I'm not for sure they all are on the reefer but one thing is for sure in my experience. They all seem not not be very professional compared to my regular doctor and tbh it is disappointing. The last one I saw 2 years ago was a total joke. I made comments on this forum that were my honest experience with my wife as a witness and I was threatened with law suit by one of the employees of the clinic. Even tho what they did was a blatant disregard for the law. Seeing the doc via Skype is not an "in person evaluation"