A long time ago, when you got sick, you would call to make an appointment to see a physician within a few days. The doctor would examine you, talk to you and, if appropriate, write a prescription. You would take that piece of paper to the pharmacy. While you waited, the pharmacist would fill the prescription and make sure you were aware of important information.

That old-fashioned image is now long gone. For one thing, you may have to wait quite a while to get an appointment with a health care provider. Perhaps you now use an online patient portal to make that appointment.

Frequently, patients use the portal to renew their prescriptions without even seeing the doctor. And pharmacists now get most of their orders online.

Even more radical, millions of people are bypassing the doctor’s office entirely. Commercials on television encourage viewers to visit “telehealth” companies. There, they can fill out electronic forms to access trendy prescription pharmaceuticals to lose weight, grow hair, improve sexual function and even balance your mood.

Often patients start by filling out an online form. The individual may then be referred for a video conference with a “health professional” of some sort.

Customers are told that they will get a consultation with a “licensed medical provider,” though what kind of provider is not always mentioned. Will that person be a board-certified physician, a nurse practitioner, a physician associate or a pharmacist?

Once the provider determines that a prescription is appropriate, it gets shipped directly to the customer. Renewals are relatively easy, with no in-office visits required.

Decades ago, Joe had many heated discussions with his good friend, self-care guru Dr. Tom Ferguson. Tom loved the idea of online prescribing. Joe hated it.

Tom believed that the online interface would allow for much quicker and more thorough follow-up regarding both benefits and risks of medications.

He believed that physicians would be in touch with patients within days of starting a new prescription. They would verify that it was working as anticipated, and they would closely monitor for any side effects. While this approach could, in theory, happen, that does not appear to be the dominant model today.

A recent article in the Wall Street Journal (March 14, 2025) described sexual side effects experienced by some men who had purchased prescription finasteride for hair loss from telehealth companies. Their libidos plunged and, in some cases, their genitals became smaller and changed shape.

According to the Journal, “Most said they didn’t realize there were risks of serious side effects from the hair-loss drug; others said they didn’t feel the warnings were adequate.”

We are all for modern technology. Electronic tools allow health care providers to monitor blood pressure, irregular heart rhythms, weight or blood sugar. Video conferences allow dermatologists to examine patients remotely.

For such interactions to produce meaningful outcomes, though, requires time and trust. The follow-up telehealth visits that Dr. Tom Ferguson envisioned would be wonderful if they were based on adequate time and exchange of information.

Unfortunately, in today’s profit-driven health care environment, time is money. Telehealth providers may prefer to speed customers through an online experience that minimizes medical doctor interactions or the opportunity for complex questions. In such situations, people may need to make an effort to get the in-depth drug information that they need.

In their column, Joe and Teresa Graedon answer letters from readers. Write to them in care of King Features, 628 Virginia Drive, Orlando, FL 32803, or email them via their website: www.PeoplesPharmacy.com.