Guide to Practicing Telemedicine While Living Abroad

Enzyme Health Team February 20, 2019
Guide to Practicing Telemedicine While Living Abroad

Think your medical career can’t support an international existence? Dream big and take advantage of the opportunity to work for yourself - from anywhere - with a career in telemedicine.

Ever fantasize of packing up and heading to the airport with no destination in mind? Envious of your Instagram friend posting those once-in-a-lifetime photos from their work-sanctioned sabbatical? Feeling like you missed out on the whole study abroad experience?

Choosing a medical career - while a noble and rewarding pursuit - can leave you feeling confined to the day-in-day-out grind of the hospital or medical practice.

We’re here to tell you, life doesn’t need to be that way. Telemedicine is a flexible, work from anywhere gig that can allow you the freedom to fuel those buried travel passions.

Whether you dream of an extended holiday or uprooting entirely, this guide to practicing telemedicine abroad will help you explore the benefits of working overseas, review some practicalities for getting your trip (or move!) organized, and highlight a few tips from an expert telemedicine physician traveler.

Benefits of Practicing Telemedicine Overseas

Besides the obvious “living somewhere exotic,” find out how your health and your wallet will thank you.

Make your money go further

Geoarbitrage, a term commonly heard within financial and digital nomad circles, is one of the biggest reasons expats cite for moving abroad. Simply put, when you move somewhere with a lower cost of living, your money goes further.

Following this principle, you can earn a higher salary than the average going rate in the country you travel to, everyday costs will be much lower, and you may be able to cut spending entirely on things like commuting, child care, and car payments.

Travel at your own pace

Practicing telemedicine abroad allows you to fit work around your leisure schedule - not the other way around. This means you can visit tourist sites and explore the local culture at your own pace, without having to rush site-seeing into a few days off. Seasoned telemedicine traveler Dr. Mo refers to this as ‘chaotic travel.’ Instead, he rents a flat in Barcelona or Seville for three months, travels slowly, and maintains a home base.

“The headaches are fewer, it’s cheaper, and I get to genuinely connect with the local culture rather than other competing tourists”.

Spend longer (and cheaper!) visits with family and friends

The majority of leisure travel in the US is spent visiting friends and relatives. Unfortunately, demanding work schedules often dictate shorter than ideal trip length. With a telemedicine practice, you aren’t as restricted by dates and you can avoid the rush around popular travel times - meaning more time spent with loved ones at a lower cost.

Enjoy a better quality of life

The US is known for its hectic pace of life. But in many countries, especially certain parts of Europe and Asia, the cultural belief in living slow rewards residents with longer lifespans and better quality of life. From fresh, locally-sourced diets to balanced life and work, the motto is often to put life first and work second. While this can be a hard adjustment for fast-paced US nomads making the transition to life abroad, the health benefits of reduced stress alone are enough to add years to your life.

Siesta anyone?

Pursue a passion while still earning

More time brings freedom to pursue a passion. Been wanting to write the next Great American Novel or take up photography semi-professionally? When you are living in a country where you can earn more by doing less, you can focus on the things you may have put on the back-burner for far too long. And who knows? Maybe your next passion project turns into a viable income source. Just ask Dr. Ken.

Put your health first and practice what you preach

Living slow and prioritizing life outside of work gives more time to consider your own health - something overnights and on-call shifts can often drown in neglect. From freeing up time to head to the gym or cook a homemade meal, to sleeping in or taking naps when your body says so (not when your ever-shifting hospital schedule dictates) - a flexible telemedicine schedule can shake up your routine and help highlight aspects of your health that may have been long ignored.

Preparing to Practice Telemedicine Overseas

Get your logistics in order before your trip or risk fines, hassle, or worse.

Long-term travel visas

Securing visas can be costly, confusing, and time-consuming. US citizens are lucky though in that the US passport is powerful - allowing access to 186 countries and territories without a visa or with a visa available upon arrival.

If you plan to stay awhile, following are some countries and territories with the longest travel visas courtesy of The Global Gadabout:

  • Umlimited length of stay: Equatorial Guinea, Marshall Islands, Micronesia, Svalbard

  • 1 year: Albania, Georgia, Palau

  • 240 days: Bahamas (take us with you please!!!)

  • 183 days: Peru

  • 180 days: Antigua & Barbuda, Armenia, Barbados, Bermuda, Canada, Cayman Islands, Central African Republic, Dominica, Jamaica, Mauritius, Mexico, Montserrat, Panama, St. Lucia, UK (return/onward ticket required)

  • 120 days: Andorra, Fiji, Tunisia

If you’re planning on a shorter visit, most European countries allow visits up to 90 days. We highly recommend researching potential destinations before your departure so that you understand visa requirements and length of stay restrictions before arrival.

Medical licensure

Prior to departure, take stock of your medical licenses and their expiration dates. It’s also helpful to secure multiple state medical licenses before embarking on a remote telemedicine career to ensure a consistent queue of work. Aim for at least three, particularly one from an in-demand state like New York, California, Florida, or Texas.

Accommodations

While international hostels were fun in the college days, we highly recommend securing private accommodations in advance. Not only are apartments better for long-term rentals, but if taking telemedicine calls, you’ll want to protect patient privacy with a quiet, secure place to conduct consults.

Airbnb and HomeAway are global companies with reliable international housing and most listings state whether they have wifi. Be sure to read the reviews, as some coverage can be spotty. And consider our list of vacation spots with the best wifi to help in your destination research.

Technology and equipment

With a laptop, wi-fi, and international mobile phone you’ll be well on your way.

First, ensure you are using a world phone capable of connecting to a GSM network (the global standard). Popular models like iPhones and Samsung Galaxy phones should meet this standard. Next, ensure you have a decent international mobile phone plan in case you need to tether a connection from phone to laptop or simply want to easily stay connected back home. T-Mobile is known to have one of the best international data plans with its unlimited data feature (although slow connection speeds).

If you are visiting long-term and decide to purchase a local phone plan, services like Magic Jack and Google Voice let you keep a local US number that friends, family, and colleagues can use to reach you.

Once you arrive at your destination and have ensured your apartment or house has fast and reliable wifi, you may want to consider places to work outside of your home-away-from-home. Check into the local wifi hotspots like coffee shops and libraries and conduct a practice run to ensure that the data infrastructure is up to speed. Wifi Map is an app that can help you find local hotspots worldwide.

You also may want to set up a VPN, or Virtual Private Network. A VPN lets you send and receive encrypted data over a less secure network, like public wifi. A must-have for many digital nomads today, VPNs are a security step not to be overlooked, especially in more censored locales like China and Russia.

Consult our article on other useful technology tools, apps, and extensions for telemedicine providers on-the-go for additional tips.

Get your bearings

Take a day or two before starting work to ground yourself in your new home. Where is the local bakery, grocer, or produce market? Are you within walking distance to a laundromat? Where is the bus or subway stop and how often does it come? How about the post office? Ticking off these logistical matters will help alleviate any initial stress you may feel about starting work and life in a foreign place.

Advice from a Telemedicine Nomad

Still on the fence? We asked experienced telemedicine traveler and family medicine physician, Dr. Mo, about his experiences abroad and some common hurdles.

What does your typical telemedicine day look like?

“My routine in Spain is to get up at 9:30 am, head over to my favorite cafe in Sevilla, order an espresso and see about 20 patients using a text-based telemedicine platform. I then go home, make lunch, take a nap, and go to the gym. Once I’m back I complete 10-15 telephone-based telemedicine visits with a different company. I do this routine every other day and I easily earn about $6,500/month for ~12 hours a week of work.”

Will I get enough telemedicine patients?

“I heard this from everyone before I even got started; the idea that the volume of patients is inadequate and that telemedicine isn’t widely adopted enough for a traveling physician to earn an adequate income. So I ran a few experiments before hopping on a plane. In one 13-hour marathon, I earned nearly $2,700 doing telemedicine for just one company. If you’re living in a place like Spain, $3,000 will go a long, long way. The average salary in Spain is less than €1,000 a month in most cities.”

Whether based in the US or abroad, keeping a consistent patient flow is a common concern. Signing up for multiple telemedicine platforms or selecting a position that pays by the hour rather than per consult are methods to alleviate this issue. But as telemedicine grows, this issue is becoming less of a commonality.

What about legal issues working abroad?

“I want to make sure that as a telemedicine clinician, I don’t jeopardize the company for whom I see patients. At the same time, I want to make sure that that company isn’t unnecessarily restricting me and limiting my mobility stateside.”

Consider this a gray area. Most telemedicine companies do not have strict policies on where practitioners work. That said, you must keep patient privacy at the forefront wherever you work from. Be sure to ask your telemedicine employer about their policy for provider locale.

How many telemedicine companies should I secure credentials with?

“When I went abroad, I had three telemedicine clients, and the volumes were plenty. With 15 hours a week, I was able to earn a very good salary - more than I needed.”

Consider getting credentialed with more than one telemedicine company and working part-time for each. Not only will this help establish a complete schedule, but you can test out different platforms, try asynchronous vs. real-time video consulting, and decide what you like and what works best for you.

How do I prepare to practice telemedicine overseas?

“Take your laptop and rent a beach cottage with a good internet connection for two weeks. See if you can balance working from your laptop at a café or in your cottage while still enjoying your new travel destination”.

Pro tip: If you are seriously interested in taking your telemedicine career overseas, try a test run in a place fairly local, but unfamiliar to you.

Live, Work, and Travel with a Flexible Telemedicine Job

The future of telemedicine is bright, and as the adoption of the practice grows, so do the opportunities to travel while practicing. If you are unsure if a telemedicine company will support your move, it doesn’t hurt to ask the question. While you dream of your next adventure, keep your eyes on current telemedicine jobs with us here. Happy travels!