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A 6-year-old in Canada had developed a rash on a limb.

The patient’s mother advised that the rash had started as one lesion but now there were two and they looked infected. The lesions were blistering, oozing, and itchy. The patient had no other symptoms.

The doctor diagnosed the patient with a highly contagious skin infection that often starts with red sores on the face or hands and their mother was advised to disinfect the lesions twice a day and apply a topical antibacterial agent twice a day for 7 days. She was also advised to give them antihistamines until the itching subsided.

The patient’s mother was encouraged to contact the service for a further review if symptoms did not improve or worsened or if she had any additional queries or concerns.

A 62-year-old woman based in the USA who contacted the service as she had symptoms relating to a urinary tract infection (UTI).

The patient explained that she had been drinking large amounts of water which had worked in the past, but her symptoms had continued. She was otherwise fit and well.

The doctor diagnosed her with a mild UTI and advised that she would need to start on a course of antibiotics, and provided her with a prescription.
The patient received a follow up from the doctor a few days later and she advised that she felt much better and had noticed a significant improvement in her symptoms.

She was encouraged to contact the service again should she have any further queries or concerns.

A 4-year-old child based in Mexico City who had developed a cold nearly a week ago. The mother explained that the child had not developed a fever or experienced any difficulty with breathing. Their nose was no longer blocked, they had some minor coughing, and was otherwise fine.

The doctor diagnosed them with an upper respiratory infection and recommended that they be provided with symptomatic care with fluids, saline rinse, and a spoonful of honey in hot water to help relieve the cough.
The mother was encouraged to contact the service again should symptoms persist, or should she have any further questions.

A 9-month-old based in Lesotho who had been exposed to a kitten that was noticed to have intestinal tapeworm infection.

The mother advised that the child was asymptomatic, but she wanted advice as to whether he should take medication to help prevent the development of a tapeworm.

The doctor advised the mother to check his stools for any sign of a tapeworm and to repeat the process again in two weeks time. If the mother noticed anything unusual, she was instructed to seek a consultation with a pediatrician to consider appropriate therapy.

The mother was encouraged to contact the service again should she have any concerns or questions.

A 46-year-old female based in Jersey had developed an infected toe.

The patient advised that she had recently had two of her toenails removed and had been advised that it would take up to 10 days to heal, however, she was still experiencing problems after this time. After the operation, she has been cleaning the area with alcohol wipes and a spray and putting on clean dressings, which she had done for 10 days, however, the nail bed of one toe had become infected. She had no other symptoms.

The doctor diagnosed the patient with a toenail infection and advised her to monitor it as it looked like it was improving and to keep it dry and clean. The patient was encouraged to contact the service for a further review if there was any swelling, increase in pain, discharge or onset of fever or if she had any further queries or concerns.

A 36-year-old female based in France who had contacted the service as she had queries about a recent operation.

The patient had undergone a laparoscopy due to extensive endometriosis, which had also involved a cystectomy and wanted to know about her chances of getting pregnant in the future, without intervention.

The doctor reviewed the medical notes provided by the patient and explained the extension of her endometriosis, which showed that her right ovary was not affected, which meant that she had a chance to conceive naturally and recommended that the patient use an ovulation calculator to help her conceive.

The patient was encouraged to contact the service again should she have any queries or concerns.

A 35-year-old in Spain, who had run out of antihypertensive medication and was concerned as his blood pressure was increasing.

The patient had recently reduced the dosage of his medication as he had lost weight, was exercising more and saw that his BP had become lower, however, had not seen a doctor to get advice on this as he had only recently moved to Spain. He advised that he had an appointment in three days to see a GP.

The doctor provided the patient with a short-term refill of his BP medication and explained that he should see his doctor regularly as due to the other medications he was taking they would need to carry out regular blood tests and blood pressure readings.

The patient was encouraged to contact the service again for a further review or if he had any queries or concerns.

A 45-year-old based in Belgium who contacted the service to discuss several issues including urinary frequency, a painful elbow and a sore throat.

The patient advised that their children were currently suffering from a bacterial throat infection and suspected they may have the same.

The doctor explained that based on the medical details provided, there was a strong possibility that they were suffering with a throat infection. They were advised that further testing would be required to evaluate their presenting symptoms and that they should arrange an appointment to see a physician for a face-to-face consultation/exam.

They were encouraged to contact the service again should they have any further queries or concerns.

An 80-year-old male based in Germany had developed pain in his arm.
The patient advised that this had started a couple of weeks ago with pain in his neck, shoulders and right arm, and he had seen another doctor who had given him an injection in his neck which helped. He was taking painkillers but was finding it painful to lift his arm above his head. He had no other symptoms.

The doctor diagnosed the patient with a condition where the tendon in the shoulder rubs or catches on a nearby bone and recommended conservative management for the time being, including taking anti-inflammatory medications for two weeks and some gentle exercises to help mobilise his shoulder. The patient was encouraged to contact the service for a further review if the pain was not improving, if the symptoms worsened or if he had any queries or concerns.

A female in her 40s contacted the service to discuss the findings of a recent mammogram which had picked up changes.

They consulted with both a general surgeon and a breast specialist in Greece who had provided slightly differing suggestions on next steps.

They had found it difficult to trust doctors in her local area and were feeling anxious. The doctor discussed in more detail routine screening, preventative care and different methods of diagnoses to provide them with some. They were reassured that the advice provided by the doctors in Greece was within standards of practice worldwide.

They were encouraged to contact the service again should they have any questions or concerns.

A 64-year-old male based in the Ukraine who had tested positive for COVID-19 a month ago.

The patient had mild symptoms; headache, fatigue and muscle aches and was still suffering with fatigue, brain fog and he had difficulty concentrating. The patient followed a healthy lifestyle and diet and was taking multivitamins and painkillers.

The doctor advised the patient that he may be suffering from long COVID-19 symptoms and gave him some lifestyle and diet advice including; rest, proper sleep, keeping hydrated and exercise for at least 30 minutes daily and referred him to his local doctor for his annual physical examination.

The patient was encouraged to contact the service again if he had any further queries or concerns.

A patient in their forties, based in Myanmar who had developed bad back pain and high stress for three weeks.

The patient’s job was in a high-pressure environment and they advised that they had started to have back strains and pains daily, and found sleeping difficult but was able to move around normally. They had no weakness of limbs or bowel issues.

The doctor diagnosed the patient with back pain and stress anxiety and recommended that they seek physical therapy for their back and to have regular breaks from their desk during the day and to take painkillers for the back pain.

In regard to the stress anxiety, they were advised to continue the therapy they were currently receiving through a psychologist, which would help them to learn coping techniques and relaxation techniques and encouraged to contact the service again if they had any further queries or concerns.

A 3-year-old girl based in Korea who developed a rash on her cheek.

The patient’s father advised that small bumps had appeared on her cheek a week ago, which she had picked and dressing and antibiotic ointment had been applied, however, the skin had became inflamed and red. A steroid cream had since been applied without improvement.

The doctor advised that the patient had contact dermatitis and that as it was not clear what had caused the reaction. Her father was advised to stop using the cream and that removal of irritants would slowly help the skin to clear.

The doctor followed up with the father a couple of days later and he advised that the rash was much improved. The father was encouraged to contact the service again should he have any further queries or concerns.

A 48-year-old based in China who had experienced stomach pain and bloating for the past 18 months.

The patient advised that they had a gastroscopy and ultrasound performed before but had been advised that there were no abnormal findings. They had been given some medication which had provided limited relief from symptoms. They explained that they had been under a lot of stress recently and had changed their diet.

The doctor diagnosed the patient with gastritis and provided a list of suggested tests that the patient may wish to undertake and encouraged them in the meantime to make some changes to his diet by avoiding acidic and spicy foods and to lower their alcohol intake, to see if that improved the symptoms.

The patient was advised of the red flag symptoms to be aware of and encouraged to contact the service again for a further review or if they had any further queries or concerns.

A female in their 30s had been experiencing headaches and dizziness for the past 24 hours.

The patient explained that they had temple pain, which was alleviated by lying down and resting, and that things were spinning around them, and they had felt nauseous. They had previously been prescribed a medication used to treat vertigo which had provided some relief.

The doctor diagnosed them with vertigo and explained that this can often be caused by ear conditions and recommended seeking a consultation with an ENT specialist for further management.

They were advised of the red flag symptoms to be aware of and were encouraged to contact the service again should she have any further queries or concerns.

A young girl in the Philippines who had developed a fever the day before.

The patient also had stomach pain and a sore throat. She had recently had a check up with a paediatrician and had got a clean bill of health, and had no parasites, food intolerances, past urine infection, stomach pain, vomiting, diarrhoea or constipation.

The doctor advised her parents that it was likely to be a viral non-specific episode and that it should resolve without treatment, however, they were advised to observe her symptoms over the next 24 hours.

Her parents were encouraged to contact the service again if they had any further queries or concerns and the following day the patient’s mother contacted the doctor to advise that the patient’s fever had broken and she was feeling a lot better.

A 27 year old who contacted the service as they were having a hard time concentrating after a relocation to Indonesia.

The patient advised that they had previously been diagnosed with attention deficit disorder (ADD), and they were treated with medication.

They were not currently on medication due to the way it made them feel. However, now they were now struggling to concentrate, which was negatively impact ing their life and wished to discuss their options.

The doctor advised that they would benefit from speaking to a psychiatrist as they would be able to assist with the development of a management plan and provided them with a referral for this.

The patient was encouraged to contact the service again should they have any further queries or concerns.

Barrett Woods – Philadelphia, USA

Jairo E. Garcia – Maryland, USA

Satish Rao – Georgia, USA

Chirag Shah – Massachusetts, USA

Douglas S Ross MD – Massachusetts, USA

Johnathan Berstein – Ohio, USA

Natasha Janicic Kahric – Virginia, USA

Paul R. Lambert – South Carolina, USA

UAE employers save on average £86 per employee, per doctor visit.

Portugal employers save on average £16 per employee, per doctor visit.

UK employers save on average £49 per employee, per doctor visit.

Spain employers save on average £48 per employee, per doctor visit.

France employers save on average £52 per employee, per doctor visit.

Germany employers save on average £72 per employee, per doctor visit.

Italy employers save on average £44 per employee, per doctor visit.

China employers save on average £20 per employee, per doctor visit.

Japan employers save on average £66 per employee, per doctor visit.

Singapore employers save on average £70 per employee, per doctor visit.