Video and audio calls may seem attractive at first. However, synchronous communication [video or audio calls] has many drawbacks. 1. It limits the depth and breadth of interaction between an expert and a patient. Usually, only one expert is available for a call at any time. 2. It lowers the caliber and fit of experts available for any medical situation. Logistics and availability of experts quickly become bottlenecks. 3. It rushes follow-up questions and limits contextual information for expert's views. 4. It severely reduces the efficiency of interactions for all parties involved. Most services brush over these important drawbacks. Audio and video calls may be suitable for conversations with internists and general practitioners. Calls betwen patients and doctors are suitable for physicians who are well familar with the patient. Such doctors are likely to also see the same patient in person on a regular basis. Asynchronous communication wins every time in all situations that require world's leading experts to help with complex medical situations. It is the best method to work across time zones and languages.