General Limitations

While we try our best to manage as many patients as possible, there are a few limitations of telemedicine:

  • We do NOT prescribe any controlled substances
  • We do NOT prescribe the following medications: Carisoprodol, Butalbital, Tramadol, Promethazine, Gabapentin, Fioricet, benzodiazepines
  • We do NOT treat the following patients remotely: Pregnant patients presenting with any pregnancy-related complaint including (but not limited to) any of the following symptoms and conditions: Headaches, Chest Pain, Shortness of Breath, Abdominal Pain, UTI, and/or Pelvic/Vaginal Complaints
  • Immunocompromised patients (active chemotherapy or immunotherapy, autoimmune diseases on chronic steroids, HIV/AIDS with unknown recent CD4) with infectious symptoms, including but not limited to fevers and rashes (unless clearly allergic)
  • Any patient under the age of 1
  • Any patient over the age of 85
  • Patients who have sustained animal bites or scratches: Due to variability in reporting requirements across counties/states with respect to potential rabies exposure, we are unable to provide treatment for animal-related injuries (including patients’ own animals/pets)
  • Patients with certain Sexually Transmitted Infections (STIs): We do not treat Gonorrhea, HIV, Syphilis, or Primary Herpes. Refill medications for subsequent outbreaks of previously confirmed herpes will be considered on a case by case basis. Asymptomatic treatment of a sexual partner for laboratory confirmed chlamydia will be considered on a case by case basis.
  • Patient request for lifestyle medications: We reserve the decision on the treatment and/or prescribing of medications for lifestyle issues based on safety, efficacy and best medical judgement. This includes treatment for weight loss, erectile dysfunction, emergency contraception and new start birth control medications. Refill medications for previously well controlled conditions on prescribed medications will be considered on a case by case basis. New starts will be limited to short supplies with close follow up visits where appropriate.

Behavioral health prescribing for attention deficit hyperactivity disorders, depression or anxiety medications:

We reserve the decision on treatment and/or prescribing of medications for behavioral disorders based on safety, efficacy and best medical judgement. The refill of medications will be considered on a case by case basis. For well established and controlled conditions or for recent successful use a refill may be considered. The anxiety medications that fall under controlled substances (benzodiazepines) will not be refilled. This includes benzodiazepine medications potential for abuse but may not be limited just to alprazolam, clonazepam, or lorazepam.

Physician Patient Relationship Needed

In some instances there might be a limit to how long we can prescribe. We will try to give you a couple of weeks of the medication (name med), but you will need to be seen and resume a physician-patient relationship soon. Here is a website that is really good for finding a low cost medical provider. Just put in you city, state zip code and there will be a clinic(s) near you to pick from. Freeclinics.com

 

Controlled Substances

Unfortunately we cannot prescribe any controlled substances on this platform. We did consider the patients’ well being and DEA regulations before making this decision. We do believe it’s the safest approach we can take. There are alternatives that achieve similar goals. I do want to help you and will do so in every way I can within those limitations.

Texting Safety

If it seems you are driving at the time of your visit, then safety will be a top priority. Please focus on the road – we’ll be here as soon as you are able to park or pull over to chat with us safely.

Telemedicine Safety

The most important thing to me is your safety. There are times it’s important to be seen and examined in person. I know it’s frustrating, but there are limits to what we can do virtually (remotely). Treating you without an exam in some cases may only do more harm and complicate things further. In these situations, you may require in person care.
Behavior

Unfortunately, If we are finding it difficult to conduct the conversation in a productive manner due to any given behavior, then the consultation may be discontinued. We would like to focus on your signs and symptoms and identifying a way forward to improve your health. If we discontinue your consultation due to behavior issues, you are free to return at any time. However, if the behavior is determined to be repeated or significantly egregious, then we reserve the right to refuse service.

Stopped Responding

If it seems that you are not available ton continue the consultation due to lack of responding we will resume your consultation at a later time and/or date. Please be sure to check your connectivity and strength of signal.

 

Antibiotic Safety

We do understand that you’re not feeling well but unfortunately, if your condition is determined to be due to a virus we may not prescribe antibiotics or any other unproven remedies. Viruses are not cured by antibiotics. In cases were antibiotics don’t help they can actually cause a lot of harm. They can kill off healthy bacteria and can lead to life threatening infections as a result. Overuse can also lead to resistance and we don’t want to expose you to all those risks. The best thing we can do is support your body and give your immune system every chance to fight it.

We will try some other steps to make you feel better and to support your body as it fights off the virus. You can come back if you don’t get better or if you worsen, so we can do more later. Over a determined period, usually a few days, we can meet again and adjust your treatment depending upon how you’re doing.

I know it’s frustrating, but it really is the safest thing for us to do and it’s the same advice I would give my family members, too.