Telemedicine IM vs. Neurology

[davidBA]

Which of these specialties is better suited for a telemedicine career? Which of them has more job opportunities/availability in telemedicine?

I'm an IMG applying for either IM or Neurology next year, and idea of doing telemedicine from my home country one day is quite appealing. I understand that not all companies allow doing telemedicine from abroad, and that's why I'm asking about telemedicine job availability.

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[rokshana]

Which of these specialties is better suited for a telemedicine career? Which of them has more job opportunities/availability in telemedicine?

I'm an IMG applying for either IM or Neurology next year, and idea of doing telemedicine from my home country one day is quite appealing. I understand that not all companies allow doing telemedicine from abroad, and that's why I'm asking about telemedicine job availability.

Radiology is what you are looking for…

 

[NewYorkDoctors]

Neurology? bad idea. who else is going to do the full comprehensive neurological exam? also you cant bill for in office EEG, EMG/NCV, saline injections into trigger points, infusions for MS, or injectable biologics for migraines, or buy your own MRI machine (money printing machine) for your multi-neurology group and one/two neuroradiologists

 

[chessknt]

Telemedicine career? I agree radiology is the only specialty where no in-person contact would ever be required.

 

[IMGASMD]

Neurology? bad idea. who else is going to do the full comprehensive neurological exam? also you cant bill for in office EEG, EMG/NCV, saline injections into trigger points, infusions for MS, or injectable biologics for migraines, or buy your own MRI machine (money printing machine) for your multi-neurology group and one/two neuroradiologists

Had plenty they asked the bedside nurse to do neuro exams. But for mostly nih stroke stuff.

If you cannot touch your patients and need to make diagnosis on subtle findings, I would not trust anything over the Internet.

 

[davidBA]

Radiology is what you are looking for…

Unforunately, Radiology is too competitive for IMGs. Please correct me if I'm wrong.

 

[davidBA]

Neurology? bad idea. who else is going to do the full comprehensive neurological exam? also you cant bill for in office EEG, EMG/NCV, saline injections into trigger points, infusions for MS, or injectable biologics for migraines, or buy your own MRI machine (money printing machine) for your multi-neurology group and one/two neuroradiologists

How about IM? any potential for telemedicine?

 

[darklabel]

How about IM? any potential for telemedicine?

Its pretty saturated. Its more sucessful when you do a bit of a hybrid model. You can bill them full with a video visit, but you're limited without full physical to evaluate the patient.

 

[IMGASMD]

How about IM? any potential for telemedicine?

I think your patient base will be terrible.

I will be honest, this conversation leaves a bad taste in my mouth….. why do you even want to do a residency in the US, if not practicing medicine in the US? Get a tech degree, you can remote work.

 

[davidBA]

Its pretty saturated. Its more sucessful when you do a bit of a hybrid model. You can bill them full with a video visit, but you're limited without full physical to evaluate the patient.

Thanks for your reply. Any idea how telehospitalist would work? do you see any potential in it?

 

[darklabel]

Thanks for your reply. Any idea how telehospitalist would work? do you see any potential in it?

Personally never seen it done. Most of the time there's tele-intensivist which serve area that don't have one in house. Usually its in more remote areas with an open ICU that a hospitalist can call in an intesivist for help on difficult matters. That might be the closest I've seen. Initially in COVID they had telehealth for some specialties to round on COVID patients without having to be exposed, but that was early on in the pandemic and their use has fallen out of favor.

 

[chessknt]

Thanks for your reply. Any idea how telehospitalist would work? do you see any potential in it?

There is no field in IM that will lead to a full career of remote work. There are hybrid models that exist for outreach but if you only did telehealth and found some hospital to employ you in that capacity it would be part time at best and they would probably want you to be physically in their telehealth facility not at home in another country. I would abandon this idea now.

 

[rokshana]

Unforunately, Radiology is too competitive for IMGs. Please correct me if I'm wrong.

Was…now not as much.

 

[end stage fibro]

There is no field in IM that will lead to a full career of remote work. There are hybrid models that exist for outreach but if you only did telehealth and found some hospital to employ you in that capacity it would be part time at best and they would probably want you to be physically in their telehealth facility not at home in another country. I would abandon this idea now.

/thread

With the caveat that if you're willing to have like 15 state licenses you can pursue some asynchronous remote work but I would not count on that

 

[Cognovi]

Unforunately, Radiology is too competitive for IMGs. Please correct me if I'm wrong.

There are tons of IMGs in radiology. Not nearly as many or a high proportion as in IM and neurology but still a decent amount relative to the size of the field. In recent years, about 100 non-US IMGs match to a US radiology residency per year (about 1150 positions).

 

[Phantom Spike]

/thread

With the caveat that if you're willing to have like 15 state licenses you can pursue some asynchronous remote work but I would not count on that

What would the downsides be to getting 15 state licenses? Don't get me wrong, the idea doesn't thrill me, just wondering if there are huge specific negatives that I'm not seeing.

 

[IMGASMD]

What would the downsides be to getting 15 state licenses? Don't get me wrong, the idea doesn't thrill me, just wondering if there are huge specific negatives that I'm not seeing.

$$$ for something that you may or may not be using.
Paperwork can suck. Some states are just aholes.
You have to maintain them. Different states have different mandatory CMEs.

I am hating it maintaining only 4. Also if you are credentialed are different facilities, with your 15 state licenses, every single one will have paperwork. Does it suck bad? Maybe, maybe not. But that’s a lot of paperwork to go through every year or two.

Just me though.

 

[rokshana]

$$$ for something that you may or may not be using.
Paperwork can suck. Some states are just aholes.
You have to maintain them. Different states have different mandatory CMEs.

I am hating it maintaining only 4. Also if you are credentialed are different facilities, with your 15 state licenses, every single one will have paperwork. Does it suck bad? Maybe, maybe not. But that’s a lot of paperwork to go through every year or two.

Just me though.

Agree…I have 10 licenses and my saving grace is my locums companies maintain them… but still have to do some paperwork and cme that is state specfic.

 

[BorntobeDO?]

Of the two, IM is better for tele, but as stated above. I can't see IM going full telemedicine all the time. But then again, we are doing a ton of it in clinic now.

 

[chessknt]

Of the two, IM is better for tele, but as stated above. I can't see IM going full telemedicine all the time. But then again, we are doing a ton of it in clinic now.

I have seen teleneuro all over the place. I have seen far less teleIM (any field). I think neuro is winning this one for sure.

 

[BorntobeDO?]

I have seen teleneuro all over the place. I have seen far less teleIM (any field). I think neuro is winning this one for sure.

Nuero without a nuero exam seems like a waste of a consult IMO. I don’t send them there for a history. Telenuero may be more common, but that doesn’t mean, IMO, that the field is better suited for telemedicine.

 

[CCM-MD]

Nuero without a nuero exam seems like a waste of a consult IMO. I don’t send them there for a history. Telenuero may be more common, but that doesn’t mean, IMO, that the field is better suited for telemedicine.

Neuro*

Who needs an exam when you can get CT, CTA, CTP and MRI?