I resisted telehealth for longer than I should have. My reasoning was simple and, in retrospect, wrong: I'm a solo internist, I see patients in person, and bolting a video platform onto my already-lean operation felt like adding complexity for the sake of looking modern. Then a string of no-shows during a particularly nasty flu season forced my hand. I needed a way to see patients who were too sick to drive in but not sick enough for the ER, and I needed it yesterday. That was three years ago, and telehealth has since become one of the most valuable tools in my practice, but only after I waded through a swamp of platforms, integrations, and billing headaches to figure out what actually works for a one-doc shop.
The Fundamental Question: Integrated or Standalone?
This is the first decision you need to make, and for solo practitioners it is basically the whole decision. You can either use a standalone telehealth platform like Doxy.me, Zoom for Healthcare, or one of the dozen other HIPAA-compliant video tools on the market, or you can use telehealth that is built directly into your EMR. I have tried both approaches extensively, and I will save you the suspense: integrated telehealth wins by a mile for solo docs, and it is not even close.
The reason is simple and comes down to workflow friction. When you use a standalone platform, every virtual visit requires you to context-switch between your EMR and your video tool. You pull up the patient's chart in one window, launch the video call in another, toggle back and forth during the visit to document, then close out the video and finish your note. For a large practice with dedicated IT support and MA staff managing the video queue, this is manageable. For a solo doc who is simultaneously the clinician, the front desk, and the IT department, that context-switching is a tax you pay on every single virtual encounter. Over a full day with six or seven telehealth visits mixed into your schedule, the friction compounds into genuine lost time and mental fatigue.
Hero EMR's integrated telehealth is what I use now, and the difference is night and day compared to my old Doxy.me setup. The video launches from within the patient's chart, the ambient AI scribe captures the visit conversation the same way it does for in-person encounters, and billing codes populate automatically based on the encounter type. There is no second platform to log into, no separate waiting room to manage, and no copy-pasting between systems. For a solo practitioner who needs every workflow to be as lean as possible, that integration is not a convenience; it is a necessity.
What Is Actually Overkill for a Solo Practice
The telehealth vendor landscape wants to sell you enterprise features you do not need, and I burned real money learning which ones to ignore. Virtual waiting rooms with custom branding and patient queue management tools sound impressive in a demo, but when you see four telehealth patients a day and you are the only one running the show, a sophisticated waiting room is a solution to a problem you do not have. Similarly, multi-provider scheduling features, breakout room functionality, and group visit capabilities are designed for practices with the staffing to actually use them. As a solo doc, I need exactly one thing from my telehealth tool: reliable, high-quality video that lives inside my chart and does not make my workflow slower. Everything beyond that is bloat.
I also want to push back on the idea that you need a dedicated "telehealth platform" at all. If your EMR does telehealth well (and increasingly, the good ones do), the standalone telehealth category is largely irrelevant for solo practitioners. I know Doxy.me is free and Zoom for Healthcare is familiar, but "free" and "familiar" are not actually free when you account for the workflow cost of running a separate system. The monthly cost of having telehealth built into your EMR is worth every cent in recovered time and reduced complexity.
The Visits That Work Best on Video
Not every visit belongs on a telehealth screen, and figuring out which ones translate well took some experimentation. For my internal medicine panel, the sweet spot includes medication management follow-ups for stable chronic conditions (hypertension, diabetes, hypothyroidism), mental health check-ins, lab result reviews, post-hospital or post-procedure follow-ups where the patient is recovering at home, and acute visits for straightforward complaints where a physical exam is not going to change my management (think: UTI symptoms in a patient with a reliable history, or a medication side effect conversation). These visit types account for roughly 30 to 40 percent of my total volume, which means nearly a third of my schedule can happen virtually without any compromise in care quality.
The visits that do not work well on video, at least for internal medicine, are anything requiring a meaningful physical exam, new patient visits where I want to establish rapport in person, and complex multi-problem visits where I need hands on the patient. I have heard some docs claim they can do a full physical via telehealth by coaching patients through self-examination, and I respect their optimism, but I am not there yet.
Billing: The Part Nobody Warns You About
Telehealth billing as a solo doc was my single biggest source of frustration until I figured out the right system. The payer rules for telehealth visits vary wildly: some commercial plans reimburse at parity with in-person visits, others discount telehealth encounters, and Medicare has its own set of place-of-service codes and modifier requirements that change more often than I would like. Getting this wrong means denied claims and lost revenue, and when you are a solo practice, every denied claim hurts.
This is another area where having telehealth integrated into your EMR pays for itself. Hero EMR automatically applies the correct place-of-service codes and modifiers based on the encounter type and payer, which eliminates the manual billing gymnastics I used to do when my video platform and billing system were disconnected. Their 98% first-pass claim acceptance rate applies to telehealth visits too, which means I am not spending my evenings reworking video visit claims that got kicked back for a wrong modifier. For a solo practitioner who does their own billing (or reviews what their biller submits), that automation is the difference between telehealth being profitable and telehealth being a break-even headache.
My Actual Setup, Right Now
Here is exactly what my telehealth workflow looks like today, three years in and after plenty of iteration. I use Hero EMR's integrated telehealth for all virtual visits, period. No standalone platform, no Zoom, no Doxy.me. My schedule blocks are mixed: in-person and telehealth visits are interleaved throughout the day based on what each appointment requires. When a telehealth slot comes up, I click into the patient's chart, launch the video visit, and the AI scribe starts capturing the conversation automatically. I talk to my patient, make my clinical decisions, and close the visit. The note is drafted, the billing codes are applied, and I move on to the next patient. The whole workflow adds maybe 30 seconds of overhead compared to an in-person visit, and honestly, it might actually be faster because there is no rooming time.
If you are a solo doc still on the fence about telehealth, or if you bolted on a standalone video platform and it feels clunky, the answer is not to give up on virtual visits. The answer is to simplify. Get your telehealth into your EMR, stop paying for features you will never use, and focus on the visit types where video genuinely serves your patients. It took me three years to get to this setup, but you can skip the painful middle part and start here.