Many patients and even physicians still wonder whether online medical consultations truly offer value or whether they are simply a substitute when the patient cannot physically visit the clinic. After years of practicing rheumatology, I can say that online consultations, when used correctly, can be extremely powerful and may provide diagnostic clarity that even an in-person examination may not achieve in selected cases. The turning point for me was the case of a nine-year-old child from Yemen who had been diagnosed with juvenile rheumatoid arthritis and was receiving escalating treatments with no improvement. His father insisted on booking an online consultation, and I initially refused. Later, when I reviewed the medical file, laboratory results, and imaging, it took less than one minute to realize that the child did not have rheumatoid arthritis at all. Instead, he had a rare condition known as Caffey Syndrome. The amount of unnecessary treatment this child would have continued receiving was alarming, and the online review changed the entire course of his life. This experience reshaped my understanding of how powerful file-based evaluation can be, especially in rheumatology, where diagnosis depends heavily on history, imaging, laboratory results, and pattern recognition. As a result, I built a structured online consultation model that includes reviewing the full medical file before accepting the consultation, ensuring that only suitable cases benefit from the service. Online consultations are not for emergencies and are not meant to replace physical examination when necessary. However, they are highly effective for patients seeking diagnostic clarification, second opinions, or comprehensive explanation of their condition. For patients who live far from specialized rheumatology centers, this model can be lifesaving.