For an interesting read, check out this report on Teleneurology from Saadi and Mateen detailing neurology referrals from Doctors without Borders delivered via a Collegium Telemedicus platform. As is so often the case with relatively new healthcare services, the report raises as many questions as it answers. If anyone reading this has utilized this system for MSF neurology consultation requests, it would be fascinating to better understand what the barriers are to referral given the relatively low numbers received. So few referrals were requested, I was reminded of the Peanuts cartoon with Lucy sitting all alone in her consultation booth awaiting the opportunity to give Psychiatry consultations for ¢5. Having provided these asynchronous telemedicine consultations myself, I must say my comfort level when offering advice to physicians located in regions where I have professional experience working and am very familiar with local clinical epidemiology, disease burden and health services capacity is quite high. In contrast, I am frankly uncomfortable when asked for my opinion on cases from regions where I lack these basic insights.