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Not only is the time spent between doctors and patients shorter, but there is no check-in at the desk and no need for expensive waiting rooms.

Tania Elliott, a Doctor on Demand physician licensed to practice in 14 states, estimates that just 5 to 7 percent of her virtual patients ultimately require help from an in-person doctor.

The patient might need lab tests or a physical exam, she says, "or if I think they need a higher level of care" she refers patients to their doctor or the emergency room.

Last year, Elliott urged a 60-year-old woman to head straight to the emergency room, worried that she suffered from more than the fatigue and light-headedness that she had initially described. A seemingly minor condition like a cough — assumed by the patient to be seasonal allergies — could signal a more serious condition such as pneumonia or the early stages of heart failure, says Russell Thomas, who practices family medicine near Houston.

Proponents say telemedicine has the potential to improve access to care, lower costs and provide reliable, specialized care to patients who need it.

But some doctors and researchers question to what degree virtual care equates to in-person treatment, and whether these e-physicians might overprescribe drugs to keep patients satisfied, misdiagnose an ailment or miss a more serious medical problem entirely.

She asked him to squeeze the glands below his jaw and the area below his eyes to test for sensitivity and to describe "the color of whatever was coming out of my nose." "You can tell a lot by looking at people," Antall says.

"That saved my bacon for the rest of the trip," he says.

However, a 2015 study in the same journal looking at prescription rates for respiratory infections found no significant difference in the number of prescriptions written by virtual doctors and by those who saw patients in their offices.

In Texas, the state's medical board amended its rules last April to stipulate that doctors can't diagnose new patients via telemedicine unless a medical professional is on hand who can provide "objective diagnostic data." Lewisville, Texas-based Teladoc, the country's largest telemedicine company, which conducted more than 550,000 virtual visits in 2015, filed suit, arguing that the board was illegally limiting competition.

Increasingly, employers and insurers are including the services as part of benefits packages.

A recent survey of 140 large employers by the National Business Group on Health found that 74 percent of the nation's largest employers are offering telemedicine services in 2016, up from 48 percent in 2015.

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