I do some telemedicine work on the side for a company. Its a general medical platform. Visit reasons range from UTIs, Cough, Sinus Congestion, N/V/D, Styes, Conjunctivitis, Pain, Rashes, Dental Infections, etc... Some visits I send in prescriptions, some I recommend only OTC remedies, and others advise them to seek in person medical evaluation with PCP, UC, or ER depending on severity of complaints.
You don't have to be a Zpack mill if you don't want to. All you have to say is "No." Follow evidence based guidelines and give short succinct medical reasoning that people can understand why you are treating them with this thing or that thing. To me this is no different than if I was at my main office job. If the person is still being a jerk/dick/karen after you have given them sound medical reasoning that a child can understand, you do the same as if you were in your office. End the visit, mark them as a problem patient and thus they get dismissed, and move on.
I am 1099, so I take care of my licensing but if you work with some as a W2, I think they will pay to help you get your total number of state licenses up to a specific amount.
Lastly, I don't know if I could ever do this full time. I would miss patient contact and office procedures too much I think. However, it is nice to have a side gig to make some extra cash. Doing some telemed work also comes in handy if you are ever between W2s jobs. You can just log on and take consults and make some money. It acts somewhat like a safety net for you so you are never without an income if you dont want to be.