En español | By now you've probably heard that more people are using telemedicine during the pandemic. If you'd like to avoid an in-person doctor's appointment because you're concerned about exposure to COVID-19, or you simply want to save time, you might be tempted to schedule a virtual visit. There are several ways to do this, including through a telemedicine company like Teladoc or a retail pharmacy such as CVS.
But doctors across the country agree that if you have a primary care physician, it's best to start with him or her. “Your doctor has your medical records, and they enable him or her to make an informed decision about your care,” says Paul Testa, M.D., chief medical information officer and assistant professor in the department of emergency medicine at NYU Langone Health. “Keeping your medical records in one place allows for the safest, highest-quality care.” What's more, your doctor probably takes your insurance and knows which pharmacy you use.
If your doctor is part of a hospital system, setting up a virtual visit is relatively easy. You'll download an app (if you're using a mobile device), create an account, and log in just before your appointment. You'll click on a link to begin your video visit. In some cases the appointment will automatically become part of your medical record. For example, hospital systems — such as Cleveland Clinic, NYU Langone Health, MedStar Health, Partners HealthCare, Johns Hopkins Medicine, Mayo Clinic, Geisinger, Novant Health and Providence — have integrated patients’ medical records into their telemedicine platforms.
Even if your doctor doesn't belong to a hospital system, she may be willing to see you through a videoconferencing service you connect to through your phone or laptop, such as Zoom, FaceTime, Google Duo, Cisco Webex, Skype or Doxy.me. Many doctors and hospital systems use Zoom because it's secure and HIPAA-compliant, meaning it protects your health information. Also, Zoom visits can be integrated into a patient's medical record. If you're familiar with another service, don't hesitate to ask about using it. “Patients have the right to request a service they're comfortable with, such as Skype or Zoom,” says Joseph Kvedar, M.D., president of the American Telemedicine Association and professor of dermatology at Harvard Medical School.
Setting up your first appointment
To set up a telehealth appointment with your primary care physician, you can either call your doctor's office or go through your health system's app. (Some doctors prefer that you call so the nurse or scheduler can determine how quickly you need to be seen.)
A few days before your appointment, you'll receive a call, email or text from your doctor's office reminding you of your visit. Some medical assistants will ask if you've tested the audio and video components of your mobile device or computer to make sure they're working. If you're using a computer, you should also test your internet connection. If you're on a mobile device, make sure the app you use is current. Consider doing a video chat with a family member or friend a few days before your appointment. Alternatively, some health systems provide a link that lets you test your technology.
In addition, you may need to check in before your appointment. Your doctor's office may call and ask about your health concern and whether there have been any changes in your medications or allergies. Some health systems require that you complete an online check-in. If you have a chronic condition like high blood pressure or diabetes, you may be asked to monitor your blood pressure or blood sugar over a few days and record the readings in MyChart — or bring them to your telemedicine appointment. (Some patients use Bluetooth-enabled blood glucose monitors and blood pressure cuffs, which transmit the readings to their smartphone and electronic medical record.)
If you're having a routine physical, you may need lab work to check your blood counts, cholesterol, blood sugar and, for men, prostate-specific antigen. Plus, your doctor may ask you to take a picture of something (perhaps a mole or wound) and text it to him or upload it to MyChart before your visit.
If you need to find a doctor or teledoc to see virtually
If you don't have a primary care physician, can't get a timely appointment with your doctor or are traveling, consider a provider affiliated with a telemedicine company or retail pharmacy. Companies such as Teladoc, Amwell and MDLIVE provide telemedicine services to consumers, hospitals and health plans. Their board-certified internists and family-medicine and emergency-medicine physicians diagnose and treat a host of common ailments, such as sinus infections, pink eye and ankle sprains. These doctors also refill prescriptions, provide patient education and manage chronic conditions, like diabetes. Psychologists, psychiatrists and clinical social workers affiliated with the companies offer counseling for depression, anxiety and other mental health disorders.
To use these services, you download an app to your smartphone or tablet or visit the company's website and click on a link to set up an appointment. In the case of Amwell, you can select the first available physician or read about physicians’ backgrounds before making a choice. You're placed in a virtual waiting room, where you're told when the physician will be available. If the wait is too long, you can switch to a different provider.
During a virtual visit, the doctor takes a medical history and asks about your medication allergies and symptoms. Although she is able to verify your current prescriptions and medication allergies through a third-party service, “patients need to be honest and forthcoming about their health history,” says Mia Finkelston, M.D., medical director at Amwell. The doctor may ask to see a rash or check your throat, depending on your symptoms. At the end of a visit, you receive a treatment plan. If necessary, the provider will recommend that you see your primary care doctor or head to an urgent care facility. “Ninety percent of our patients are able to resolve their medical concerns after a virtual visit,” says Lewis Levy, M.D., chief medical officer at Teladoc.
CVS Health and Walgreens also offer telemedicine services for common illnesses, injuries and skin conditions. CVS Health provides two types of virtual appointments: E-Clinic visits allow patients to connect virtually with a local MinuteClinic provider (a nurse practitioner or physician assistant), typically between 9 a.m. and 5 p.m., seven days a week. This service is available in 33 states and Washington, D.C. CVS Health also uses Teladoc's platform to offer video visits, which are available 24 hours a day, seven days a week. Appointments are scheduled via MinuteClinic.com. Walgreens offers Find Care — a variety of in-person and virtual health care services, including video visits with physicians through partners such as MDLIVE, Amwell and DermatologistOnCall. When you click on one of the services, you're taken to the company's website. Find Care can be accessed via walgreens.com/findcare/services or by downloading the retailer's mobile app.
The cost of a visit to a provider affiliated with a telemedicine company or retail pharmacy varies. If you're using a company like Amwell or Teladoc, the fee depends on the service you need and your insurance plan. If you don't have insurance, an urgent care visit for a condition like the flu or a urinary tract infection may run $80. If a telemedicine company accepts your insurance, you may have a copay similar to an office visit, or, if your employer offers the service as a benefit, you may pay nothing. CVS Health requires customers to have active medical insurance for a MinuteClinic E-Clinic visit (the retailer accepts most plans). MinuteClinic Video Visits, on the other hand, cost $60. They're covered by most Aetna insurance plans. Walgreens either lists the price of Find Care services or indicates that “Price varies.” While these services can help you avoid the emergency room, they may not be right for everyone. “If you're generally healthy and are taking only a few medications, it's reasonable to use one of these options,” says Ateev Mehrotra, M.D., associate professor of health care policy and medicine at Harvard Medical School. “But if you've seen a lot of specialists and are taking a lot of medications, it's better to see a doctor in your health system."