PRIMARY CARE | PRECISECAREMEDICAL

 Under normal, nonpandemic circumstances, virtual urgent care may be the best way to deal with non-life-threatening health concerns that crop up in the middle of the night, while you’re on vacation, or when you can’t get to your primary care doctor’s office for some other reason. For symptoms that suggest a sinus infection, urinary tract infection, or pink eye — the same types of issues you’d take to a local urgent care center — a virtual urgent care visit with a doctor can lead to a diagnosis, at-home treatment suggestions, a prescription for medication if needed, and, if necessary, recommendations for tests and follow-ups with an in-person health professional.

 Who Provides Virtual Urgent Care A growing number of hospitals, healthcare systems, health insurance companies, and private, direct-to-consumer telemedicine companies all offer urgent care services. Virtual urgent care companies include Amwell, Doctor On Demand, MDLIVE, PlushCare, Teladoc, and others.

 Cost of Virtual Urgent Care A telemedicine urgent care visit could cost as little as $20 — the self-pay rate for anyone who uses Houston Methodist’s urgent care service, according to Bishop. Houston Methodist also accepts insurance for virtual urgent care visits; benefits vary based on patient coverage.

 Other urgent care services have varying fees. For example, you may pay more if you use a company that doesn’t take your health insurance (or you don’t have health insurance), and you may pay less if you use a service covered by your health plan or by your employer.

 How Virtual Urgent Care Works You need audio and video for this type of telehealth visit, so use a smartphone, tablet, or laptop or desktop computer with a video camera. Download the app for the urgent care service you want to use, and follow the directions for scheduling an appointment and providing credit card information for payment. You can usually meet with a doctor online within minutes.

 The Telemedicine Tipping Point Is Here, and Laws Have Changed to Make It Easier to Access

 The Telemedicine Tipping Point Is Here, and Laws Have Changed to Make It Easier to Access

 When it comes to telemedicine, different primary care practices do it differently. Some practices, such as Parsley Health, offer the option of in-person visits but are able to conduct all care via telehealth — although you will likely still need to visit a physical facility for such things as lab tests, imaging tests, vaccines, and certain procedures.

 Other practices may offer only certain types of interactions online. For example, you doctor may be able to review your lab test results or check on your progress after some procedures via phone, video, email, or secure online messaging but still want to see you in the office for other types of care.

 In some cases, you’ll need to provide certain data before a virtual visit, such as readings you upload from your glucose meter to your doctor’s patient portal, if you have diabetes, or from a blood pressure monitor if you have high blood pressure.

 In rural areas, your family doctor may be able to help you access online health services, such as mental health appointments and visits with specialists. Indeed, video conferencing with specialists is an important way that rural patients and their doctors can get help managing complex chronic diseases.

 Major medical centers, including the Cleveland Clinic, Stanford, and Harvard-affiliated Partners Healthcare, offer virtual second-opinion programs that give you access to top specialists who can review a medical diagnosis or treatment plan online.

 If you’d like to try an online consultation with a doctor you currently see, ask the doctor, or their office assistant, if this service is available and right for you.

 “A consult or scheduled virtual visit with your own doctor means you’re working with someone who knows you and your health history,” Bishop says. “Some doctors in our system will also do on-demand urgent care visits for their own patients, so it’s worth asking.”

 Generally, you pay the same price for a virtual visit with your doctor as an in-person visit. But pricing and availability vary among doctors, health systems, health insurers, and states, so it’s worth checking with your doctor and with your health insurer to find out what’s available to you, Bishop adds.

 For pets, look for an online provider staffed with licensed veterinary professionals, including doctors and technicians, and a clear fee structure.Learn More

 Having a virtual visit with a mental health professional has become a go-to option for people with anxiety, depression, and other mood or mental health disorders since early 2020, with in-person visits to therapists’ offices and healthcare facilities curtailed because of the COVID-19 pandemic.

 However, remote psychotherapy is hardly new. Mental healthcare was among the first disciplines to move to telemedicine or, more specifically, telepsychology, with research on the viability of counseling delivered via phone, video, or both dating back to the early 1960s. The internet and mobile communications devices such as cellphones and tablets have only added to the options in the decades since, according to the American Psychological Association.

 What has changed, though, is broader acceptance of telemedicine, or telehealth, within the field, experts say.

Primary Care

 “Telemedicine provides a socially distanced way for people to access professional services that support their recovery,” says Alice Medalia, PhD, director of the Lieber Recovery Clinic at Columbia University in New York City, which offers telehealth options for psychiatric services.

 Of course, the traditional doctor-patient relationship isn’t the only telemedicine approach gaining use. Platforms such as Talkspace, Teladoc Health, and Doctor-on-Demand can help you set up virtual appointments with mental health professionals, conducted by video call or traditional phone call.

 However, not all online platforms offer medications management and remote prescribing; if you need those services, they may connect you to a psychiatrist in your area for further help.

 In addition, there are many apps that are designed to use the principles of cognitive behavioral therapy (CBT) to guide you through what is essentially a self-care regimen of activities and exercises. However, it’s important to note that these apps don’t connect you with a single, trained therapist who oversees your care.

 “Many people find CBT apps informative and helpful, and increasingly, therapists are incorporating apps into their practice with patients anyway,” Dr. Medalia says.

 However, “they don’t replace a therapist,” she adds. “Rather, they add a new way of accessing help.”

 A study published in January 2021 in JAMA Psychiatry generally found that these CBT-guided apps are effective at helping people with depression — one of the most common mental health conditions — manage their symptoms, provided they were guided by support from a care professional.

 A study published in January 2021 in JAMA Psychiatry generally found that these CBT-guided apps are effective at helping people with depression — one of the most common mental health conditions — manage their symptoms, provided they were guided by support from a care professional.

 As with anything else, there are pros and cons to the various virtual care services available in the mental health space, according to Medalia. Although these technologies allow you to maintain vital care services when in-person is not possible, and appointments are easy to schedule around work, school, and family obligations, some important aspects of mental healthcare — such as direct interaction with your therapist — may get lost in the virtual realm, where it may not be as easy to see and interpret changes in facial expression or demeanor, she says.

 “And there’s the issue of Zoom fatigue,” with so much of our social and work lives spent on the platform, Medalia adds. “My research on the use of telehealth for people with serious mental illnesses has found that the majority of clients prefer in-person sessions.”

 In addition, as important as these virtual services have become, particularly since the start of the COVID-19 pandemic, they haven’t solved all the problems related to access to care, according to Medalia. These technologies are “only viable for people who have access to web-connected technology and private space to engage in therapy,” she says. “There is, in fact, a significant percentage of the population that does not have access to the technology needed for telemedicine.”

 Much can be accomplished during a virtual visit to the gynecologist, including discussing birth control and getting a prescription for birth control pills; getting advice on urinary tract infections (UTIs), including whether to use an over-the-counter UTI test kit; having your hormone replacement therapy regimen adjusted; having rashes or bumps in the vulvar area examined; and discussing any other health concerns you might have.

 However, there are symptoms for which you will likely need to seek urgent or emergency in-person care. Those include, but aren't limited to, any symptoms of a possible ectopic pregnancy, severe vaginal bleeding, complications following a gynecological surgery or other procedure, more severe vaginal or uterine pain, and symptoms of a vaginal infection with a fever.

 Many skin problems are diagnosed primarily by appearance, in combination with a person’s medical history, and that makes dermatology a good candidate for telemedicine. So-called teledermatology is also effective for follow-up visits, when a person has been seen in person in the past, or for medication refills for an ongoing problem.

 There are instances where an in-person visit is better, such as for an annual skin check, in which a tool called a dermatoscope allows the doctor to see a magnified view of any skin lesions. And of course, any procedures involving the skin, such as taking a biopsy, need to happen in person.

 Good asthma management often requires regular check-ins with a doctor, and virtual visits can be a good alternative to in-person visits for routine appointments.

 Telemedicine typically works well for discussing your current treatment plan, refilling prescriptions, and asking your doctor any questions you might have about your health or your treatment plan. Telemedicine has the added benefit of minimizing your in-person exposure to others, and it saves you the time you’d spend traveling to and from appointments.