Emergencies
Chest pain or pressure, stroke symptoms, severe breathing difficulty, severe bleeding, major injury, a head injury with vomiting or drowsiness, seizures, or thoughts of self-harm: call 911 or go to the nearest emergency department. For suicidal thoughts you can also call or text 988. See our emergency care notice.
Problems that need a physical examination
- Abdominal pain, where where it hurts and how it responds to pressure is the diagnosis.
- Joint and limb injuries, where stability and range of movement must be tested.
- Ear pain requiring an instrument to see the eardrum.
- Any lump or mass, including breast and testicular concerns.
- A red eye with pain, light sensitivity, vision change or contact-lens use.
- New neurological symptoms needing an examination.
Procedures, imaging and in-person diagnostics
Stitches, drainage, splinting, injections, removals, X-rays, ultrasound, CT and in-office diagnostics all require a physical location. A virtual visit can order imaging and refer you — see how labs and imaging work with virtual care — but it cannot perform it.
Medication categories we do not prescribe virtually
- Controlled substances.
- Any medication requested without a clinical indication, however specifically it is asked for.
- Anything requiring monitoring you are unwilling or unable to complete — the monitoring is what makes it safe.
Situations rather than diagnoses
- Pregnancy with new or concerning symptoms.
- Infants and very young children who seem unwell — those need hands-on assessment.
- Anyone rapidly deteriorating, however minor the original problem looked.
- Problems that have already failed a reasonable virtual attempt.
What Presence does when you are outside virtual scope
You are told directly, with a recommendation for the right setting. In Dallas–Fort Worth, scheduled in-office care is available at our North Richland Hills practice for ages 13 and older. See local primary care, or use Start Here to check the right setting before you pay for anything.