Page 22 - Diagnostic Radiology - Interpreting the Risks Part Two_Neat

SVMIC Diagnostic Radiology: Interpreting the Risks

teleradiology and “nighthawk” services have been around for a

long time, these were typically performed by radiologists within
the same state as where the patient was located. With the

increased emphasis on telehealth and the potentially lucrative
benefits it offers to participating physicians, many radiologists

are performing teleradiology across state lines (and even across
international borders). This practice raises certain legal issues;

specifically, licensure and jurisdictional issues, along with the
question of which standard of care is to be applied?

For most legal purposes, the practice of medicine is held to

occur at the location of the patient. State medical boards are
charged with protecting their citizens from malpractice, fraud,

and quackery. Their dilemma for teleradiology/telehealth is
that they have no jurisdiction over the license or performance

of a doctor located in another state (or country). Discussion
has been ongoing for decades about national licensure,

reciprocity/portability agreements, limited telemedicine
licenses, and uniform standards. So far, states have tended to

protect their autonomy, with considerable variation in laws and
regulations. However, in 2014 the Federation of State Medical

Boards published a Model Policy for the Appropriate Use of
Telemedicine Technologies in the Practice of Medicine (a copy

of this can be found at www.svmic.com and also available
at https://www.fsmb.org/siteassets/advocacy/policies/

fsmb_telemedicine_policy.pdf). Many states have incorporated
principles from this model in their own regulations.

Although each state establishes its own criteria and laws for
determining when the physician-patient relationship exists, it

is safe to say that if radiology services are being performed on
behalf of or for the benefit of a patient, the physician-patient

relationship has been established, and that radiologist owes

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