What telehealth can't do with us, and why
What telehealth can't do with us: we don't prescribe controlled substances or compounded GLP-1 medications, don't recommend medical cannabis, don't issue the certificado de salud or certificates that need an in-person exam, and don't handle emergencies or patients outside Puerto Rico. For children we don't confirm ear infections, do strep tests or give vaccines. Here is why.
Not offered by video
- Emergencies
- Controlled substances
- Confirming ear infections in children
- Strep tests
- Urine tests for young children
- Vaccines
- PVAC-3 (hoja verde) vaccination certificate
- Certificado de salud (health certificate)
- School, daycare or sports physicals
- Well-child checks
We don't prescribe controlled substances
We do not prescribe controlled substances by video, such as opioids, controlled anxiety or sleep medications, or ADHD stimulants, even where federal rules allow it in some cases. It is our choice: these medications need follow-up that a video visit does not offer. If appropriate, the doctor can prescribe medication. We do not prescribe controlled substances.
We don't prescribe compounded GLP-1 medications
We do not prescribe compounded semaglutide or tirzepatide (made by compounding pharmacies). The FDA declared the shortages of these drugs over, and the grace periods for compounding them ended in 2025. If you are interested in weight treatment, talk to your primary care doctor.
We don't recommend medical cannabis
In Puerto Rico, recommending medical cannabis requires the doctor to be registered with the cannabis regulatory board and to have an established doctor-patient relationship. Our service does not offer medical cannabis recommendations.
Why telehealth can't do the health certificate or other in-person exams
Puerto Rico's certificado de salud (health certificate) can only be issued by doctors authorized by the Department of Health, at the authorized location and with in-person tests, so it can't be done by video. We also don't issue the medical certification for a driver's license (DTOP-DIS-260), which requires the doctor to examine the applicant in person, or school, daycare or sports physicals. See the health certificate guide and the medical certificates guide.
For children: what telehealth can't do
The doctor is not a pediatrician and sees children from 6 months old for common problems. Some things cannot be done well by video:
- Confirming an ear infection: the eardrum has to be examined with an otoscope.
- Strep tests: they need a rapid test or a culture.
- Urine tests for young children.
- Vaccines, the PVAC-3 vaccination certificate (hoja verde), and well-child checks.
- Babies under 6 months: we don't see them.
We don't see patients outside Puerto Rico
The doctor is licensed in Puerto Rico, and the law requires the patient to be in the jurisdiction where the doctor is licensed. So you must be physically in Puerto Rico for the whole visit. See the guide to the telemedicine law.
We don't do form-only, message-only or phone-call visits
Every visit is a real-time video visit. We do not prescribe from a questionnaire or do phone-call-only visits.
We don't give notes without a visit, or backdated notes
A doctor's note is only given after a real visit, for an illness the doctor assessed, with the real date. See doctor's notes.
We don't handle emergencies
In an emergency call 911 or go to the nearest emergency room. For a mental-health crisis, call Línea PAS at 1-800-981-0023 or 988. See when to go to the ER.
Is this an emergency?
Call 911 or go to the nearest emergency room for chest pain, trouble breathing, weakness or numbness on one side of the body, confusion, bleeding that will not stop, or if you think your life is in danger.
Help lines:
- 911 — Emergencies
- 1-800-981-0023 — Línea PAS (mental-health crisis line)
- 988 — Suicide & Crisis Lifeline
- 1-800-222-1222 — Poison Help
Before you book
- You must be physically in Puerto Rico during the visit (visitors and tourists are welcome).
- We see patients from 6 months old. Patients under 21: a parent or legal guardian must be on camera for the whole visit.
- Real-time video only; we do not do phone-call visits.
- We do not prescribe controlled substances.
Frequently asked questions
- Which medications can't be prescribed by telehealth with you?
- We do not prescribe controlled substances, such as opioids or stimulants, or compounded GLP-1 medications. Other medications are prescribed only if the doctor considers them appropriate after the visit.
- Do you prescribe GLP-1 weight-loss medications, or compounded versions?
- We do not prescribe compounded versions. For weight treatment we suggest talking to your primary care doctor, who can follow up with you in person.
- Can you recommend medical cannabis?
- No. Our service does not offer medical cannabis recommendations.
- Can you fill out the health certificate or a school physical?
- No. Both need an in-person exam, and the certificado de salud can only be issued by authorized doctors at an authorized location.
Sources
- FDA clarifies policies for compounders as national GLP-1 supply begins to stabilize (FDA) (accessed 2026-09-30)
- Medical cannabis: requirements for physicians (Puerto Rico Department of Health, Spanish) (accessed 2026-09-30)
- Health certificate guide (Puerto Rico Department of Health, Spanish) (accessed 2026-09-30)
- Puerto Rico Telemedicine and Telehealth Act, Ley 168-2018 (LexJuris, Spanish) (accessed 2026-09-30)
- AAP clinical practice guideline on acute otitis media (Pediatrics, 2013) (accessed 2026-09-30)