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"Right" to an In-Person Encounter

Last time I looked at the Bill of Rights I saw nothing guaranteeing patients a "right" to an in-person encounter with any and every medical provider. Criminal defendants may have a right to representation by an attorney, but attorneys have an obligation to represent defendants, even without compensation, under some circumstances. Such an obligation for medical providers does not exist as far as I know. 

Availability for in-person encounters depends on the ability of patient and provider to meet at a location reasonably accessible to each. Telemedicine allows patient and provider to meet almost regardless of the geographical distance between them. 

Today, some providers can limit there availability to telemedicine, but others, especially where examination requires physical contact, can only provide their services in-person. 

There's nothing new about this dilemma. For decades, providers have made treatment recommendations by telephone to patients away at college, living part of the time in other states or countries, or traveling for work. Likewise, traveling providers have sometimes continued to provide limited professional services by telephone to patients still at home.

Even when located conveniently close to one another, timing also comes into play. Providers ordnarily have no obligation to meet with a patient, even one close by, at any time on any day. Patients may sometimes have to wait for regular office hours or use a different provider, such as an emergency room or urgent care clinic.

Though unrelated to "rights," reimbursement and payment questions arise as well. Telemedicine services may allow for considerable cost savings. By limiting payment for in-person encounters where possible, health plans might offer lower premiums.

Ideally, patients should always have access to needed services on a timely basis, but we should never require in-person availability of all providers. Telemedicine increases the overall availability of medical services, especially where audio-only does not suffice. If the patient's condition or complaint demands physical contact, they can and must rely on providers with facilities nearby. Any notion that the patient-provider relationship demands that they follow one another around is absurd.

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