Telemedicine has developed as a tool for increasing access to health-related services. However, clinicians are required to achieve effective communication and provide quality care despite the remoteness of patients. The aim of this review was to focus on the interactional components of telemedicine consultations, identifying the social and embodied practices that health care professionals and patients draw on when managing the complexities of videoconferencing technology. A systematic review of telemedicine research using conversation analysis and discursive psychology was conducted, resulting in six articles eligible for inclusion. Interactional practices were synthesized into three categories: positioning utterances, visual and audiological clarification, and directional feedback. These categories demonstrate complex but ordered multimodal interactions that position the technology and health care professional as key to ensuring effective communication. Their interactional relevance highlights a gap in telemedicine research, where the need to focus more on the communicative and clinical richness of these unique consultations is reinforced.