Video consultations in Switzerland: the rules that apply

In Switzerland, a consultation by video is a medical consultation like any other. The same rules apply as in the practice, and some steps cannot be done by video. This article explains what a video consultation can do, where its limits lie and which cantonal rules apply to the physician.

No specific act, but the general rules

Switzerland has no specific federal act on telemedicine. The term describes the form of the consultation, not a legal category of its own. Consultations by video are therefore governed by the general rules of the Medical Professions Act (MedBG), the Therapeutic Products Act (HMG) and narcotics law.

The cantonal rules of professional practice

Physicians who practise under their own professional responsibility need a licence from the canton in whose territory they practise (Art. 34 para. 1 MedBG). The requirements are explained under licence to practise.

• Practising in another canton. Holders of a cantonal licence may practise in another canton for at most 90 days per calendar year without obtaining a licence there. They must notify the competent cantonal office, and any restrictions of their licence apply there too (Art. 35 para. 2 MedBG).
• Cantonal supervision. Each canton designates an authority that supervises the physicians practising in its territory and takes the measures needed to ensure compliance with professional duties (Art. 41 MedBG). According to the BAG, cantonal physicians supervise compliance with the medical duty of care (BAG FAQ on cannabis medicines).
• Cantonal health acts. Alongside federal law, the cantons enforce their own health acts (KAV job profile).

The professional duties apply whether an appointment takes place by video or in person. Physicians practise their profession carefully and conscientiously, safeguard patients' rights and professional secrecy, and advertise only in a way that is objective and neither misleading nor intrusive (Art. 40 MedBG).

What a video consultation can do

In a video consultation, the physician reviews your medical history and your current medication, answers your questions and documents the assessment. She decides individually whether treatment is an option, on the basis of a weighing of benefits and risks. There is no entitlement to a prescription; the physician decides on the basis of the medical assessment.

Two rules set out what that assessment must rest on:

• Medicines may only be prescribed if the patient's state of health is known (Art. 26 para. 2 HMG).
• Physicians may prescribe medicines with controlled substances only for patients they have examined themselves (Art. 46 para. 1 BetmKV).

In our practice, the physician holds every consultation herself; it is never delegated. Whether an additional appointment in person would be useful for the assessment is something she discusses with you; by arrangement, the consultation takes place at our practices in Zurich and Liestal.

What cannot be done by video

Some steps remain tied to paper and to the pharmacy, even when the consultation takes place online.

• The narcotics prescription is a paper form. For medicines of Verzeichnisse a and d, the official narcotics prescription form must be used (Art. 46 para. 2 BetmKV). It carries the physician's original signature; a scanned signature, a fax, an e-mail or a photocopy is not sufficient (KAV 0025, section 6.2).
• No digital transmission. When the medicine is dispensed, the white original and the pink copy must be physically present at the pharmacy. Digital transmission is not possible for Verzeichnisse a and d, and sending the prescription to the patient by e-mail, messenger service or fax is expressly not allowed (KAV 0025, sections 6.5.3 and 6.6).
• Dispensing takes place at the pharmacy. Pharmacies may dispense narcotics to the public only on a medical prescription (Art. 13 BetmG). Our practice does not store, sell or send medicines.

The original is handed or posted to you or, with your consent documented in writing, posted directly to a pharmacy of your choice (KAV 0025, section 6.5). You choose the pharmacy freely (Art. 26 para. 2bis let. b HMG). More: how the prescription reaches the pharmacy and postal delivery rules.

The physician and the canton

Narcotics prescription pads are ordered in writing from the cantonal issuing office. According to the cantonal pharmacists, only physicians with a valid licence to practise and activity in the canton may obtain them (KAV 0025, section 7). A video consultation does not change this. Our canton pages name the office responsible in your canton, and who supervises prescriptions gives an overview.

In our practice

Consultations are held by our physician Oxana Smagulova, who is licensed to practise in Switzerland. They take place by video, 100% online and without a waiting room, or in person by arrangement. You see the same physician at every appointment, and everything you tell us is handled under Swiss data protection law and medical confidentiality.

Before the consultation, a free ten-minute information call answers questions on the process, the legal situation and the costs. The fees are on our prices page.

Further reading

• Preparing for your first consultation
• Reading the narcotics form
• The medical route in Switzerland
• How the consultation works and who may prescribe

This article is general information and not legal or medical advice.