1. Lack of attention:

This physician looks frazzled and distracted—by sounds coming from outside her home office, by her phone, by her cat, and by any noise potentially coming from her television, which she inadvertently left on during her call with the patient.

2. Privacy Breaches:

By leaving the door open and failing to wear a headset (thus potentially allowing the patient to be overheard by anyone who might be walking by), the physician may be violating HIPAA requirements. The fact that other patients’ chart folders are visible to the current patient is also a privacy error.

3. Quality-of-Care issues:

Because the physician is not paying strict attention to her patient and has no apparent way to verify his identity, review his chart, or record details of their telemedicine visit, it is possible that the quality of care she provides will suffer. She may overlook concerning symptoms or narrative details provided by the patient, possibly leading to a failure to diagnose him correctly or prescribe appropriate care.

4. Unprofessionalism:

The patient can see and hear all of the unprofessional aspects of the physician and her office, including the exercise show on the television, the messy books and papers behind her, her biking T-shirt under her white coat, her unkempt hair, and the half-eaten breakfast on her desk. This may lead to a loss of confidence in the physician by the patient.

5. Lack of Documentation:

Without having a way to take notes, the physician is unable to timely and accurately document what is taking place during the telemedicine visit. This could lead to the omission of critical details or the inclusion of inaccurate information, especially if the physician doesn’t document what took place until sometime after the visit has concluded—or fails to document it at all. An hours-long delay in documentation caused by a hectic clinical visit schedule could make remembering exact details more difficult and could lead to questions about the chart’s accuracy if a poor outcome occurs and a malpractice case ensues.