What to expect from a video consultation

A regulated form of consultation, not a lesser one

Remote consultation in Costa Rica is governed by Decreto 44363‑S, in force since 2024. It applies to private and public providers alike, and it sets out what must happen before, during and after. Knowing what it requires tells you what a properly run video consultation looks like.

That regulation is covered in detail elsewhere on this site. This page is the patient's version.

Before: consent, and what it should contain

You should be asked for consent in writing or digitally before or at the very start, and it should be more than a tick box. The regulation expects you to have been told how the consultation works, the privacy arrangements, what happens if the technology fails, how you will be contacted, and how your images and data will be handled.

The consent document itself should carry your full name and identification, the date, your signature, your current diagnoses and the risks of being seen this way. You can withdraw it at any moment.

If what you signed was a terms‑and‑conditions page, you did not give informed consent in the sense the regulation means.

What to have ready

1. Your results, as files, open on the screen or sent in advance.
2. A complete medicines list with doses, including supplements. Photographing the boxes is easier than writing it out.
3. Your own measurements if you have them — weight, blood pressure, waist.
4. Your questions, written down. People forget two‑thirds of what they meant to ask.
5. Somewhere private, with a decent connection. The clinician is required to be somewhere private too.

What a video consultation can do

• Take a history — which is where most diagnoses actually come from
• Review your laboratory results in detail
• Prescribe, including for ordinary medicines, with the prescription properly signed
• Adjust an existing treatment and review how it is going
• Order further tests
• Refer you for examination or imaging

What it cannot do

The regulation is explicit about the exclusions, and a clinician who declines on these grounds is following the rules rather than avoiding you:

• Anything requiring a physical examination.
• Issuing a certificate of health status, a birth or death certificate, an aeronautical certificate, or a dictamen for a driving licence or firearms permit.
• Starting a controlled medicine. Those require a previous in‑person consultation on record, and in the private sector must go through the national Receta Digital system.

Teleconsultation is also defined as complementary — it does not replace in‑person assessment, and whether a given problem suits video is meant to be agreed between you and the clinician rather than decided for you.

What should happen about the prescription

If one follows, it must carry the prescriber's name, profession, specialty and professional code, and your name, identification, age, the date and your weight and height. A digital prescription needs a valid digital signature certificate.

A photograph of a hand‑signed prescription sent over a messaging app is expressly prohibited. If that is what arrives, something is wrong.

What should happen if the call drops

You should have been told, before starting, what the alternative is. That is an explicit principle in the regulation — no abandonment — and it is a small thing that reveals whether a service was designed or improvised.

Afterwards

The consultation should produce a record, and you are entitled to a copy. Ask what the follow‑up interval is, what will be retested and when, and how to reach the clinician if something changes before then.

If you were prescribed something, ask what would make you stop it and who to contact.

The boundary

A good remote consultation is a real consultation, and for a condition managed by measurement rather than examination it can be as good as being in the room. A clinician who tells you that you need to be seen in person is doing their job, not dismissing you.