Revised guidelines could leave practitioners exposed if they cut clinical corners.
The rapid rise of telehealth and virtual care has transformed how Australians access medical services – but it has also opened a complex regulatory can of worms.
Recent revisions to the Medical Board of Australia’s guidelines have brought fresh attention to high-risk models of telehealth prescribing, particularly those involving weight-loss medication, peptides, and medicinal cannabis.
Medical defence organisations (MDOs) such as Miga are warning practitioners to proceed with extreme caution when approached to work for telehealth companies offering online prescribing services.
These businesses often promote quick and convenient consultations, sometimes without any video contact or prior relationship with the patient.
But such arrangements can leave doctors exposed to significant professional and legal risk, says Anthony Mennillo, head of Claims and Legal Services at Miga.
“We have had queries from doctors who have been approached to get involved in these types of organisations and the advice that we give is to be very careful,” he explains.
“You need to comply with the Medical Boards’ guidelines – we encourage doctors to carefully read those guidelines and then think about whether they still want to be involved.”
While there may be strong financial incentives for doctors to participate, many indemnity providers have made it clear that they will not cover practitioners engaged in completely asynchronous prescribing – where no video consultation or face-to-face interaction takes place.
“The practitioner needs to satisfy the Board, if there’s a notification, that they are providing safe medical practice,” says Mr Mennillo.
“I think the doctors are up against it, particularly where they have never met the patient. So the concern is there’s no video or face-to-face interaction at all.
“They don’t know the patient’s medical history other than what the patient might put down on the questionnaire. This will make it difficult to convince a regulator that they are providing safe medical practice in those circumstances. It’s not impossible, but very, very difficult.”
Mr Mennillo notes it is not the role of MDOs to dictate how practitioners practice medicine but warns they should check whether practices like asynchronous prescribing are covered by their medical indemnity insurance policy.
“We don’t cover those doctors that are only prescribing medicinal cannabis or peptides via telehealth without an established therapeutic relationship”.
“I think most of the medical indemnity providers will have similar guidelines in place.
“We also may not cover a telehealth consultation which is completely asynchronous.”
“If you have an established relationship and/or you have access to the patient’s medical records, we would cover telehealth in their consultations in those situations, and they will comply with the medical boards’ guidelines.
“The underlying guidelines are on the basis that if you comply with the medical boards guidance, including the good medical practice code of conduct, then you can’t go too far wrong, and we will cover it.”
Practitioners who choose to practice this type of medicine are advised to check the medical boards’ guidelines in the resource links below and check with their medical indemnity insurance provider to see whether they will be covered.
https://www.ahpra.gov.au/Resources/Information-for-practitioners-who-provide-virtual-care.aspx
https://www.ahpra.gov.au/News/2025-10-07-Updated-telehealth-guidance.aspx
“If you’re not, then you need to get indemnity from the organisation that you provide the service for if you’re going to do it,” Mr Mennillo advises.
“You need to be really careful, because you’re going to be in the medical boards and AHPRA’s crosshairs. They’re going to look specifically at this, and they are already looking at it.
“It’s not as if they need to have a notification from a third party, whether it’s a patient or another provider. They are already looking at and they’re going to continue looking at it to make sure that healthcare providers that are regulated by the boards are doing the right thing.”
Despite the caution, not all telehealth is fraught with high risk. Far from it in fact, says Mr Mennillo.
It can be highly effective, especially for practitioners and patients who have an established relationship. It can ensure patients needing urgent but uncomplicated care can access it in a timely way and can help bridge the tyranny of distance for rural and remote patients.
“There is certainly a place for it, says Mr Mennillo.
“More and more, I think we’ll see telehealth and virtual care being provided as a mainstream way of practicing medicine where you’ve got a good relationship.
“This is not what this revised guidance and what the medical board is trying to stop – it’s those who are skirting around the edges of the guidelines.”
What the board is targeting, he says, are those who exploit gaps in regulation to deliver one-off, high-risk prescribing without adequate patient oversight.
“This isn’t about stopping telehealth,” he says.
“It’s about stopping unsafe practice.”
While the current framework remains guidance rather than enforceable standards, there is speculation that formal regulations may follow.
“It’s probably inevitable,” Mr Mennillo says.
“The challenge will be balancing innovation and patient demand with public safety. The entrepreneurial providers out there haven’t always got that balance right and that’s what the medical board is trying to address.”
