I have consulted with a doctor over the phone. He was very specialized in something I needed, but was in another state. He was recommended by people who had used him and who I trusted. I would have my primary care doctor do all of the needed tests, send off the results to the telephone consultation doctor, and then call his office at a scheduled time. I would pay by the minute, though it actually was always cheaper than an office visit with my primary care doctor, though my insurance would not cover it, as it was not an office visit.