15 health conditions your online doctor cannot diagnose & treat

Reviewed by:
Angela DiLaura, NP
Clinical Informatics and Quality Manager
Last updated on September 7, 2022 UTC

Telemedicine has grown leaps and bounds in the past several years. It helps provide services for patients who may have difficulty getting to in-person appointments.

Online doctors, like our own at HealthTap, can diagnose, treat and even provide numerous online prescriptions. Yet, there are still some health conditions your online doctor may not be able to diagnose or treat.

Online doctors may be unable to treat certain conditions because:

  • Government regulations prevent certain online prescriptions.

  • Patients need a thorough in-person exam to determine the symptom's causes.

  • The safety of the patient could be compromised without an in-person physical assessment.

Health conditions your online doctor cannot diagnose and treat online

For many medical conditions, online doctors can provide diagnosis and treatment. However, there are health concerns they may not be able to address virtually, and may need to refer patients to in-person care.

Conditions with severe pain

Conditions that cause severe pain or sudden pain will require an in-person evaluation. In many of these cases, urgent treatment or diagnostic imaging is needed. An online doctor will not be able to treat the following conditions:

1. Severe Abdominal Pain
Sudden or severe abdominal pain could signal a life-threatening condition such as an abdominal aortic aneurysm or appendicitis. Conditions like this require emergency medical treatment.

2. Chest Pain
Chest pain could be as simple as muscle pain, but may also indicate a number of urgent health conditions. These conditions include (but are not limited to): heart attack, pneumothorax, or pulmonary embolism. If a doctor suspects a patient has any of these conditions after a virtual evaluation, the patient will need to seek immediate treatment and diagnostic imaging to confirm the diagnosis.

3. Severe Pain After an Injury
Anyone who has experienced a car accident or suffered any other type of injury will need in-person treatment. Broken bones, whiplash, and head trauma can result from injuries, and these conditions require a thorough hands-on exam and emergency treatment.

The above list does not include all the possible medical conditions requiring emergency care. Any urgent conditions should be addressed in the emergency room for the patient's safety.

Conditions requiring treatment with controlled substances

Government regulations prohibit online doctors from prescribing certain controlled medications. Since these medications can have the potential for abuse, a physical office visit is required. Online doctors will not be able to treat:

4. Chronic or acute pain requiring narcotic relief
Pain after injury, surgery, or a chronic condition that is severe enough to require controlled pain medication cannot be treated online. An online doctor cannot prescribe medications such as Vicodin, tramadol, or codeine.

5. Severe insomnia
Doctors cannot prescribe sleep aids that are controlled substances, such as Ambien, in an online visit.

6. Drug addiction
Drug addiction treatment requires in-person care for the patient's safety. It also may involve using controlled substances, such as methadone, which cannot be prescribed online.

Certain sexual and reproductive health concerns

While online doctors can help with many sexual and reproductive heath concerns, there are some limitations. These conditions often require in-person assessments or medication unavailable through virtual care. Some of these conditions include:

7. Infertility treatments
Infertility treatment requires multiple in-person visits with hands-on treatments and close monitoring.

8. HIV treatment
Treatments for people currently diagnosed with HIV will need to schedule an in-person visit. Regular testing and monitoring are often required, which can be more difficult with an online doctor.

9. Contraceptive device treatment
Online doctors will not be able to prescribe contraceptive devices such as IUDs and implants as they require in-person placement.

Psychiatric emergencies and closely monitored mental health conditions

Severe psychiatric emergencies often involve situations where the patient may consider harming themselves. In these cases, immediate treatment should be sought for the patient's safety.

Online doctor visits are limited by a lack of physical contact and sometimes timing issues. Because of this, psychiatric emergencies should be handled through emergency treatment means.

Aside from emergent psychiatric situations, there are other mental health conditions that online doctors cannot treat.

10. ADD or ADHD
While patients may see their virtual Primary Care doctor for ongoing treatment for ADD or ADHD, most medications used for treating ADD and ADHD are controlled and require in-person visits for a prescription.

11. Bipolar disorder
Since bipolar disorder requires close monitoring and a variety of medications, regular in-person doctor visits are needed.

12. Psychosis or schizophrenia
Medications associated with schizophrenia and psychosis cannot be prescribed online, and both conditions require routine in-person assessments.

13. Mental health of a minor
Children under 18 will need to seek out in-person care for mental health issues. There may be more risks associated with prescribing medication used for mental health conditions in younger patients. Close medication monitoring is required.

Certain lifestyle health treatments

Online doctors can assist with various lifestyle treatments, such as cholesterol management, high blood pressure, and weight-loss counseling. Yet, they are limited when it comes to lifestyle treatments requiring certain prescription medications. Some of the conditions that would require in-person doctor visits include:

14. Prescription weight loss
When taking prescriptions used to assist with weight loss, patients should be closely monitored. These medications can affect the heart and other body systems. It’s also important to have regular in-person check-ins to monitor progress when using prescription weight loss medications.

15. Prescriptions to quit smoking
Online doctors may counsel patients on how to quit smoking, but they do not prescribe smoking cessation medications. These medications can have adverse side effects in some patients.

Online doctors also do not provide care for infants under a year of age and usually cannot provide disability certification or physical or mental competency evaluations.

If traveling to a doctor is difficult, or for people with mobility issues, or other reasons where regular in-person doctor visits are difficultan online doctor is a perfect solution. While there are many conditions that online doctors cannot treat, they are still the ideal solution for many patients.

If you are unsure if your condition can be treated by an online doctor, schedule a consultation to discuss your needs. If online treatment is not available, your online doctor can make recommendations for how to proceed to get your health needs taken care of.


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