By Dr. Mia
You woke up with a red gooey eye. Or you have a fever, cough, and feel very tired. Or maybe you simply want an expert to answer some medical questions for you. If you can’t get an appointment with your primary care physician (PCP) for 2 weeks, what can you do? Is a telehealth appointment safe? Will you get good care? How do you know if what you have can be treated through a telehealth visit?
These are common questions for people who have never had a video-based visit on their computer or mobile device with a doctor they may not know.
When telehealth can help
While there are many medical conditions that doctors can safely treat by taking a thorough history and performing a virtual physical exam, there are also times when you might need emergency attention. But before we talk about when you shouldn’t try a virtual visit, let’s talk about what a doctor can do through a virtual visit. Keep in mind, most doctors have gained experience in the office or hospital setting before they begin offering care via telehealth. They also trust you, the patient, to be honest, open, and forthcoming in answering questions about your health. With that as a foundation, here’s what a telehealth doctor can do:
- Take your medical history: Through a virtual face-to-face encounter, an experienced provider can listen to your concerns and ask questions to hone in on what aspects may be more – or less – serious. They may also ask questions about your family history and lifestyle habits. Through this thoughtful discussion, the provider can come up with a diagnosis, a treatment plan with medications if indicated, and a follow-up plan if you do not respond as predicted. It may surprise you to know that 80% of medical diagnoses can be made through a good history-taking by an experienced provider.
- Conduct a physical exam: Surprisingly, there are many elements of the exam that a provider performs in the office that can still be done through a virtual visit. These include observing how you speak; how you appear; whether you are comfortable or grimacing in discomfort; whether you are sniffling, coughing, rubbing your nose or eyes, or bending forward as you speak; whether you need to rush off to the bathroom during the visit; and whether you can walk without limping. There are many more examples. The provider may also ask you to press on certain areas of your body, move into better lighting, or try different maneuvers without assistance while they watch the response.
- Discuss the possible diagnosis: Making sure you have a clear understanding of instructions, concerns, and what to expect after the visit is a key part of a virtual visit. This is most important if you’re meeting the provider for the first time. Expect the provider to explain how important it is for you to have a PCP for in-person visits, as there are times when an in-person visit is needed.
When to seek in-person care
So, when should you seek immediate in-person care? When you have significant chest pains, can’t get a breath in, are coughing or spitting up blood, or even have pain that’s keeping you from sleeping and it’s something you’re not familiar with are a few reasons to seek emergency care, especially if you’re alone. There are also times when a provider will need more information, such as further testing or studies, and these cannot be done through a video visit.
If you’re not sure, remember that you can use a telehealth visit as a way to get an expert’s recommendation on your symptoms, too. If the provider thinks you should be seen in an emergency department or an urgent care, then listen to that advice and go accordingly. The provider may also decide that there are some things you can try at home first and, if you don’t improve, seek in-person care, either through an office visit with your PCP or through emergency services.
Lastly, if you have never had a telehealth visit before because you’re not sure of receiving care this way, or it makes you nervous to see someone you don’t know at all, I recommend trying a visit once to see what it’s all about. Through that, you can understand the capabilities of the provider, as well as the limitations. I predict you will be pleasantly surprised. Most providers who offer care this way have a skill. They know how to communicate well with people, and they can treat you or refer you as needed.