Online prescription, referral and medical certificate services
online prescription, referral, and medical certificate services in Australia, as of 2024–2025:
Legal Framework (Australia)
Permissibility
- It is legal for a registered medical practitioner to provide prescriptions, referrals, or medical certificates via telehealth or online platforms, provided:
- There is a valid doctor–patient relationship.
- The practitioner exercises appropriate clinical judgment.
- The service complies with the Medical Board of Australia (MBA) and Ahpra guidelines.
Unacceptable Practice
- Issuing prescriptions, certificates, or referrals without a proper consultation, history-taking, or clinical review may:
- Breach the Code of Conduct for doctors.
- Risk regulatory action (Ahpra notifications).
- Violate Schedule 8 prescribing controls (e.g. for opioids or psychotropics).
Certificates
- Under the Fair Work Act and state legislation, medical certificates must be issued in good faith after a proper assessment. Certificates issued without a consultation may be considered fraudulent or misleading.
Ethical Considerations
Medical Board of Australia (Code of Conduct)
- Doctors must:
- Provide safe, appropriate, and patient-centred care.
- Ensure continuity of care and proper clinical handover.
- Avoid care that is superficial or transactional without meeting the patient’s clinical needs.
Risks of Online-Only Models
- Fragmentation of care: No access to patient’s full history.
- Inadequate examination: May miss serious diagnoses.
- Overprescribing: Especially of antibiotics or scheduled medications.
- Loss of trust: Undermines public trust in proper medical care.
RACGP Position
The RACGP strongly cautions against the widespread use of online-only services for prescriptions, referrals, and certificates without an established doctor–patient relationship or continuity of care. Their key concerns:
Safety and Quality
- These services may compromise clinical care, especially without face-to-face or proper telehealth consultations.
Continuity of Care
- Encourages patients to engage with their usual GP or medical home.
- Opposes models that disrupt longitudinal care, especially for chronic or mental health issues.
Advocacy
- The RACGP has publicly:
- Criticised “tick-box” services that provide scripts or certificates without real clinical evaluation.
- Emphasised that general practice must not become transactional or commodified.
Telehealth Standards (Relevant to Online Services)
Ahpra and MBA Guidelines (Updated 2023)
- Telehealth is supported when:
- There is adequate clinical information exchange.
- Doctors can form a diagnosis and management plan safely.
- Purely asynchronous services (e.g. only online forms, no live interaction) are discouraged or non-compliant with good practice.
Summary Table
| Aspect | Acceptable Practice | Unacceptable Practice |
|---|---|---|
| Prescriptions | After telehealth or in-person consult | Without assessment or history |
| Referrals | Based on known history and current complaint | Without clinical justification |
| Medical Certificates | After appropriate clinical review | Without seeing or speaking to the patient |
| RACGP View | Supports appropriate telehealth within GP context | Opposes transactional, stand-alone online services |
| MBA/Ahpra Compliance | Requires good medical practice and patient safety | Breach may lead to regulatory consequences |
Recommendations for GPs
- Use telehealth consults with clinical discretion.
- Always document a clear history, assessment, and rationale.
- Avoid issuing scripts or certificates via form-only services.
- Educate patients on the risks of fragmented care.
- Consider refusing requests for services that fall outside ethical or professional boundaries.