Telemedicine is redefining the boundaries of the doctor and patient encounter. No longer do the doctor and patient need to be in the same room. No longer does the doctor have to visually see the patient to develop a diagnosis. New telecommunications infrastructures have created the possibility for a virtual office visit, outside of the constraints of time and space. This radical change in physical boundaries creates a profound transformation of the doctor and patient relationship, the organizational cultures of the healthcare institutions involved, and the administration, management, and reimbursement of services. Debakey (1995) argued that telemedicine, or the use of telecommunications technologies within the field of healthcare, has the potential for having a greater impact on the future of medicine than any other modality. Although the term telemedicine can include a wide variety of applications and technologies, including database management, distance education, and electronic patient records, this chapter will focus the application of telemedicine on delivery of remote electronic clinical consultations. This chapter will discuss telemedicine’s historical development, the transformation of the clinical environment from an external, internal, and individual perspective, and future trends.