How I Practice
I practice entirely by telemedicine, and have done for more than seven years. In that time I have completed over 100,000 virtual consultations. I am licensed in all fifty states, the District of Columbia and Guam, and I see patients through Teladoc Health.
That last part matters for anyone who arrived here looking for care, so let me be direct. I do not take bookings on this site. This is where I write. It is not a scheduling system and it is not a clinical portal, and the contact form is not a way to reach a physician about a medical problem. I will not answer clinical questions through it.
My views here are my own and are not affiliated with any corporation.
What I See
Most of my work now falls into three areas.
Obesity medicine and GLP-1 therapy. Starting anti-obesity medication, choosing among what is available, managing side effects, working through plateaus, and the practical problems that come with all of it, including what happens when insurance stops covering a drug you are already on.
Menopause and midlife women’s health. Symptom evaluation, hormone therapy decisions, and the cardiometabolic changes that show up alongside menopause and get written off as ordinary aging.
Virtual urgent care. Rashes, infections, and the everyday problems that make up most of what comes through any clinic door.
Alongside those, diabetes prevention and management and cardiometabolic risk reduction more generally.
What a Video Visit Handles Well
More than most people expect.
Anything where the diagnosis lives in the history rather than the examination. Medication management of every kind, which is most of chronic disease care. Reviewing labs drawn wherever is convenient for you. Watching you actually use an inhaler in your own kitchen, which catches errors a clinic demonstration never will. Looking at a rash in good daylight, which frequently beats thirty seconds under fluorescent light.
Obesity medicine in particular suits the format. The work is conversation, titration and follow up, and the bloodwork happens near you rather than near me.
What It Does Not
I would rather say this plainly than have you find out partway through a visit.
I cannot examine you. I cannot listen to your chest, feel your abdomen, look in your ear, or assess a painful joint by moving it. I cannot swab your throat, which means I cannot confirm strep. I cannot drain an abscess or remove a nail. I cannot check your blood pressure or your oxygen level unless you own the equipment yourself.
Depth is the other honest limit. Burns and wounds are genuinely hard to grade on a screen, and the line between something that needs a dressing and something that needs a surgeon can come down to how the tissue feels under a finger.
On some visits the most useful thing I do is tell you that you need to be seen in person, and help you work out where.
Go To An Emergency Department Instead
Chest pain or pressure. Trouble breathing, or being unable to finish a sentence. Sudden weakness, facial droop, difficulty speaking, or a severe sudden headache. Confusion, or a stiff neck with fever. Bleeding you cannot stop. A serious injury. Any thought of harming yourself.
None of that belongs on a screen, mine or anyone else’s.
The Bottom Line
Telemedicine is very good at medication management, chronic disease, and the large category of problems solved by talking with someone who knows what they are doing. It is poor at anything that requires hands. Any physician who tells you it does everything is selling you something.
Related Reading
When to Use Telemedicine vs. Urgent Care: How I Spot the Sick One
Menopause Treatment by Telemedicine: How It Works
Scott Rennie, D.O.
Board Certified in Obesity Medicine and Family Medicine
This blog is for educational purposes only and does not constitute individual medical advice. Always consult your own physician before making changes to your health, medications, or treatment plan.