What to Expect from Telemedicine

How you use telemedicine and the kind of doctor you're seeing will affect what you should expect from an appointment.

For example, there may not be much difference between a telemedicine therapy session and an in-person one. 

However, there are more differences between an in-person visit with a primary care physician and a telemedicine one.

"Depending on where you get seen, you may still interact with a nurse at the beginning of the appointment before getting transferred to the physician. However, in some private practices, you will go straight to the physician so there is no waiting room time or time spent answering questions from a nurse. This allows the patient more time with the actual provider. 

If any additional work-ups are needed, at-home test kits could be provided, or the patient could be sent to a local lab if any of the tests can’t be done at home," says Lisa Ballehr, DO.

Here's what you can expect from telemedicine:

• You can get simple diagnoses and medical advice.
• You can use telemedicine for therapy.
• You should prepare for appointments.
• Telemedicine does not replace the emergency room.

You can get simple diagnoses and medical advice.

Telemedicine is used by a surprising number of medical specialties including oncologists, OBGYNs, opthamologists, and dermatologists. Through telemedicine services, you can receive simple diagnoses and get medical advice.

One concern many have regarding telemedicine is its care quality. A 2020 study by healthinsurance.com found that 64.65 percent of people did not think telemedicine was as good as an in-person visit. While telemedicine does have limitations, you can be confident in the care you receive from it.

"The standard of care for doctors seeing patients virtually is the same as if they were seen in person, so for example, if a doctor made an erroneous diagnosis or prescribed a medication that was contraindicated, they could be held legally responsible," says Kay Van Wey, board certifed personal injury trial lawyer.

While doctors still deliver a high standard of care and are liable for mistakes, keep in mind that the nature of telemedicine includes some limitations.

Amy Baxter, MD, PainCareLabs founder and CEO, offers a few examples:

"The biggest difficulty with telemedicine diagnoses in physical therapy is assessing strength. When you find out what's weak, you can extrapolate how someone is moving that results in pain.

In general, therapy telemedicine makes more sense than diagnostic telemedicine. There are some telemedicine diagnoses that result in an overprescription of antibiotics or pain medications. When people pay for a diagnosis, they expect something in return. When a practitioner has laid hands on you, you feel as if you've received something and believe them. When you've paid for them to look at you, you expect something in return — a prescription. 

In medical school, we were taught never to go on visual examination of an ear infection, but always to puff air and see if in fact the eardrum moved (red but fine) or didn't (fluid behind it). Telemedicine will never insufflate an ear." 

Keep these limitations in mind, though the doctor you speak with should let you know if an in-person visit is necessary.

"Sometimes a doctor can reach a diagnosis without a physical examination. Certainly for established patients physicians can refill most routine prescriptions for chronic medical conditions, seasonal allergies, etc. However, in the case of a new onset, acute condition, it will be incumbent upon the physician to explain the limits of the exam and either require you to come to the office or go to the ER depending upon the circumstances," says Van Wey.

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You can use telemedicine for therapy.

Mental health doctors and physical therapists use telemedicine.

Therapists and psychiatric doctors hold appointments over video chat or through telemedicine services. If you see a therapist regularly, ask what options they offer for remote appointments.

Check with your insurer to see if they have their own telemedicine services to see if they have a preferred telemedicine resource. You can also look at telemedicine subscriptions.

"While some states and insurers will provide some coverage for teletherapy sessions, a large portion of individuals are paying out of pocket. Many therapists in private practice have their own fee, and online therapy apps like BetterHelp and TalkSpace provide access to a mental health professional at a lower rate. Payments are typically made weekly and are either per session or monthly for a prescription package with one of the apps," says Haley Neidich, LCSW.

If you're using telemedicine for physical therapy, you may get additional technology that will improve your experience.

"Some of the new PT platforms using virtual reality and accelerometers for sensors will be able to make sure that a patient is doing the exercises correctly," says Baxter.

You'll also want to talk to your physical therapist about exercises to do before and after your appointment.

"Before a tele-physical therapy event patients need to warm up stiff muscles. Afterwards, they may need to reduce pain with mechanical or electrical stimulation, ice, or both," advises Baxter.

You'll need equipment like a high-frequency vibration unit for mechanical stimulation or a TENS unit for electrical stimulation.

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You should prepare for appointments.

Even though telemedicine is highly convenient, you should still prepare for appointments.

 "Don't treat it like a casual phone call or meeting — treat it like a true doctors appointment. Show up on time (hopefully your doctor will too), bring a list of questions, and come prepared," advises Yuna Rapoport, MD MPH, Manhattan Eye director and assistant clinical professor of ophthalmology at Icahn School of Medicine at Mount Sinai.

Being prepared will help you get the most out of your telemedicine visit and have answers to your questions. Another aspect of preparing for a telemedicine visit is making sure your tech is working well.

"Try to find a place that is quiet and that is well lit so your provider can hear and see you clearly. Be sure that your device is plugged in or charged fully before your appointment to avoid any technical issues," recommends Ballehr.

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Telemedicine doesn't replace the emergency room.

While telemedicine is a great option for non-emergency care, it won't help you in an emergency situation. If you have a medical question or don't feel well, then scheduling an appointment via telemedicine is great.

In fact, many people make unnecessary visits to the ER. UnitedHealth Group found that two thirds of ER visits by privately insured people were avoidable.

So, if your typical point of contact with doctors is in the ER, you can re-evaluate how you reach out to medical professionals. Using telemedicine or calling your doctor's office for non-emergency situations can also save you from expensive ER bills.

However, if you need immediate medical attention, don't spend time on telemedicine — get yourself to the ER or call 911.

If you think you have COVID-19, mention it in your call so that first responders and hospitals can follow their protocols for receiving COVID-19 patients.

Telemedicine is a convenient way to receive medical advice, simple diagnoses, and therapy. As you explore telemedicine, be sure to understand the costs and carefully consider apps to ensure that they are HIPPA-compliant. For more information on these topics, read "Telemedicine: What You Need to Know."