Challenges to the Registration of Health Professionals

With the advent of e-health, provision of telemedicine services across state borders and national borders is now possible. However, this development causes difficulties with the registration of health professionals, particularly if the country allows state-based registration for health professionals. From a liability perspective, state-based registration present difficulty in the determination of which jurisdiction’s law to be applicable in the resolution of the dispute. For instance, a health professional may find himself practising outside the jurisdiction in which he is registered if he is asked to offer emergency assistance to a patient outside his area of practice. Such difficulty is faced by countries such as the United States and Australia. In Australia, although separate registration requirements exist in each state or territory, a mutual recognition scheme has operated since 1993 which addresses the registration issues that arise in telehealth initiatives that are provided within state or territory borders.

In Malaysia, telemedicine practice would not raise problems caused by state-based registration of health professionals. This is due to the fact that the Malaysian Medical Council regulates the registration of all health professionals in all states. However, section 3 of the Telemedicine Act 1997 provides that a medical practitioner who is registered or licensed outside Malaysia may offer telemedicine services in Malaysia if that person obtains a certificate to practise telemedicine from the Malaysian Medical Council. This would mean that a medical professional residing outside Malaysia can only provide telemedicine services through a registered medical professional in Malaysia. It would seem that this provision would not raise problems caused by the provision of telemedicine across national borders because only the Malaysian fully registered medical practitioner will remain primarily responsible to the patient. It has also been argued that only the Malaysian fully registered medical professional will have the patientdoctor relationship and be liable for medical negligence. It is up to the Malaysian medical professional to arrange for an indemnity agreement with the medical professional residing outside Malaysia.