Telehealth has become a routine part of New Zealand healthcare, but many people are unsure what it is suited to. Some assume a video call can handle anything. Others assume it is only good for sick notes. The reality sits between the two, and knowing where the line falls helps you choose the right kind of appointment.

What a video consultation can do well

A large share of primary care is conversation. The doctor listens to your history, asks questions, looks at what can be seen on camera and reaches a judgement. For many common problems, that is enough.

Common infections. Colds, flu-like illness, sore throats, sinus problems, urinary tract infections and skin infections can often be assessed through history and observation. Antibiotics are prescribed only where they are appropriate.

Skin concerns. Rashes, acne, eczema flares and insect bites can often be assessed by video, especially with a clear photo.

Repeat prescriptions. Ongoing medicines for stable conditions can usually be renewed after a review of your history.

Sexual and reproductive health. Contraception discussions, emergency contraception advice, STI concerns and test requests can all be handled online, which many people find more comfortable.

Mental health. Initial assessment of low mood or anxiety, medication review and follow-up conversations work well by video for many people.

Minor injuries. Sprains, minor cuts and bruises can be assessed for severity and appropriate follow-up.

Medical certificates and paperwork. Work, study and ACC certificates, along with referrals and test requests, are well suited to telehealth.

Chronic disease follow-up. Reviews of stable conditions such as blood pressure, cholesterol or weight management involve discussion and results rather than examination.

Travel health and preventive advice. Discussion of vaccines, medications and screening.

What a video consultation cannot do

Physical examination. Listening to a chest, feeling an abdomen, checking reflexes or examining a joint properly all need a person in the room.

Investigations that need equipment. Ear examinations with an otoscope, throat swabs, blood tests taken on site, ECGs and urine dipsticks require in-person or laboratory services, although a telehealth doctor can order tests you then attend locally.

Procedures. Wound suturing, injections, cryotherapy, biopsies and removal of skin lesions.

Emergencies. Chest pain, difficulty breathing, signs of stroke, severe bleeding, serious injuries and loss of consciousness need emergency services, not a video appointment.

Things that start online and move offline

A good telehealth consultation includes a decision about whether the problem can be safely managed remotely. A doctor may begin a consultation, decide that an examination is required and refer you to an urgent care clinic, a GP or a hospital. That is the service working as intended, and it is often more efficient than sitting in a waiting room to be told the same thing.

Examples include a child with a fever and a fast breathing rate, an ear pain that needs to be looked into, abdominal pain with concerning features, a lump that needs palpation, or a mole that needs specialist review.

Choosing between options

Ask yourself three questions.

Does this problem need to be touched, measured or looked at closely to be diagnosed? If yes, an in-person visit is likely needed.

Is this an emergency or could it become one quickly? If yes, call 111 or go to the nearest emergency department.

Is this mainly about talking, reviewing, prescribing or documenting? If yes, a consultation with one of the growing number of online doctors is probably a sensible and convenient choice.

Getting the most from it

Have your symptoms and their timeline clear. Keep a list of medications and allergies at hand. Take a photo if the concern is visible. Use a room with good lighting and a reliable connection. Be ready to describe things in detail, since the doctor cannot see or feel what you can.

If the doctor recommends an in-person review, take that advice seriously, and follow up promptly.

Continuity of care

Telehealth works best as part of a wider set of care rather than a replacement for a regular GP. Many people use it for convenience when they cannot get in to see their own doctor, or for services they prefer to access privately. It is worth letting your regular GP know about significant new diagnoses or medications, so that your records stay complete.

Children and older adults

Children can be assessed by video with a parent or caregiver present, though younger children are more likely to need an in-person examination. Older adults may benefit from telehealth if mobility is limited, but may need help with technology or a family member present.

The bottom line

Telehealth is neither a cure-all nor a gimmick. It is well suited to a large category of common problems, and much less suited to others. Knowing which is which saves time and gets you to the right care faster.