The purpose of this pilot study is to investigate the feasibility, effectiveness, and acceptability of a patient-physician real-time encounter using videoconferencing technology (a virtual visit) compared to a face-to-face office visit in the general medical setting. The three broad aims of the study are (1) to compare the physician's ability to make diagnoses in both settings, (2) to compare the physician's ability to provide therapy in both settings, and (3) to examine both patient and physician satisfaction with both modalities. Thirty patients were recruited from a single practice to participate in the study. Patients were first interviewed and examined in the virtual setting, and then in the face-to-face setting. Both patients and physician were surveyed after each visit type with regard to quality of the history, quality of the examination, and satisfaction with the experience. The data were analyzed using two-tailed t-tests and analysis of variance. Patients significantly preferred the in-person visit (4.7 of 5), but were very satisfied with the virtual visit as well (4.1 of 5) (p < 0.0001) (scale: 1= poor, 2 = fair, 3 = good, 4 = very good, 5 = excellent). Physical examination effectiveness was significantly worse in the virtual visit modality (2.3 versus 4.9 for the face-to-face visit, p < 0.0001), but history and therapeutic effectiveness were not significantly different. Both patients and the physician felt comfortable with the technology: patients 4.1, physician 4.3. Results suggest that both patients and the physician found the virtual visit a potentially useful alternative to the traditional visit for many medical conditions. This may have significant implications for the general medical care environment. Patients may benefit from reduced opportunity costs associated with physician visits and clinicians may benefit from decrease overhead costs. Further research is ongoing to investigate the generalizability of these findings.