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[Sticky] Conditions requiring physical exam or imaging


Michael Gray MD JD
Posts: 107
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in most cases, telemedicine is NOT appropriate when a condition clearly requires a hands-on physical exam or imaging to make a safe diagnosis.

Many problems can only be evaluated properly with:

  • Direct palpation or movement testing

  • Listening to heart / lungs / abdomen

  • Looking in the ears, throat, or eyes with instruments

  • X-rays, CT, MRI, ultrasound, or other imaging

Because these cannot be done virtually, a telehealth provider will usually redirect you to in-person care if such an exam is needed.


Examples of conditions that usually need in-person evaluation or imaging

  • Suspected fractures or major injuries

  • Head trauma or concussion assessment

  • Severe abdominal pain

  • Chest pain or suspected heart/lung problems

  • Possible appendicitis, gallbladder disease, or kidney stones

  • Pelvic pain with concerning symptoms

  • Ear pain in very young children (requires ear exam)

  • Eye injuries or vision loss

  • Severe or rapidly worsening infections

  • Any condition where urgent labs or imaging may be necessary

Telemedicine isn’t safe as the first step for these because delays could miss serious disease.


👍 When telemedicine can still play a role

Even for these conditions, a virtual visit may help with:

  • Triage (helping choose ER vs urgent care vs clinic)

  • Reviewing prior results or follow-up after treatment

  • Counseling and medication review

  • Monitoring recovery or chronic symptoms

But the initial diagnostic evaluation must be done in person.


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