Legalities of Telemedicine

Image Credit: anaken2012/shutterstock.com

A brief has been filed with the U.S. Supreme Court that, if the court decides to hear the case, could have wide-ranging implications for online medical care and the limits of a physician’s First Amendment right to free speech.

Medical Advice Via e-Mail

Institute for Justice Senior Attorney Jeff Rowes filed the brief at the end of June on behalf of a Texas veterinarian who was punished by the Texas Board of Veterinary Medical Examiners for giving advice about pets via e-mail. Retired and physically disabled, Ron Hines, DVM, PhD, of Brownsville, Texas, was contacted years ago by missionaries in a remote part of Nigeria who wondered how to help a stray dog suffering from distemper. Dr. Hines advised them to look through their medicine cabinets to see if they happened to have anything that he thought might help the dog recover.

The missionaries had no access to a vet, and they had never met Dr. Hines. Instead, the missionaries contacted him after they came across his online articles about pets—articles on the “Ten Rules for Finding the Right Pet,” “Preventing Dental Problems in Your Cat” and “Ain’t Misbehavin’—Training Your Puppy”—thinking he might be able to give them some advice.

Many people around the world do not live close to a veterinarian. Over a 10-year period, half of Dr. Hines’s clients were not in the U.S. In complex cases when people in North Africa asked him for advice, he often recommended that they take their animal to a Dutch friend and colleague of his practicing in Marbella, Spain. Some complex cases he sent to acquaintances at the veterinary school in Ghent, Belgium. Difficult Middle Eastern cases he referred to friends he trusted at the veterinary school in Bursa, Turkey, Dubai or Irbid, Jordan.

Dr. Hines was not prescribing medicine, but he was giving advice based on his many years of experience. The Texas Board of Veterinary Medical Examiners eventually took notice. The Board “threatened to permanently revoke my veterinary license if I ever provided ‘any opinion related to the health and well-being of any animal anywhere in the world’ through e-mail, telephone or other electronic means unless the animal was presented to me in person.”

The Board also fined him, placed him on probation and made him retake the veterinary jurisprudence portion of the licensure exams as punishment for having done so in the past. Dr. Hines had violated a Texas board regulation stating that a vet cannot give advice about a specific animal unless he has physically examined the animal.