I read Dr Junaidi Ismail’s recent article with deep respect for the concerns he raised. His reflections on clinical safety, professional responsibility, and the potential risks of poorly governed digital care echo many of the same challenges that those of us working within digital health have been grappling with for years, not only confined to Malaysia but worldwide.
Telemedicine is not without its limitations, and any form of misuse, whether through commercial pressure, inadequate assessment, or the oversimplification of clinical encounters must be addressed firmly. No compromise!!!
Where I hope we can expand the discussion is in acknowledging that digital health and telemedicine, when practiced responsibly, is not a substitute for traditional medicine, but a complementary extension of it.
What we should be debating is not whether digital health should exist, but how it should evolve with appropriate safeguards, national standards, and accountability structures that protect patients while supporting innovation. Malaysia has already taken significant steps towards this balance, and it is important that we do not lose the momentum.
When the pandemic accelerated teleconsultations, what we witnessed across the country was not reckless experimentation, but doctors stepping in to support patients who genuinely had no other access to care.
That foundation has continued: today, digital consultations serve working adults unable to leave job sites, chronically ill patients needing frequent reviews, elderly individuals with mobility limitations, and rural communities lacking timely access to physical clinics. These are not edge cases; they are everyday realities in our health care system.
It is true that a physical examination is essential when the diagnosis depends on it. This principle is deeply embedded in medical practice and should remain non-negotiable. But it is equally true that many clinical encounters like simple infections without red flags, women’s health issues that are history-based, allergic conditions, stable chronic follow-ups, medication counselling, mental health support just to name a few can be safely conducted without in-person examination when adequate training, appropriate triage, escalation pathways, and documentation standards are in place as well as the support of wealth of database.
The question, then, is how we strengthen governance so that digital health is practiced at its highest standard, rather than assume that the modality itself is inherently unsafe. Malaysia has already demonstrated that a governance-first approach works.
When e-prescriptions first emerged, there were concerns about authenticity and misuse. Instead of banning the entire practice, the country adopted digital signatures certified by licensed Certification Authorities (CA) and amended the Poisons Act to ensure all electronic prescriptions are verifiable and traceable.
Today, e-prescriptions are used safely in hospitals, clinics, pharmacies and corporate health networks nationwide.
The same principle can guide digital MCs and telehealth documentation: enforce proper identity verification, require digital signatures, mandate audit trails, define clear triage rules, and accredit platforms based on clinical governance. These steps address the real risks without dismantling the access that many Malaysians now rely on.
I also appreciate Dr Junaidi’s reminder that digital health must not become a commercial shortcut. On this, I believe clinicians on both sides of the digital and physical divide share the same concerns.
What we need is proportional, evidence-based regulation that targets irresponsible practices while protecting responsible ones. The danger of a blanket prohibition is that it sweeps away legitimate care pathways along with the problematic ones, leaving vulnerable groups without timely support.
My hope is that this conversation becomes a turning point, not toward polarisation or competition, but toward collaboration. We need a national telehealth framework that defines what is clinically appropriate, when escalation is mandatory, how digital documents should be authenticated, and what standards platforms and practitioners should meet.
This is not a call for leniency, but for clarity. Not a call to choose between digital or physical care, but to integrate both meaningfully.
I believe every doctor involved in this discussion, including Dr Junaidi and myself, shares the same purpose: to ensure patients receive safe, ethical and accessible care. If we can build on that shared intention, Malaysia is more than capable of developing a digital health ecosystem that is both clinically grounded and future-ready.
It is my sincere hope that we continue this dialogue constructively and collectively, for the benefit of our patients and the strengthening of our health care system as a whole.
Dr Raymond Choy is founder and CEO of Heydoc Health, as well as secretary of the Association of Digital Health Malaysia.
- This is the personal opinion of the writer or publication and does not necessarily represent the views of CodeBlue.
