Since the 1950s, health planners and medical informatics sages have wanted to link local practitioners in remote areas with specialists in academic medical centers. Despite several pilot projects and substantial federal monetary support, practical remote medical consultations remained beyond reach until recently. The revolution in personal computers and Internet communications makes it possible to piggyback telemedicine on multiuse computers and communications channels. This solves the key technological problem that stalled the routinization of telemedicine—access to sufficient audio and video processing power and communications bandwidth at an affordable cost. With the technological barriers lowered, the implementation of effective telemedicine now depends on solving legal and reimbursement policy questions. Until these questions are resolved, telemedicine poses substantial legal risks, making it essential that medical care practitioners who are involved with telemedicine understand the basic legal constraints on such practice.