Is anyone doing telemed and what are your thoughts?

[gogogurt]

I've been looking for a side gig to help save up for a house and am considering telemed as there isn't a lot of per diem available in my area. I like the idea of being able to work from home but wondering if it actually works (meaning you actually get the number of patients they promise) and what the practice is like. I'm a bit worried I'm going to end up seeing a bunch of folks who I can't do anything for or who just want a Z-pak for their two days of sniffles. I'm also wondering how licensing and cost works out. I'd greatly appreciate insight from anyone who has experience doing this.

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[jacobus1919]

When COVID started it was when telemedicine started to ramp up, and I was still in residency. I liked doing telemedicine - virtual or telephonic. And I agree the only issue is that some encounters are just hard to decide on what to do specially for really acute visits when all you can do is give a Z-pack or even end up sending them to a walk-in or the ER to be evaluated. Regarding licensing i do not have experience about licensing since all my telemedicine visits are with my own clinic patients. But I hear it is a really good side hustle to do.

 

[B1GM0N3Y86]

I do some telemedicine work on the side for a company. Its a general medical platform. Visit reasons range from UTIs, Cough, Sinus Congestion, N/V/D, Styes, Conjunctivitis, Pain, Rashes, Dental Infections, etc... Some visits I send in prescriptions, some I recommend only OTC remedies, and others advise them to seek in person medical evaluation with PCP, UC, or ER depending on severity of complaints.

You don't have to be a Zpack mill if you don't want to. All you have to say is "No." Follow evidence based guidelines and give short succinct medical reasoning that people can understand why you are treating them with this thing or that thing. To me this is no different than if I was at my main office job. If the person is still being a jerk/dick/karen after you have given them sound medical reasoning that a child can understand, you do the same as if you were in your office. End the visit, mark them as a problem patient and thus they get dismissed, and move on.

I am 1099, so I take care of my licensing but if you work with some as a W2, I think they will pay to help you get your total number of state licenses up to a specific amount.

Lastly, I don't know if I could ever do this full time. I would miss patient contact and office procedures too much I think. However, it is nice to have a side gig to make some extra cash. Doing some telemed work also comes in handy if you are ever between W2s jobs. You can just log on and take consults and make some money. It acts somewhat like a safety net for you so you are never without an income if you dont want to be.

 

[Ironheme]

I do some telemedicine work on the side for a company. Its a general medical platform. Visit reasons range from UTIs, Cough, Sinus Congestion, N/V/D, Styes, Conjunctivitis, Pain, Rashes, Dental Infections, etc... Some visits I send in prescriptions, some I recommend only OTC remedies, and others advise them to seek in person medical evaluation with PCP, UC, or ER depending on severity of complaints.

You don't have to be a Zpack mill if you don't want to. All you have to say is "No." Follow evidence based guidelines and give short succinct medical reasoning that people can understand why you are treating them with this thing or that thing. To me this is no different than if I was at my main office job. If the person is still being a jerk/dick/karen after you have given them sound medical reasoning that a child can understand, you do the same as if you were in your office. End the visit, mark them as a problem patient and thus they get dismissed, and move on.

I am 1099, so I take care of my licensing but if you work with some as a W2, I think they will pay to help you get your total number of state licenses up to a specific amount.

Lastly, I don't know if I could ever do this full time. I would miss patient contact and office procedures too much I think. However, it is nice to have a side gig to make some extra cash. Doing some telemed work also comes in handy if you are ever between W2s jobs. You can just log on and take consults and make some money. It acts somewhat like a safety net for you so you are never without an income if you dont want to be.

Can I ask how much do you make doing this? How much on average per patient?

 

[B1GM0N3Y86]

I average about $25-26 per consult.

Most consults take 6-8 minutes from the time I open the chart to the time I'm signing off.

I just log in, leave the page open in the background, and get notified when a consult is ready while I'm doing other thing.

Usually have between 4-6 pph. I only have 2 state licenses, however the more you have the more consults are available to you.

 

[AMEHigh]

I did telemedicine in a specific niche for a bit and I liked it. I have a lot of colleagues that also do telemedicine for a specific niche and enjoy it as well. I think I would hate it for "primary care" URI, abdominal pain, etc. It was a nice little source of income when I did it so it was good for bulking up savings during the height of Covid when things were uncertain for me.

For licensing I could only see patients in the 2 states I already had licenses in. I’m not sure what you mean about costs. There were no other costs.

 

[Prehealth1011]

2020 FM Physicians - what do you earn?

Ok I posted earlier but I got new jobs and I know upcoming graduates are looking... $190,000 working in a community health center. All appointments are 30 min. I work 4 days a week, 1 day is admin. $1000 a day abortion care (I usually do 2-3 shifts per month, hours are usually 9-3 or 4)...

forums.studentdoctor.net

One of the posters here made 470k.

 

[trickydoctor]

I do some telemedicine work on the side for a company. Its a general medical platform. Visit reasons range from UTIs, Cough, Sinus Congestion, N/V/D, Styes, Conjunctivitis, Pain, Rashes, Dental Infections, etc... Some visits I send in prescriptions, some I recommend only OTC remedies, and others advise them to seek in person medical evaluation with PCP, UC, or ER depending on severity of complaints.

You don't have to be a Zpack mill if you don't want to. All you have to say is "No." Follow evidence based guidelines and give short succinct medical reasoning that people can understand why you are treating them with this thing or that thing. To me this is no different than if I was at my main office job. If the person is still being a jerk/dick/karen after you have given them sound medical reasoning that a child can understand, you do the same as if you were in your office. End the visit, mark them as a problem patient and thus they get dismissed, and move on.

I am 1099, so I take care of my licensing but if you work with some as a W2, I think they will pay to help you get your total number of state licenses up to a specific amount.

Lastly, I don't know if I could ever do this full time. I would miss patient contact and office procedures too much I think. However, it is nice to have a side gig to make some extra cash. Doing some telemed work also comes in handy if you are ever between W2s jobs. You can just log on and take consults and make some money. It acts somewhat like a safety net for you so you are never without an income if you dont want to be.

Hello, I’m 3rd year FM resident. If possible
, Can you DM me the name of the telemedicine company you are working with? Thank you and appreciate your input.

 

[B1GM0N3Y86]

I did telemedicine in a specific niche for a bit and I liked it. I have a lot of colleagues that also do telemedicine for a specific niche and enjoy it as well. I think I would hate it for "primary care" URI, abdominal pain, etc. It was a nice little source of income when I did it so it was good for bulking up savings during the height of Covid when things were uncertain for me.

For licensing I could only see patients in the 2 states I already had licenses in. I’m not sure what you mean about costs. There were no other costs.

Yeah, I don't think I could do long term Primary Care Telemedicine by itself. It is okay logging in few times a month for a few hours to pick up some consults and extra cash however the niche telemed fields I would think would be somewhat easier. You know of any platforms that are a specific field that allows you to log on and off whenever without having to sign up for shifts? Thats the main reason why I chose the current general medical telemed platform I do some work for, being able to log on whenever and get off whenever is nice. Some of the others I looked at required specific amounts of shifts per month which did not interest me.

Feel free to shoot me a private message if you don't mind.

 

[FrustratedFamDoc]

I'll go on record to say that I hate it.

I do a limited number of visits if necessity warrants.

The video component adds absolutely nothing to the visit for me, but is necessary to get the level of billing required. The video reception is frequently choppy and makes things take longer than they already do. I much prefer to just pick up the phone and call a patient, but that maxes out as a level 2, I believe, and hardly worth my time. I'd rather just call a patient at the end of the day and fill that visit with a garden variety, 99214 visit with someone else. Why do I need a video camera to see if the higher dose of vyvanse is helping, or for them to describe their UTI symptoms? Does the video make me better at what I do?

I do see it's utility for online urgent care issues, but for my estab. pts, video is worthless and the level 2 audio only visit that I would likely do has an opportunity cost higher than I want.

 

[scharnhorst]

What is the malpractice climate for telemed at this time ?it was all uncharted waters back in 2020 but do we have more clarity of what can or cannot be managed by telemed in primary care ?