Well suited to a virtual visit

  • Cold, cough, sore throat, sinus symptoms and seasonal allergies
  • Suspected urinary symptoms in adults with a straightforward history
  • Rashes, bites and skin concerns that can be clearly photographed or shown on video
  • Pink eye and other common eye irritation
  • Nausea, vomiting and diarrhea without red-flag features
  • Follow-up on a condition already being managed, including home blood pressure or glucose trends
  • Medication questions, side effects, refills and deprescribing conversations
  • Results review and next-step planning after labs
  • Minor injuries where the question is whether it needs to be seen at all

The common thread is that the diagnosis depends mostly on history and visible findings. A careful conversation plus a good camera answers a surprising amount of primary care.

Sometimes suited, depending on the specifics

ConcernWhat virtual can doWhen it moves in person
Ear painAssess history, judge urgency, plan next stepWhen the eardrum needs to be visualized
Abdominal painTriage severity, decide where you should goAlmost always needs an exam
Back painReview history, discuss red flags and managementIf neurologic symptoms appear
Preventive visitReview history, risks, screening plan, order labsFor the physical exam component
Chronic disease managementMost routine follow-upPeriodic in-person assessment

Not suited to a virtual visit

  • Anything requiring a physical exam to reach a diagnosis
  • Wounds needing repair, drainage or in-office procedures
  • In-the-moment imaging, X-rays or point-of-care testing
  • Vaccination administration
  • Concerns where the clinician cannot safely rule out a serious cause remotely

Call 911 or go to the nearest emergency department for chest pain, trouble breathing, stroke symptoms such as facial droop or sudden weakness, severe bleeding, a serious injury, or any sudden severe symptom. Do not wait for a virtual visit.

Why membership virtual care behaves differently

Per-visit telehealth has an awkward incentive: you paid for a visit, so a visit tends to produce something. Membership virtual care removes that pressure in both directions. There is no charge for included visits, so asking early costs you nothing, and there is no reason for a provider to stretch a call that should end with an honest go be seen in person.

It also removes the cost hesitation that quietly drives a lot of bad outcomes. Symptoms that get discussed on day two are usually simpler than the same symptoms on day six. What Presence includes is on 24/7 virtual care, and the fit between virtual and in-person care is covered in when should you use virtual care.

Prescriptions and honest limits

A licensed provider can prescribe by telehealth when it is clinically appropriate, and will not when it is not. Certain categories, including controlled substances, are restricted by law and by clinical judgement, and no legitimate service treats a prescription as the product being purchased. If a virtual visit ends without a prescription, that is often the correct outcome rather than a failure of the format.