A general practitioner working in a semi-rural area (municipality of about 6,000 inhabitants) shares his experience. Telemedicine consultations began in 2023, somewhat by chance — a patient on vacation needed a prescription renewal, and Doctolib offered the feature. Three years later, telemedicine represents 12% of my consultations. Here's what I've learned.
What telemedicine can do (and cannot do)
It works well for:
Renewing chronic prescriptions — a well-controlled diabetic who comes every 3 months to renew metformin + statin. If recent test results are good, a 10-minute telemedicine consultation is sufficient. The patient saves 45 minutes of travel and waiting room time. For me, it frees up time for consultations requiring physical examination.
Post-consultation follow-up — A patient reporting side effects after a recent prescription. Via telemedicine, I see the patient, assess the situation, adapt treatment. No need to monopolize an office slot for that.
Dermatological problems — to my great surprise, good quality photos in video calls allow me to correctly evaluate most skin lesions (rashes, eczema, bites). Caution is necessary: in case of doubt, it's better to see the patient in person. But for typical shingles or urticaria, video is sufficient.
Advice and referral — A patient hesitant between the ER and a regular consultation. Telemedicine allows me to reassure or redirect without the patient overwhelming emergency services for a question resolved in 5 minutes.
It doesn't work for:
- Auscultation (obviously)
- Abdominal palpation, ENT examination, gynecological examination
- Elderly patients uncomfortable with technology (though this is improving — children help)
- Emergency situations
- First consultations with a new patient (initial physical examination is preferable)
Practical organization
Time slots
The practitioner dedicated 3 slots of 30 minutes per day to telemedicine (late morning and end of day). Each slot accommodates 2 telemedicine consultations of 15 minutes. That's 6 telemedicine consultations per day, 5 days a week.
In practice, not all slots are filled. Utilization rate is approximately 60%, or 15 to 20 telemedicine consultations per week.
The tool
The tool used is Doctolib Telemedicine, integrated with existing appointment booking. The patient receives a link, clicks, and we're on video call. No need to install an application. Video quality is sufficient in 90% of cases (it mostly depends on the patient's connection).
Alternatives: Maiia, Qare (if you want additional patient flow via the platform), Leah (focused on paramedical services).
Billing
Telemedicine consultation is reimbursed at the same rate as in-person consultation: 26.50 euros (2026 rate for general practitioner sector 1). Transmission is done via dematerialized Vitale card (ApCV) or dematerialized claim form.
Reimbursement conditions:
- The patient must be known to the doctor (at least one physical consultation in the last 12 months)
- The telemedicine consultation must be by video (not by phone)
- Maximum 20% of activity in telemedicine (beyond that, Health Insurance may consider you no longer practice neighborhood medicine)
Financial summary
15 telemedicine consultations/week × 26.50 € × 47 weeks = 18,682 € of additional annual revenue.
Additional costs:
- Doctolib Telemedicine subscription: ~1,500 €/year (included in Doctolib subscription for many)
- Quality webcam: 100 € (one-time investment)
- Headset: 80 € (one-time investment)
This is nearly net income, since there's no additional office cost (telemedicine consultations are done from the usual office).
What it changed in my practice
More availability for true emergencies. By freeing up physical slots through video renewals, it's possible to open unscheduled consultation slots. My access time went from 5 days to 2 days.
Fewer no-shows. The absence rate for appointments is 2% for telemedicine versus 8% in-person. The patient is at home, no transportation or parking excuses.
Better management of chronic conditions. Paradoxically, chronic patients consult more often when telemedicine is offered. With the travel barrier removed, they come (virtually) for things they would have put off.
My advice for getting started
Start small. Open 2 telemedicine slots per day for a month. Test with your regular patients, those you know well. Refine your organization over the weeks. After a month, you'll know if it's right for you.
Don't force reluctant patients. Some want to see their doctor in person, and that's their right. Telemedicine is a complementary tool, not a replacement.
Telemedicine will never replace clinical examination. But for 30 to 40% of consultation reasons in general medicine, it is just as effective — and infinitely more convenient for both patient and doctor.