Guides
Telehealth vs in-person doctor visit: what she can handle by video
For most non-emergency problems, a video visit is a good first step. The doctor evaluates you, diagnoses, treats, prescribes if appropriate and gives you a lab order if one is needed. Some problems do need a hands-on exam or equipment, such as a cut that needs stitches or a possible broken bone, and in those cases the doctor tells you where to go. If it is an emergency, call 911.
Is it an emergency? Call 911.
Pay now, then choose your time right away. Full refund if you cancel 24 hours or more ahead.
See the cancellation policy
You can cancel for a full refund or change the time up to 24 hours before your visit. Within 24 hours you can't cancel and there's no refund. If you don't join in the first 10 minutes, there's no refund.
If you choose a time less than 24 hours away, it can't be cancelled or changed.
If the clinic can't see you, for example because of a technical problem on our side, we refund you in full.
Is this an emergency?
This is not an emergency service. Call 911 or go to the nearest emergency room if you have:
- Chest pain or pressure
- Trouble breathing or blue lips
- A drooping face, weakness on one side or trouble speaking
- Bleeding that won't stop, a serious injury or a head injury
- Seizures, fainting or marked confusion
- Thoughts of harming yourself: call 988 or Línea PAS (1-800-981-0023)
Help lines
The short answer
You do not have to pick one kind of care for good. The useful question is what your problem needs today. If what is needed is talking, looking, asking questions, reviewing your history, prescribing or ordering a lab, a video visit covers it. If what is needed is touching, measuring with equipment or a procedure, you need to be seen in person.
For many people a video visit is the first step even when the problem ends up needing something in person: the doctor evaluates first, and if you need to be examined she says so and points you to the right place, instead of you losing a morning in a waiting room to hear the same thing.
This guide compares only a video visit with an office visit. To choose between the ER, a CDT and virtual urgent care, see where to go when you're sick.
What the doctor can do by video
Dr. Diana Nieves Castro, a general practice physician licensed in Puerto Rico, sees adults and children of all ages by video, in English or Spanish. In a video visit she can:
- Evaluate you: she listens to your history, asks the questions she would ask in an office and looks at what can be seen on camera, such as a rash, the throat, a swollen ankle or how you breathe while you talk.
- Diagnose common problems, such as colds and flu, sinus infections, UTI, allergies, skin problems, stomach upset or a sore throat.
- Treat and guide you: a care plan, what to watch for and when to check back in.
- Prescribe, if appropriate: if the doctor judges it right after evaluating you, we send your online prescription to your pharmacy. She also handles medication refills for maintenance medicines.
- Order labs: if a test is needed, you get a lab order for a lab near you.
- Follow up on conditions you already have, such as blood pressure or diabetes, within primary care.
- Give you a doctor's note if you need one, with your visit. See the doctor's note.
When you do need an in-person exam
Some things a camera cannot replace. If your situation is one of these, the doctor says so clearly and points you to the right place, which may be an office, a CDT, an urgent-care center or a hospital:
- A cut or wound that needs stitches, or a large burn.
- A possible broken bone, a deformity or a bad sprain with a lot of swelling.
- Severe belly pain, especially if it is in one spot, hurts to the touch or comes with a high fever and repeated vomiting.
- A test done with equipment on the spot, such as an electrocardiogram, an X-ray or an ear exam with an instrument.
- Procedures: drawing blood (the lab draws it with the order we give you), vaccines, removing stitches, draining an abscess or placing a device.
- Physical exams that require measurements in person, such as some license forms, and routine screening that depends on touch or equipment, such as a Pap test or a mammogram.
- A problem that does not improve with treatment, or changes in a way that worries you: the doctor may decide someone needs to see you face to face.
When it is neither: it is an emergency
Some situations are not solved by an appointment of any kind. Chest pain or pressure, trouble breathing, stroke signs, bleeding that won't stop, seizures, an allergic reaction with swelling of the face or throat or thoughts of harming yourself need urgent in-person care. Call 911 or go to the nearest ER. The full list is on when to go to the ER.
If you are in emotional crisis, call or text 988, or call Línea PAS at 1-800-981-0023.
Side by side
General guidance. Every case is different, and the doctor decides what is appropriate after evaluating you.
- Time: by video there is no drive, parking or waiting room. In person, count the trip and the wait.
- Physical exam: by video she assesses what can be seen and heard. In person, a clinician can touch, measure and use equipment.
- Prescriptions and labs: by video, the doctor prescribes if appropriate and gives the lab order. In person you can too, with more tests available on the spot.
- Hours: our video visits run 24 hours a day, 7 days a week. An office keeps set hours.
- Convenience: by video you are at home, at work or visiting the island, as long as you are physically in Puerto Rico.
- Cost: the video visit has a published price, the same for every age. We do not bill insurance. See pricing.
How a video visit works
How an online doctor visit works, in three steps:
- Request a visit and pay by card. Video visits 24 hours a day, 7 days a week: book online and choose your time right away.
- Join by video. We send you a secure link that works on your phone, tablet or computer. You need to be physically in Puerto Rico; visitors are welcome.
- The doctor assesses and treats you. A prescription if appropriate, a lab order if needed, and a doctor's note if you need one. If your case needs an in-person exam, she tells you where to go.
How to get the most out of the visit
A few minutes of preparation make the visit more useful:
- Keep a list of your medicines, with doses, and your allergies handy.
- Pick a spot with good light and a good signal, and test your camera and microphone first.
- If you have a thermometer, blood pressure cuff or glucose meter, have your latest readings ready.
- Note when the symptoms started and what you have tried.
- If the patient is under 21, a parent or legal guardian stays on camera for the whole visit and shows photo ID. See the visit for children.
It is a real medical visit, and it is regulated
Telehealth is a form of medical care with the same professional responsibilities as an in-person visit: the doctor is licensed in Puerto Rico, keeps your record and protects your information. For the legal framework, read telemedicine law in Puerto Rico. If you have no coverage, see seeing a doctor without insurance. The service is run by The Health Initiative, a nonprofit.
How we care for you
We evaluate, diagnose and treat; if needed, we give you a lab order for a lab near you.
We see adults and children of all ages. Patients under 21: a parent with patria potestad (parental authority) or a legal guardian is on camera for the whole visit and shows photo ID.
Real-time video visit. We send you a secure video link. It works on your phone, tablet or computer.
If appropriate, the doctor prescribes and we send your prescription to your pharmacy.
You must be physically in Puerto Rico during the visit (visitors, tourists and cruise passengers are welcome).
In an emergency, call 911.
Frequently asked questions
Is telehealth as good as going to the office?
What problems can't be handled by video?
Can the doctor prescribe by video?
What if the doctor decides I need to be seen in person?
Can I get lab work without going to an office first?
Do I have to be in Puerto Rico for a video visit?
Do you see children by video?
When should I call 911 instead of booking a visit?
About this page
Author: The Health Initiative
Medical care provided by Dr. Diana Nieves Castro, MD (PR license 24027)
Disclosure: Founding Executive Director of The Health Initiative
Published: 2026-10-10 · Updated: 2026-10-11
Sources (2)
- Understanding telehealth (Telehealth.HHS.gov) (opens in a new tab) (accessed 2026-10-10)
- When to use the emergency room - adult (MedlinePlus, NIH) (opens in a new tab) (accessed 2026-10-10)