Q. I've seen many places offering non-face-to-face herbal medicine prescriptions for dieting these days. How is it possible that this is available nationwide?

The nationwide availability of telemedicine in Korean medicine stems from temporary allowances introduced after COVID-19 in 2020, along with exceptions for follow-up and stable patients. From a Western perspective, obesity involves energy imbalance and hormonal issues, but teleconsultations can evaluate key factors like diet, exercise, sleep, and stress. In Traditional Korean Medicine, obesity is understood as a progression: Spleen deficiency (脾虛, píxū: weakened spleen function) → Phlegm-fluid retention (痰飮, tányǐn: fluid and waste accumulation) → Blood stasis (瘀血, yùxuè: impaired blood circulation). These states are largely identified through symptoms such as digestion, bowel movements, edema, cold sensitivity, and tongue examination (coating and body color). For instance, a thick white coating suggests Phlegm-fluid; a pale tongue indicates Spleen deficiency or Blood stasis. However, pulse diagnosis is unavailable, so other information must supplement. Culturally, pulse diagnosis has been considered essential in TKM, but clinicians have adapted by relying more on tongue and inquiry diagnosis. The advantage is that busy individuals (e.g., office workers) can receive consistent care; the drawback is limited precision in diagnosis and difficulty managing emergencies. I personally recommend an in-person initial consultation, then transition to telemedicine based on progress. Initially, I was skeptical about prescribing without pulse, but after some trial and error, I found that tongue and inquiry diagnosis yield meaningful information. Not all patients are suitable, so a consultation-based decision is safest.