In short. Where the conversation happens, who may be present, what is recorded and how your record is kept. Most of the privacy of a remote consultation is within your own control.
Key points
- Who is with you today, and how will this conversation be recorded?
- Both are reasonable, and neither should be awkward.
- A service that cannot answer them clearly is worth hesitating over.
A remote consultation moves a clinical conversation into your home and through several layers of technology. That does not make it less private by default, but it does mean the privacy has to be arranged rather than assumed. Most of it is within your control.
Where the conversation happens
Choose a room where you will not be overheard, and close the door. Use your own device and your own connection rather than a shared computer or a public network. Shared devices and public networks are the two most common ways a private conversation stops being private. If you would not take a personal call there, do not hold a clinical consultation there.
Who is present
You are entitled to know who is in the room at the other end, and to be told if anyone else is joining or listening. You are equally entitled to decide who is with you. If you want someone present for support, say so at the start. If you would rather speak alone, ask for that, and the clinician should arrange the conversation so that you can. A third party listening silently changes what a patient is willing to say, and clinicians know this.
Two questions worth asking at the start
Who is with you today, and how will this conversation be recorded? Both are reasonable, and neither should be awkward. A service that cannot answer them clearly is worth hesitating over.
What is recorded and kept
Ask before the call begins whether it is being recorded, and what will be written into your record afterwards. A written summary of the discussion, the advice given and the plan is normal and useful. A recording of the video itself is not routine, and you should be told if one is being made. Anything you send — photographs, reports, results — becomes part of the clinical record and should be handled as such, kept with the same confidentiality as the notes.
What you send and where it goes
Send images and documents through the channel the service provides rather than a personal social account. Ask how long material is kept and who can see it. If you are sending photographs of an intimate area, ask first whether a remote review is appropriate at all; sometimes it is not, and an in-person assessment is the better route.
Do not continue if
- You cannot establish who is present at the other end, or whether the call is being recorded.
- You are asked to send clinical images through a personal messaging account rather than a clinical channel.
- You are in a shared or public space and the conversation would be overheard by strangers.
Your own copy
Ask for the written summary to be sent to you, and keep it. A record you hold is what lets the next clinician understand what was said and decided, and it is the simplest protection against a consultation that later becomes unclear to everyone involved.
Frequently asked questions
Where should I hold a remote consultation?
Choose a room where you will not be overheard, and close the door. Use your own device and your own connection rather than a shared computer or a public network, since those are the two most common ways a private conversation stops being private. If you would not take a personal call there, do not hold a clinical consultation there.
Am I entitled to know who is present at the other end?
Yes. You are entitled to know who is in the room at the other end, and to be told if anyone else is joining or listening. You are equally entitled to decide who is with you: say so at the start if you want support, or ask to speak alone, and the clinician should arrange it.
What should I ask about recording and my record?
Ask before the call begins whether it is being recorded, and what will be written into your record afterwards. A written summary of the discussion is normal and useful; a recording of the video itself is not routine, and you should be told if one is being made. Anything you send becomes part of the clinical record.
Risks & Limitations
- A remote opinion is not a diagnosis. It is advice based on your account and the images you send, and it does not replace an examination.
- Photographs can mislead in both directions — they can make something harmless look concerning, and something concerning look harmless.
- Important findings can be missed without examination. Measurement, depth, texture and laxity cannot be assessed through a screen.
- A remote consultation must never delay urgent in-person care. If something is urgent, seek care rather than waiting for an appointment.
When to Seek Care
- Difficulty breathing or chest pain — seek emergency care immediately.
- A sudden change in vision.
- Severe pain out of proportion to what is visible.
- Skin turning white, grey, mottled or dusky.
- A lesion that is growing rapidly or bleeding.
- A wound that is not healing.
References & Further Reading
- World Health Organization (WHO) — telemedicine and patient safety resources
- National Institute for Health and Care Excellence (NICE, UK) — guidance on remote consultation
- American Telemedicine Association (ATA) — practice guidance for remote care
This page is patient education, not medical advice. A remote opinion is not a diagnosis, photographs can mislead in both directions, and some questions cannot be answered without an examination. To arrange a remote consultation at Chongqing West District Hospital, see Contact & Consultation.