Telehealth grew rapidly during the pandemic for good reason — it kept patients out of waiting rooms during a period when that mattered enormously. But convenience and clinical accuracy are different things. In the years since, I’ve seen a steady stream of patients who visited a telehealth provider first and came to my clinic afterward — sometimes because they weren’t getting better, and sometimes because the telehealth provider couldn’t complete the evaluation they needed.

I’m not dismissive of telehealth. There are situations where it’s appropriate and genuinely useful. But for the kinds of conditions that send people searching for urgent care — ear pain, sore throat, cough, injuries, rashes, abdominal discomfort — a video call is frequently the wrong tool for the job. Here’s why.

Diagnosis Requires More Than a Conversation

A significant portion of clinical diagnosis comes from physical examination — findings that can only be obtained by a physician in the same room as the patient. This isn’t a philosophical preference; it’s a practical limitation of what a camera and microphone can transmit.

Consider what a physical exam provides that a video call cannot: lung sounds on auscultation that distinguish viral bronchitis from bacterial pneumonia; direct visualization of the tympanic membrane that confirms or rules out a middle ear infection; lymph node palpation that adds clinical weight to a sore throat evaluation; skin texture, warmth, and fluctuance that determine whether a rash is a contact dermatitis or an infected abscess requiring drainage. None of these findings are available through a screen.

When a telehealth provider diagnoses an ear infection based on symptom description alone — ear pain, reduced hearing, fullness — they are making a presumptive diagnosis without the one piece of evidence that confirms it: looking in the ear. That leads to two clinical errors: over-prescribing antibiotics for viral or eustachian tube conditions that don’t need them, and undertreating actual bacterial infections because the full picture was never obtained.

Conditions Telehealth Consistently Underserves

The following are among the most common urgent care presentations — and the ones most likely to result in incomplete or inaccurate evaluation via telehealth:

The Diagnostic Tools That Require Your Presence

Even setting aside the physical exam, many conditions require point-of-care diagnostic testing that is simply unavailable via telehealth:

When Telehealth Is Appropriate

This is not an argument that telehealth has no place in healthcare. It does — in specific, well-defined situations where the diagnostic limitations don’t matter because the clinical question doesn’t require a physical exam:

Telehealth is well-suited for refilling a stable, established medication with no new symptoms; follow-up visits after an in-person diagnosis has already been made; mental health counseling and therapy sessions where the therapeutic relationship is the primary tool; and straightforward administrative tasks like referrals, prior authorizations, or sick notes when the underlying condition is already confirmed.

It is poorly suited for new-onset illness, any condition with pain as a primary symptom, respiratory complaints, ear or throat symptoms, skin findings, and anything requiring a procedure or point-of-care test. For those presentations — which represent the majority of urgent care visits — coming in produces a more accurate diagnosis and a more appropriate treatment plan.

What In-Person Urgent Care at Monarch Medicine Provides

Frequently Asked Questions

Questions before your visit? Contact us — we triage over the phone during open hours.