Virtual Clinics: IMA Viewpoint • In one of its judgment, Martin F. D’Souza vs Mohd. Ishfaq, 3541 of 2002, dated 17.02.2009, the Supreme Court has said that medicines should not be prescribed in a telephonic consult, unless it is an emergency. But this does not apply to counselling and advice. The Govt. of India runs helplines on mental health, tobacco cessation, child sexual abuse etc. • ‘Virtual visit’ is a new trend today. It is available via video conferencing apps that can be downloaded to a smartphone, tablet or home computer. • Patients can experience a ‘virtual’ visit with a qualified physician at any time, day or night. It’s not just a fad. The benefits go beyond triage. It’s a step towards remote, affordable, convenient primary health care. • In the west, the cost can be half of in-person visit, and most insurance companies are now covering them. In the United States, Blue Cross policies, offer the services of their own virtual doctor free of charge. Medicare does not cover virtual visits. The cost of a virtual visit can be even less than the out-of-pocket co-payment that Medicare requires for an in-person doctor visit. • In US, the consulting doctors are licensed, vetted and are assigned to the patient based on where he or she lives. They carry malpractice insurance and are authorized to order tests and prescriptions. However, without actually seeing the patient in person, they may not be able to evaluate the patient completely. • There are limitations in such consults. A physician can look at your rash, but he or she cannot examine the back of your throat or listen to your lungs. While this may not make a difference in patients with depression, a physical examination is essential in patients with abdominal pain. • The care may be no different. People who go to a virtual visit are just as likely to have a follow-up appointment in the next few weeks, have similar antibiotic prescribing rate. However, one is most likely to end up with a broad-spectrum antibiotic and less specific drugs and specific tests like in strep throat. • In US, two of the most widely used are Teladoc (www.teladoc.com) and Doctor On Demand (www.doctorondemand.com). • Virtual visits are not meant to replace doctor’s office visits but may be a good option for minor, temporary problems (cold, flu, sinusitis, a non strep sore throat, rash, diarrhea, vomiting, or conjunctivitis, especially in odd hours or for follow up visits. • It’s best to see your regular doctor as soon as possible.