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Q: Can a U. S., German, or English patient replace their expensive psychiatrist. . ( No Answer,   2 Comments )
Question  
Subject: Can a U. S., German, or English patient replace their expensive psychiatrist. .
Category: Health
Asked by: health777-ga
List Price: $50.00
Posted: 28 Aug 2006 08:38 PDT
Expires: 27 Sep 2006 08:38 PDT
Question ID: 760168
Can a U. S., German, or English patient replace their expensive
psychiatrist with an Indian one through Telephychiatry, as mentioned
in medicalcountries.org (possibly at 1/20 the cost), or has the
medical lobbies prevented this from happening, in some states and
countries, and could the patient ignore or get around such laws, where
they exist, in order to get affordable treatment from their home? The
only equipment the patient would need would be a computer, modem,
Internet connection, Internet telephone, and a web cam, all
inexpensive equipment that could be purchase with a few hours of
treatment savings.

Request for Question Clarification by bobbie7-ga on 28 Aug 2006 10:20 PDT
Hello again Health777,

I?m not really sure what kind of material you require.. 
Please take a look at the information below and let me know what you think.


The Effectiveness of Telepsychiatry: A Review 
? Effectiveness must be determined for each new technology because it
may have advantages and disadvantages over what is currently offered.
We reviewed the literature to synthesize information on whether
telepsychiatry is effective. Based on the literature, we suggest that
the effectiveness of telepsychiatry be evaluated on access to care,
quality of care (that is, outcomes, reliability, satisfaction and
comparison with in-person care), costs and empowerment. Further, we
discuss other factors that influence effectiveness (for example,
technology, administrative coordination and financial support).?

?Telepsychiatry appears effective, and recommendations are offered for
further evaluation of its effectiveness.??

Please read the complete report here:
http://www.cpa-apc.org/publications/archives/Bulletin/2003/october/hilty.asp



?Trott and Blignault (1998) reported that a telepsychiatry service in
rural Australia saved over $100,000 per year in health care costs when
there was an established rate of over 40 consultations per month. This
was mainly due to a reduction in employee travel costs. In addition,
the service potentially saved almost $100,000 per year in reduced
patient transfer costs. They acknowledged that equipment maintenance
and (future) upgrade costs were not considered.?
http://www.psychiatry.med.uwo.ca/ecp/info/toronto/telepsych/telepsychguide.html
Telepsychiatry in Europe."
http://www.med.mcgill.ca/ruis/Docs/telesante/Telepsychiatry_in_Europe.pdf


"Telepsychiatry in the UK"  see page 9
http://www.rcpsych.ac.uk/pdf/ip3.pdf

Regards, 
Bobbie7

Request for Question Clarification by bobbie7-ga on 28 Aug 2006 10:48 PDT
5. MEDICAL- LEGAL CONSIDERATIONS

According to the Canadian Medical Protective Association there are no
legal precedents regarding telepsychiatry. Future actions will be
resolved according to provisions of a

reasonable standard of care, accompanied by good documentation
regarding what was said (Broder, 2001a).

The most important principle is always act in the best interests of
the patient. There is consensus among many authorities 1 that the
issues to be considered include informed consent, clinical/case
responsibility, duty of care, delegation of responsibility to a
non-medical person, confidentiality, medical records, licensure and
liability/malpractice.

http://www.psychiatry.med.uwo.ca/ecp/info/toronto/telepsych/telepsychguide.html

Clarification of Question by health777-ga on 29 Aug 2006 11:55 PDT
I was trying to discover the ways doctors are limiting telemedicine
competition to protect themselves and increase their prices. Almost
all trades and profession do this, but the medical profession is
greediest. Some regulation is needed but it must be fair to both the
doctor and the customer. For example, if dollar distance eyeglasses
are available, legislation should not exist that makes the customer
pay $300 for a pair that offers no better vision.

 I was looking for more of the following including the same in Germany and England:

   A national teleradiology license does not exist. Most states
require the physician to have a license in each State where the
patient?s physical care occurs. Some states offer special telemedicine
licenses and teleradiology licenses.

Full License required in = Alabama, Alaska, Arizona, Arkansas,
California, Colorado, Connecticut, Florida, Georgia, Illinois,
Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland,
Massachusetts, Michigan, Minnesota, Missouri, Nebraska, New Hampshire,
New Jersey, New York, North Carolina, North Dakota, Oklahoma,
Pennsylvania, South Carolina, South Dakota, Utah, Vermont, Washington,
West Virginia, and Wisconsin.

Telemedicine, Teleradiology License Available = New Mexico, Ohio,
Oregon, Tennessee, Texas, Montana

No laws addressing Telemedicine, Teleradiology. Out of State
Physicians may consult with a licensed Physician = Rhode Island,
Hawaii, Idaho, Wyoming

No laws addressing Telemedicine, Teleradiology = Delaware

Special Purpose License Required= Nevada,

politicalguru-ga has raised some good points: (1) As learnt painfully
by BA and other British service providers,
Indians do not always understand the Brits and vice versa (esp.
Scottish accent). I am not talking about German. Get another German to
understand the Bavarians, not an Indian, who might know German. And
what about the cultural connotations/associations?

1.Reply: Anyone who has had trouble with their computer and calls
India to have it repaired has talked to some technicians that they
cannot understand and others who speak more clearly than their own
family members.

(2) A second question is whether a physician not licensed in a
Specific country can write prescriptions,

2. Reply: I do not have all the answers!!!!!!!! How should this
problem be handled? Could the patient consult with their local doctor,
on the medicine, or what would be the best rational course of action
that is fair and safe for both the patient and their providers?

(3) A third question, regarding Britain and Germany, is whether health
insurance would accept it or not. I live in Germany, and for me a
psychiatrist, shall I need one, is not expensive at all - it is
covered by my relatively cheap state insurance. If I need one, I'll
have to pay 10 EUR each 3 month for his services. I don't think that
even an Indian psychiatrist would work for such amounts. Not even a
Google Answers Researcher! Theoretically, the British NHS also covers
psychiatric treatment to those afflicted with mental illness (I say
theoretically, because I understand that the problem is getting an
appointment with a *good* consultant.
3. Reply:You have answered your own question when you say: I
understand that the problem is getting an appointment with a *good*
consultant. Many British citizens go to India to have their eye
operated on for $400 because they do not want to wait 18 months to
have it done at home. It is an illusion that the British or German
patient is only paying what the state charges them for a particular
procedure. What about the yearly fees, taxes and other state costs
they have had to pay for even having the insurance?
Answer  
There is no answer at this time.

Comments  
Subject: Re: Can a U. S., German, or English patient replace their expensive psychiatrist
From: politicalguru-ga on 28 Aug 2006 11:45 PDT
 
Dear Health, 

There are several issues that are besides these points: 

(1) As learnt painfully by BA and other British service providers,
Indians do not always understand the Brits and vice versa (esp.
Scottish accent). I am not talking about German. Get another German to
understand the Bavarians, not an Indian, who might know German. And
what about the cultural connotations/associations?

(2) A second question is whether a physician not licensed in a
specific country can write prescriptions;

(3) A third question, regarding Britain and Germany, is whether health
insurance would accept it or not. I live in Germany, and for me a
psychiatrist, shall I need one, is not expensive at all - it is
covered by my relatively cheap state insurance. If I need one, I'll
have to pay 10 EUR each 3 month for his services. I don't think that
even an Indian psychiatrist would work for such amounts. Not even a
Google Answers Researcher! Theoretically, the British NHS also covers
psychiatric treatment to those afflicted with mental illness (I say
theoretically, because I understand that the problem is getting an
appointment with a *good* consultant.
Subject: Re: Can a U. S., German, or English patient replace their expensive psychiatrist
From: bipolarmo-ga on 21 Nov 2006 14:38 PST
 
I am a UK psychiatric patient and I do not have an "expensive
psychiatrist" as here we have a free state health service.

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