Telemedicine: What Cannot Be Treated Online?

Written by Dr. Ryner Lai
January 22, 2021

Telemedicine, or the ability to consult with a doctor or provider remotely, has become increasingly indispensable today. As people start to work remotely and socialize remotely, people are rightly beginning to ask, “Why not see a doctor remotely?”

It seems that one of the biggest barriers to telemedicine is the novelty of the idea, which results in the hesitancy of some to embrace this new technology. People want to know: Is it safe? Is it secure?

However, concerns surrounding telemedicine are breaking down. In the United States, the number of telehealth visits increased by 50% during the first quarter of 2020 compared to the same period in 2019. This means that telemedicine is likely to stay and form an integral part of the future of medicine.

Although many treatments can be conducted via telemedicine, certain situations, conditions, and symptoms require an in-person visit and cannot be properly analyzed and treated online. Here are some of them:

Conditions causing severe pain

If you experience severe pain in any part of your body, you should be evaluated in-person. Though not always the case, severe pain can be a sign of an acute condition that requires emergency treatment.

For example, severe abdominal pain can be a sign of abdominal aortic aneurysm (AAA) or acute appendicitis, both of which require immediate medical intervention. If you are having chest pains, you might be having a heart attack, pulmonary embolism, or a pneumothorax.

When you experience severe pain, the doctor needs to rule out medical emergencies when diagnosing your condition. This can only be done in an in-person setting and cannot be carried out through telemedicine.

For example, your doctor might request an imaging test, such as an X-ray or an ultrasound. In cases of chest pain, your doctor will want to perform an electrocardiogram (ECG or EKG), which will give your doctor some indication of the possible cause of the chest symptoms. When in doubt, it is best to see a doctor in-person or go to your nearest emergency room.

Conditions requiring a thorough in-person examination

When you experience any physical trauma, such as a fall or an accident, you should see a doctor in-person. A doctor will carefully examine every part of your body to ensure that no internal injuries were sustained, which may require further treatment.

Always remember that when you experience physical trauma, you may have injuries that aren’t obvious to the naked eye.

Prescription and refill of controlled substances (other than Suboxone)

Most prescriptions for controlled substances, whether new or a renewal, require an in-person visit to be written.

Suboxone is the exception to this guidance, and licensed services like QuickMD can treat opioid use disorder online.

Any condition requiring in-person drug administration

For obvious reasons, telemedicine is not useful for conditions that require an in-person intervention or the injection of a drug. For example, if you are experiencing low oxygen levels, you might need to be administered nebulizer treatments, which are attached to an oxygen machine.

Another common route of drug administration that requires an in-person visit is intravenous (IV) or intramuscular injection. This can be simply the administration of fluids in cases of dehydration, or it can be the intravenous injection of certain medications. In most cases, it is unsafe to self-administer an IV medication.

Psychiatric emergencies

Some patients with mental health illness may experience moments in which they become a danger to themselves or to others, or when they are in an acute mental health crisis or experiencing psychosis. For example, patients who are suffering from depression and feeling suicidal should see a doctor in person immediately to discuss their feelings.

Some patients suffering from severe mania or schizophrenia could cause harm to themselves or others. In any case, patients who are experiencing psychiatric emergencies should seek professional help immediately. If you are uncertain about what constitutes a psychiatric emergency, speak to a doctor who will be able to advise you.

Highly specialized care and complex medical conditions

Patients who require highly specialized care, such as cancer treatment, generally need to get treatment from an in-person team of specialists. Though telehealth doctors may treat the most common medical conditions, treatments that require complex specialty care can only be carried out in an in-person setting.

Telemedicine benefits and limitations

Telemedicine gives greater options to patients to receive high-quality medical care, all in the comfort of their own home. It increases access to care, lowers costs, decreases waiting times, and eliminates the need to drive to an appointment and potentially get exposed to hospital germs and viruses.

Even in certain emergency cases, telemedicine may serve as a triage tool to assess the urgency of the problem and guide the patient to the correct facility (e.g., burn center, trauma center, urgent care, ophthalmologist). However, patients should be aware that telemedicine has its limitations. In certain situations, an in-person setting like a hospital or emergency room is still required for a workup, close medical observation, and/or intervention.

How to see a doctor through telemedicine

QuickMD can take care of the most common urgent care complaints via video or phone, and in some states, via chat. Get in touch with a doctor or make an appointment today.

Articles on this website are meant for educational purposes only and are not intended to replace professional medical advice, diagnosis or treatment. Do not delay care because of the content on this site. If you think you are experiencing a medical emergency, please call your doctor immediately or call 911 (if within the United States).

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