Key Takeaways
- Telehealth has become popular, but it doesn’t lower the standard of care in Texas; providers still owe a duty to patients.
- Malpractice cases often arise from failures such as ignoring the limitations of virtual exams and inappropriate prescribing.
- Physicians must ensure thorough assessments and must refer patients to emergency care when necessary.
- Key evidence includes visit records, prescriptions, and follow-up instructions to support malpractice claims.
- A doctor-patient relationship exists in telehealth, creating accountability for physicians.
The Screen Does Not Reduce the Standard of Care
Since the COVID-19 pandemic permanently reshaped how Americans access medical care, telehealth has become a routine method of delivering diagnosis, prescription, triage, and follow-up services. By 2024, tens of millions of Americans will use telehealth platforms annually. The convenience is real, but so is the risk of error. Texas law does not reduce the standard of care that a provider owes a patient simply because the visit occurred through a video platform rather than in an exam room. A physician who conducts a telehealth visit assumes a duty of care to that patient, and if a negligent decision during that visit causes injury, the patient may have a malpractice claim.
How Telehealth Malpractice Cases Arise
Texas telehealth malpractice cases typically involve one of several recurring patterns:
- Failure to recognise the limits of a virtual examination: Some conditions cannot be safely evaluated through a screen. Abdominal tenderness, signs of stroke, respiratory distress, cardiac instability, and acute surgical emergencies require physical examination. A provider who conducts a telehealth visit for symptoms that should have triggered an urgent in-person evaluation or emergency room referral may have committed a critical clinical error.
- Missed diagnosis based on incomplete information: Without the ability to auscultate, palpate, or observe directly, telehealth providers must be more vigilant, not less, about the limitations of their assessment. Dismissing worrying symptoms because they “can’t hear anything concerning” through a phone speaker does not constitute a reasonable clinical evaluation.
- Inappropriate prescribing: Remote prescribing has generated a wave of controlled substance prescribing issues, as well as cases where providers prescribed medications without adequate history-taking, allergy review, or acknowledgement of contraindications.
- Failure to direct patients to emergency care: One of the most legally significant decisions in a telehealth visit is whether to tell the patient to go to the emergency room. When a provider opts for watchful waiting or a follow-up appointment for a patient whose symptoms indicate a time-sensitive emergency, the delay in accessing appropriate care can cause permanent injury or death.
- Inadequate follow-up planning: Telehealth visits that end without adequate discharge instructions, follow-up scheduling, or clear return precautions leave patients without a safety net when their condition deteriorates.
Evidence in a Texas Telehealth Malpractice Case
Telehealth encounters generate a distinct evidentiary footprint. Key records to preserve and request include: the visit record or encounter note from the telehealth platform, any audio or video recording of the visit (if the platform records sessions), patient portal messages before and after the visit, electronic prescriptions, follow-up instructions, and the records from any subsequent emergency department, hospital, or specialist encounter where the consequences of the telehealth decision became apparent. The timeline in these cases often tells the story clearly: a telehealth provider dismissed symptoms that required emergency evaluation, and within hours or days, the patient presented in extremis at an emergency room with the condition that should have been caught during the remote visit.
Is There a Doctor-Patient Relationship for Telehealth?
Texas follows the general rule that a physician-patient relationship arises when a physician undertakes to provide medical services to a patient and the patient relies on that undertaking. A telehealth provider who conducts a visit, issues a diagnosis, and prescribes treatment has clearly established that relationship. Even limited telehealth interactions, such as triage calls, nurse line encounters, and asynchronous messaging platforms, may create a duty of care, depending on the nature of the clinical activity involved.
📞 FREE CASE REVIEW: If a telehealth visit in Texas resulted in a missed diagnosis, a delayed emergency response, or another harmful clinical decision, the medical malpractice lawyers at Rasansky | McKenzie Law can evaluate your case. Virtual care does not mean reduced accountability. Call today for a free consultation.
