time actually spent in the activity. To successfully earn credit, participants must complete the
activity online during the valid credit period that is noted on the title page. To receive AMA PRA Category 1 Credit™, you must receive a minimum score of 70% on the post-test.
Follow these steps to earn CME/CE credit*:
You may now view or print the certificate from your CME/CE Tracker. You may print the certificate but you cannot alter it.
Credits will be tallied in your CME/CE Tracker and archived for 6 years; at any point within this time period you can print
out the tally as well as the certificates from the CME/CE Tracker.
*The credit that you receive is based on your user profile.
CME / ABIM MOC Released: 10/17/2019; Reviewed and Renewed: 9/5/2023
Valid for credit through: 9/5/2024, 11:59 PM EST
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Dr Benson is a full-time telemedicine doctor working from home. She provides as-needed consultations to employees whose employers subscribe to Telehealthy through a secure video link embedded in an electronic health record maintained by Telehealthy. No enhancements other than the video link and the facilitation of patient and physician exchange of material (records, test results, etc) electronically through secure email are offered. Of note, Dr Benson is compensated additionally if she is able to provide services that save costs by decreasing inappropriate use of health care resources by employees. Employers who subscribe actively promote the availability of telemedicine and provide financial incentives to employees who use the service.
Dr Benson is talking to Ms Jones, 29, who works at Company A; she is using the service for the first time. Her medical records are not available. The patient has had a few days of dysuria, vaginal discharge, and some burning and itching. She is also experiencing bouts of fatigue. She is sexually active but is reluctant to talk about sexual history from the office conference room she is sitting in or to give more details about the discharge. Dr Benson suggests this is likely a simple urinary tract infection but could also be vaginitis secondary to candidiasis, pregnancy, or a sexually transmitted infection.
Ms Jones would like to try antibiotics for a bladder infection. Dr Benson is weighing how to tell Ms Jones she needs a physical exam and lab work when Ms Jones says she feels really uncomfortable and is in pain now, has multiple project deadlines to meet this week, and is not able to leave work.
"I had a UTI last year, can’t you just phone in a prescription for something?" Ms Jones asks.
Dr Benson tells the patient she needs to be seen for an in-person exam and lab work (and when Ms Jones eventually sees her primary care physician 2 weeks later, it turns out she still has symptoms, is pregnant, and her physician tells her, "Yes, you needed to be seen").
Nevertheless, the patient hangs up frustrated that this service did not yield a prescription. Dr Benson is frustrated at the outcome of this interaction as well. She also reflects on the fact that her compensation could be adversely affected by doing what she thinks is clinically indicated and the right thing in recommending this patient have an in-person evaluation.
