In its general meeting this week, the German Medical Assembly (Deutscher Ärztetag) voted in favour of an amendment of the current provision in the template for the professional code of conduct for physicians (Musterberufsordnung Ärzte) practicing in Germany that in the past has explicitly prohibited the treatment of patients only via telemedicine. The argument for this prohibition has been the believe that a treatment generally requires a personal and physical contact and examination of the patient in order to ensure a proper consultation and treatment.
In recent years technical developments have increasingly cast doubt on the absolute truth behind this statement. Experiences from other countries with less restrictions have shown no clear indication that the patient's safety is jeopardized by allowing telemedicine options. In addition, German physicians were suddenly faced with competition from foreign telemedicine service providers like Dr Ed. Since these providers and the physicians working for them were located and practicing outside of Germany, the German professional codes of conduct did not apply to them. Also within Germany, a first trial run with German physicians was also brought underway in the federal state of Baden-Württemberg.
The changes adopted by the German Medical Assembly open the German market for telemedicine even more. While it remains the standard of care that physicians have personal and direct contact to their patients, the new wording allows German physicians to conduct the consultation and treatment solely through the use of telecommunication in individual cases. For this purpose the physician must ensure in particular that a telemedicine consultation and treatment is justifiable in the specific case and that the required diligence is maintained. In addition the patient must be informed about the peculiarities of a telemedicine treatment.
The new language marks a big step towards opening up the German market for telemedicine services. The language, however, also leaves some room for interpretation, in particular whether the relation between telemedicine and 'traditional' treatment is that of rule and exemption or of more or less equal alternatives. This also gives rise to the question whether service providers offering only telemedicine services can operate in Germany, if they did not also offer the option for physical contact to its customers. These and other questions will need to be addressed in time. The new German Federal Minister for Health has already announced a round table in which the specifics will be further defined. Before the new provision can be applied, however, it must first be adopted by the professional codes of conduct in each federal state.