Why a remote consultation changes things
Your first estimate probably came from photos, a form or a short history. A live consultation adds a clinician's questions, your answers, a closer look at your records and, for some treatments, a guided view on camera. New information can change a recommendation, and it should. The time to find out is before you've paid for flights.
Colombia regulates this kind of care. Under Resolución 2654 de 2019, the Ministry of Health's telemedicine rules, the professional in a live video consultation takes responsibility for the diagnosis and treatment decisions made there. The resolution also:
- requires telemedicine activities to be recorded in the patient's clinical record (historia clínica)
- sets out what patients should be told about how remote care works, including its risks, benefits, privacy and how emergencies are handled
- makes the need for an in-person visit a matter for the professional's own clinical judgment
- allows the professional to decline or stop remote care if they give a reason
In practice, this means a changed recommendation from a video call is a real clinical act. You can reasonably ask for it to be summarised in writing.
The six common kinds of change, and what each does to the booking
| What changed | Effect on the booking | What to ask for |
|---|---|---|
| A different procedure is recommended | The old quote no longer applies | Why it differs, the alternatives, and a new itemized quote |
| An extra procedure is added | Longer trip, possibly later return, different total | The clinical reason, sequence, timing and separate pricing |
| A smaller procedure, or you're not a candidate | Lower cost, or no trip | The reasoning in writing, and what happens to any money paid |
| A prerequisite is added (tests, clearance, weight, stopping smoking) | The date may move | A dated list of requirements and who reviews the results |
| An in-person exam is needed before a final plan | The booking becomes provisional, or needs two trips | What can be decided now, what can't, and the terms if the exam changes things |
| The price changes with no change to the plan | The total moves | The specific reason, and a revised line-by-line quote |
If you haven't paid anything yet
This is the easiest case. Treat the revised recommendation as a new starting point:
- Ask for a written summary of the consultation: what was found, what's recommended now and why.
- Ask for a new itemized quote that matches the new plan.
- Compare it again. A changed procedure may make other providers worth a fresh look. See how to get a quote from an overseas hospital.
- Re-check the names. If a different clinician would now perform the procedure, verify them too.
- Book travel only after the revised plan and quote are settled. Our guide on booking travel after the clinical plan explains why that order matters.
If you've already paid a deposit
Now the terms you agreed matter. Before you respond to the new plan:
- Re-read the cancellation and rescheduling terms, especially any clause about plan changes or being found unsuitable.
- Ask in writing whether the deposit transfers to the revised plan, is refundable if you decline it, or is partly kept, and under which clause.
- Don't treat the deposit as a reason to accept a plan you don't yet understand. Money already paid shouldn't override new clinical information.
Our checklist of cancellation and rescheduling policies shows which clauses to look for.
Telling a clinical change from an upsell
Most changes are honest. A few aren't. These signs help you tell the difference:
Usually a clinical change
- It's tied to something specific, such as a finding, a measurement or something in your history.
- The clinician explains the alternatives, including doing less or nothing.
- You're given time to think and offered the reasoning in writing.
- The price change matches the change in scope.
Worth a harder look
- The reason is vague, such as "you'll get a better result."
- Extra procedures are suggested by sales staff rather than the clinician.
- The price rises but the plan is the same.
- There's pressure to accept before a discount or slot runs out.
The NHS treatment-abroad checklist (reviewed 2023) names pressure to decide quickly and a lack of information among its warning signs.
When the answer is "I need to see you in person"
Some clinicians won't settle a plan by video, and under Colombia's telemedicine rules that's their call to make. It isn't a brush-off. It's an honest statement of what a camera can't show. Your options are usually:
- A provisional booking: travel for the exam with treatment provisionally scheduled, on the clear understanding that it may change. Get the terms for that situation in writing.
- Two trips: a short visit for assessment, then a separate treatment trip once the plan is final.
- A local exam first: ask whether a specialist at home could do the assessment and send results.
For cosmetic surgery, the NHS (reviewed 2022) advises meeting the operating surgeon on two separate occasions before surgery. A video call may count as one, but it's worth asking whether the second happens before or after you travel.
What to write down during the call
Changes often come up quickly in a consultation, and details are easy to lose. While you're still on the call, or straight after it, note:
- what the clinician said they saw or learned that changed the recommendation
- the new recommendation, in their words
- any alternatives they mentioned, including doing less
- anything they said can only be decided in person
- any new tests, clearances or preparation, with deadlines
- who will send the written summary and revised quote, and when
Then compare your notes with the written summary when it arrives. If they differ, ask about it before you accept anything.
If you've already booked travel
Ideally, flights wait until the plan is settled. If you've already booked them, don't change anything until the revised plan and dates are in writing. Then check which parts of your trip still fit. A longer procedure may need a later return. A new prerequisite may push the whole trip back. An in-person assessment first may turn one trip into two. Rebook in order, starting with the clinical date, then lodging, then flights, so you're not paying change fees twice.
An illustrative example
A hypothetical patient sends photos and receives an estimate for one procedure. On the video call the surgeon asks about a medical condition the patient hadn't mentioned on the intake form. The surgeon says they'd want recent test results and a clearance letter from the patient's own doctor before confirming a date. The procedure itself hasn't changed, but the timeline has. The patient asks for this in writing, books an appointment with their own doctor, and holds off on flights until the clearance is back and the clinic has confirmed the date.
Getting a second opinion on the change
If the new recommendation is significantly bigger, different or more expensive, a second opinion is reasonable. Share the written summary with your home clinician, or arrange a remote consultation with another verified specialist. Colombia's ReTHUS registry (MinSalud) lets you confirm that a professional is authorized to practice.
The Takeaway
A plan that changes after a real consultation is usually your case being taken seriously. Get the change and its reasoning in writing, ask for a matching new quote, find out what happens to any deposit, and don't let travel bookings decide for you.
Frequently asked questions
Is it normal for a video consultation to change the quote?
Yes. Early estimates often rely on photos or a form, and a live consultation adds a clinician's questions and closer review. What matters is that any change comes with a specific reason and a revised itemized quote.
Can I get a written record of what was said in the video call?
Ask for one. Colombia's Resolución 2654 de 2019 requires telemedicine activities to be recorded in the patient's clinical record. A short written summary of the findings and recommendation is a reasonable request.
The doctor says they must examine me in person first. Is that a bad sign?
No. Colombia's telemedicine rules leave that call to the clinician's judgment, and some decisions genuinely need a physical exam. Expect either a provisional booking or a separate assessment trip, and get the terms for that situation in writing.
What happens to my deposit if I don't accept the new plan?
That depends on the terms you agreed. Ask in writing whether the deposit transfers, is refunded or is partly kept, and under which clause, before you respond to the new plan.
Should I get a second opinion if the plan gets bigger?
If the new recommendation is significantly larger, different or more expensive, a second opinion is reasonable. You can share the written summary with your home clinician, or with another verified specialist.