On a Skype connection that is unusually consistent, a 31-year-old man is describing his anxiety attack to Doctor Sirfraz Hussain. "Big headache, sweating … I got really scared, I was going in and out of the toilet every five minutes." He pressed his heart, to indicate the fear that mustered around it like a physical pain. His cat got up off the windowsill and moved towards him; for those of a romantic bent, it looked as though it were trying to comfort him. He only half the time made eye contact, the rest of the time casting his eyes towards the ceiling, evasively, as though he were ashamed of having to ask for help.

"But I can tell he's not depressed," Doctor Hussain said afterwards, "because depressed patients don't look at you, there's no trace of emotion from them. Stress and anxiety come first; then when people reach the point of thinking, this is never going to end, they become depressed. Then they think, if I wasn't here I wouldn't be such a burden on everybody, and they become suicidal. This is a well-trodden path, and I needed to see where he was on it. He isn't depressed yet, he's anxious about a problem at work. A simple sensitivity on his employer's part and he wouldn't be here." Then, with an upswing, as though he'd just found a fiver in the pocket of his jacket, he added: "That cost less than a phone call, and yet it told me so much more."

The news broke this week that patients may, in the future, be able to Skype their doctors. In Moss Side health centre, Manchester, Hussain introduced this a year ago. There were plenty of procedural hoops – the NHS is a justifiably late adopter with technology, in case there are privacy trade-offs – but patients immediately loved the idea. "Anybody who has a loved one abroad will already be using Skype a lot." Recent immigrants, so often characterised as "hard to reach" (the new term is "seldom heard") were actually much easier to reach. Conversely, "when you look at areas like Altrincham, you have these big posh houses, with their big gardens, and behind those doors there are a lot of very lonely elderly people. Because they're affluent, they have high-achieving families, their children are living in London, or New Zealand, or Canada. They're reluctant to go to a doctor for anything. The patients who could benefit much more from this are the typically English ones."

To dispatch any expectations we may have had from the suppurating sores on Embarrassing Bodies (the videolink version), Dr Hussain says he wouldn't attempt to examine anybody by Skype. He wouldn't ask you to put your itchy ear up to the camera. "But having said that, we are working with community matrons and they could do it for you. You could have someone by the bedside, and direct their examination. That would make things so much better for people who are seriously bedbound."

There are things he can recognise pretty much immediately. "You can see somebody who's really sick compared to people who are not … From the way they are moving, talking, reacting. It's pattern recognition, isn't it? We see ill people so often and well people so often. So a parent might say, 'little Johnny's really sick' when he's running around the room tearing it apart. Or they might say, 'he's fine, it's just a temperature and a blocked nose', and you'll see the kid is completely floppy. People aren't necessarily very good at recognising what's going on."

Another patient gets through to him, after six or seven abortive attempts. (During which time, he says: "Right now I'm talking to you, but in real life I would be doing paperwork; none of this time would be wasted." He's big on efficiency – the doctors in the practice Skype each other, to save the 30 seconds it takes to get up.)

"She's got a very brave soul, she really battles to keep on top of her problems. And there are a lot of them," he says. The main one is crippling arthritis, so it's surprising how cheerful she seems when she finally gets his face on the screen. "I can't get into the surgery, but I can get to see you. And that's lovely," she says. Hussain is leaning in, gesticulating; he has a kind posture, receptive and encouraging. "You have to be jolly," he says. "When you're serious, people won't tell you anything."

At the end, the Guardian photographer was trying to get an unsmiling picture of him, in case we went with a headline like "millions of people remain ill". "It's no good," she said to herself, exasperated. "Even his eyes are smiling." There's more going on here than the simple transmission of symptoms: some human spark that goes both ways.