Your Patient Rights in a Telehealth Visit

Most patient rights apply identically to remote and in-person care; some have telehealth-specific wrinkles. This page covers the rights that come up most often in telehealth: informed consent, recording rules, the right to refuse, what creates a doctor-patient relationship at distance, and how to file a complaint with the state medical board if something is seriously wrong.

The short version

You have the right to informed consent — a real explanation of options, risks, and benefits — before any treatment.
State recording laws vary: some states require all parties' consent to record; others require only one party's consent. Both clinicians and patients are subject to these laws.
You can refuse any treatment, including a recommended medication, test, or hospital admission, for yourself.
A doctor-patient relationship is established when a clinician undertakes care; it carries duties even if the encounter is brief and remote.
State medical boards license physicians and accept patient complaints. Each state has a board; the Federation of State Medical Boards (FSMB) maintains a directory.
The American Medical Association's Code of Medical Ethics addresses telemedicine and informs board expectations.

Informed consent

Informed consent is not a signature on a form. It is a conversation that includes the diagnosis or working diagnosis, the proposed treatment, reasonable alternatives (including doing nothing), the risks and benefits of each, and the patient's questions answered in plain language. Patients have a right to enough information to make a meaningful choice. This applies just as fully to a telehealth visit as to an in-person one.

Many states and many practices also have a "consent to telehealth" — a separate acknowledgement that the visit will be conducted remotely, that there are limits to remote evaluation, and how privacy will be handled. This is a procedural consent and not a substitute for the substantive informed consent for whatever is being treated.

If you do not understand something, say so. If a clinician proceeds without giving you the information you need to decide, that is a defect in the encounter, not in you for asking.

Recording the visit

Recording rules vary by state. Most US states are "one-party consent" jurisdictions, meaning a recording is legal if at least one party (which can be the patient) consents. A minority of states are "all-party consent" (sometimes called "two-party consent") jurisdictions, where every party to the conversation must consent. The rules apply to recordings made by the patient, the clinician, or anyone else involved.

For a patient who wants to record a visit for personal review (especially useful for complex specialty consultations), the safer path is to ask the clinician for permission and document their consent. Many clinicians are fine with it; some are not. Some practices have policies. The 21st Century Cures Act gives access to clinical notes in many cases — see accessing your medical records — which often makes recording less necessary.

Patients sometimes want to record because they distrust the clinician. If the relationship is at that point, recording is treating a symptom rather than the underlying problem. A second opinion or a different clinician is usually the better answer. See getting a second opinion remotely.

The right to refuse

An adult with decision-making capacity has the right to refuse any treatment, including treatments their clinicians strongly recommend. This includes refusing a medication, declining a test, declining hospital admission, or stopping a treatment course. The clinician's role is to inform — including documenting the refusal and the discussion — not to override.

The right to refuse has limits. It does not extend to refusing care for someone else without authority. Refusal of treatment for a child or for a person without capacity raises distinct legal questions; courts and state-specific laws apply. Refusal of treatment in some specific public-health situations (certain communicable diseases) interacts with public health authority. Refusal in the setting of impaired capacity (intoxication, severe psychiatric impairment) may trigger involuntary holds in narrowly defined circumstances. None of this should worry a competent adult declining a particular medication.

What creates a doctor-patient relationship

The doctor-patient relationship is a legal and ethical concept. It carries duties of competence, confidentiality, informed consent, and continuity. State medical boards have generally taken the position that a real-time telehealth visit creates a doctor-patient relationship just as an in-person visit does. The American Medical Association's Code of Medical Ethics and the Federation of State Medical Boards have provided guidance to similar effect.

A few practical implications. Once the relationship is established, the clinician cannot simply abandon a patient — there are duties to provide reasonable continuity, to give notice if leaving the practice, and to ensure ongoing access to medications during transitions. A "one-time consultation" model still creates obligations during and shortly after the encounter. A practice's clinicians coming and going on a roster does not absolve the practice of these duties.

Privacy and HIPAA

HIPAA covers most clinical telehealth visits because the providers and platforms involved are covered entities or their business associates. The platform itself must be configured to be HIPAA-compliant — many consumer video products have HIPAA-compliant business tiers that practices use. The protections include limits on disclosure of protected health information, a right to access (see accessing your medical records), and the right to file a complaint with the HHS Office for Civil Rights.

Patients should be aware that "wellness" apps and some direct-to-consumer health services are not always covered by HIPAA. Mental health and reproductive health apps in particular have varied privacy practices; the FTC and state attorneys general have brought actions against some of them. See mental health telehealth for the privacy specifics in that domain.

What clinicians cannot do

They cannot prescribe to you without a real evaluation; some states explicitly require a real-time interaction.
They cannot abandon you without arranging reasonable continuity.
They cannot share your information without authorization, except in specific permitted situations.
They cannot deny you a copy of your records on impermissible grounds; HIPAA right of access applies.
They cannot misrepresent their credentials or scope of practice.
They cannot offer treatment they are not licensed to provide where you are physically located. See cross-state licensing.

Filing a complaint

Each US state has a medical board (the names vary — board of medicine, medical examiners, etc.) that licenses physicians and accepts patient complaints. The Federation of State Medical Boards maintains a directory of state boards. Common reasons to file a complaint include unprofessional conduct, prescribing without adequate evaluation, abandonment, fraud, or substandard care. Boards investigate complaints and have authority to discipline licenses.

For privacy violations specifically, complaints go to the HHS Office for Civil Rights. For information blocking, complaints go to the ONC. For billing disputes, see disputing a telehealth bill. For consumer protection issues with a service that is not behaving like a clinical practice, the FTC and state attorney general are options.

Filing a complaint does not require a lawyer. Boards typically have online complaint forms and accept submissions from the public. Provide a clear summary of what happened, dates, names of clinicians, and any documentation you have (notes, receipts, screenshots).

Special situations

Recording by the clinician

Some practices record visits for documentation. If they do, they should disclose this. Even where state recording law permits one-party consent, the AMA Code of Medical Ethics and reasonable practice expect disclosure. Recordings of clinical visits become part of the chart and are subject to HIPAA.

Translation and accessibility

Patients with limited English proficiency have rights under federal civil rights law to language assistance in healthcare. Many telehealth platforms offer interpreter services on demand. Practices receiving federal funds (Medicare, Medicaid) have obligations under Title VI and Section 1557 of the Affordable Care Act. Patients with disabilities are similarly entitled to reasonable accommodations under the ADA.

Minors and proxies

Parents or legal guardians generally consent on behalf of minors, with state-specific exceptions for adolescent care of certain types. Personal representatives consent for adults without capacity. See telehealth with elderly parents and telehealth for children.

What to ask any service before your first visit

Is the clinician licensed in the state where I will physically be during the visit?
Are visits HIPAA-compliant? What platform do you use?
How are records shared, and how do I get my notes?
What is your policy on prescribing controlled substances?
What happens if my clinician leaves the practice?
Where do I file a complaint if there is a problem with care?

When this is not enough

Patient rights are a floor, not a substitute for an engaged relationship. If your clinician is not meeting basic obligations — informed consent, access to records, reasonable continuity — formal complaints are an option, but a different clinician is usually faster and more useful. See advocating for yourself in a remote visit and getting a second opinion remotely.

Your patient rights in a telehealth visit