What telehealth can't do: the safety limits

Telehealth cannot replace emergency care, physical examinations, hands-on procedures, or imaging. It is not the right setting for acute severe symptoms, serious mental health crises, certain medication first-prescriptions, or any situation where a clinician needs to physically examine you. Abby Health's clinicians are trained to recognise these limits and redirect you to the right level of care when they apply.

Why naming the limits matters

Telehealth is often discussed as if it were a newer, better version of seeing a doctor. It isn't. It is a different delivery model with its own strengths and its own boundaries. A clinician who knows where those boundaries are is a safer clinician than one who doesn't. This article is the list. Being honest about what telehealth does not do is part of the care.

It cannot replace emergency care

If you have symptoms that could indicate a medical emergency — severe or crushing chest pain, sudden weakness on one side of the body, slurred speech, severe shortness of breath, heavy bleeding, loss of consciousness, seizure, significant head injury, or any symptom that is rapidly getting worse — call 000 or go to your nearest emergency department. Do not wait for a telehealth appointment.

This is not a limitation of Abby or any other service. It is a limitation of the delivery model. A doctor on a video call cannot take an ECG, start fluids, or get you into a resuscitation bay.

It cannot do a physical examination

A Specialist GP's skills include palpation, percussion, auscultation, and targeted manual tests. Telehealth provides none of these. A clinician can look at a photo, watch you move, ask you to press on a spot and describe what happens, and make good inferences. But for a lump that needs feeling, a belly that needs pressing, a joint that needs moving, or a neurological examination, an in-person appointment is the right call.

It cannot perform hands-on procedures

Telehealth cannot administer vaccines, remove sutures, take a blood pressure, syringe ears, excise a skin lesion, or conduct a cervical screening test. Some of these can be coordinated through telehealth — we can refer you to a pathology collection centre for a blood test, or request a cervical screening sample with a self-collection kit where appropriate — but the procedure itself happens in person.

It cannot perform imaging

X-rays, CT scans, MRIs, and ultrasounds all require specialised equipment and trained radiographers. Telehealth clinicians can order these investigations for you, and review the results once they're back, but the scan itself happens at a radiology practice. Our guide on imaging referrals explains how this works.

There are medications we will not prescribe online

Certain classes of medication are not appropriate to prescribe for the first time through a telehealth consultation. This includes most Schedule 8 medications (opioids and other controlled drugs) and a number of Schedule 4 drugs with dependence potential, cardiovascular risk, or a clear need for in-person assessment. It also includes weight-loss medications that require documented in-person criteria assessment before initiation, and any medication where a physical examination is a required part of safe prescribing.

This is not a gap in the service — it is how safe prescribing works. If you are already stable on a treatment and your Abby clinician has your full history, repeat prescribing may be appropriate. Our guide on what Abby can and can't prescribe online safely sets out the detail.

It is not the right place for acute mental health crises

If you are in crisis, having thoughts of suicide or self-harm, or your mental health has escalated rapidly, please reach out to immediate support now — Lifeline on 13 11 14, Suicide Call Back Service on 1300 659 467, or 000 for emergencies. Our crisis support page has the full list of free, 24/7 Australian services. A scheduled telehealth appointment is not the fastest way to reach someone when you need support right now.

Routine mental health care — Mental Health Care Plans, reviews, ongoing support, and medication follow-up for stable conditions — is very well suited to telehealth. The distinction is urgency, not topic.

It cannot replace your local GP forever if you need continuity-of-presence care

Some patients — those managing complex conditions, those living with frailty, those with a care plan that needs in-person visits to keep working — benefit from a GP they can physically attend. Abby Health's mission is to restore continuous care for the Australians who can't or don't have that today. For patients who do have a strong in-person GP relationship and want to keep it, Abby is a supplementary service, not a replacement.

How Abby stays inside the limits

Our clinicians are trained on Abby's clinical governance standards, set by Chief Medical Officer Dr Ramu Nachiappan and Clinical Director Dr Bosco Wu of the AMA NSW Council. When a case is outside what telehealth can safely handle, your clinician will say so and direct you to the appropriate setting — whether that is a local practice, a specialist, an imaging centre, an emergency department, or an in-person review.

Your booking flow also screens for red flags before the appointment starts. Our guide on when telehealth is right for you sets out the positive side of the same boundary — what telehealth is well suited to.

Frequently asked questions

Why doesn't Abby just prescribe everything? Other services do.

Because safe prescribing is not the same as easy prescribing. Some medications need a proper clinical work-up and that cannot always be done on a screen. Abby is built on continuity and long-term care. Our clinicians are accountable for the decisions they make.

What should I do if I'm not sure if my symptom is an emergency?

Call Healthdirect on 1800 022 222 — a free 24/7 Australian health advice line staffed by registered nurses. For any symptom that may be life-threatening, call 000.

Can I still see an Abby doctor if my situation isn't telehealth-suitable?

You will need to see a clinician in person for issues that require physical examination or hands-on care. An Abby clinician can help coordinate a local referral where appropriate.

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