Colleges can do little to regulate telemedicine: registrar
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* Heather Kent

Licensing in telemedicine can be a complex issue because of jurisdictional and geographic factors, says Dr. Tom Handley, registrar of the College of Physicians and Surgeons of BC.

The college's Board of Directors recently discussed 4 resolutions on telemedicine developed by the Federation of Medical Licensing Authorities of Canada. They call for licensing bodies to establish requirements for doctors wanting to practise telemedicine "through whatever regulatory or legislative mechanisms are appropriate." Handley said there are limits to what regulatory bodies can do because there is often no prosecution involved and the mandate of "protecting the public" is interpreted differently across the country.

The federation's second recommendation was that telemedicine services should be provided where the patient lived, a notion that Handley said is unrealistic. As an example, he cited a complaint to the college regarding a doctor who was involved in an incident with a flight attendant during a flight. "In that case, where is the jurisdiction?" he asked. Similarly, Handley said the federation's recommendation that physicians practising telemedicine satisfy the licensing requirements "of the jurisdiction in which their intended patients reside," is impossible to apply in all circumstances. Moreover, the federation suggests that professional misconduct in a jurisdiction includes telemedicine practices in which the physician has not obtained the necessary approval to provide the medical services.

Handley responded that the college could only monitor its members' standards of conduct within the province and could not control illegal practitioners, including those who practise across the province's or the country's borders by electronic means. "We have to tell patients that if they choose to get medical care by phone or any other method [that may involve a doctor outside the province], the college can't deal with any complaints." However, it will help a member of the public to complain to another jurisdiction, especially within Canada or the US.