Professions and Occupations


Subchapter I. General Provisions

Recognizing that the practice of medicine and the practices of certain other healthcare professions are privileges and not natural rights, it is hereby considered a matter of policy in the interests of public health, safety, and welfare to provide laws covering the granting of those privileges and their subsequent use and control, and to provide regulations to the end that the public health, safety, and welfare are promoted and that the public is properly protected from the unprofessional, improper, unauthorized, or unqualified practice of medicine and practice of certain other healthcare professions and from unprofessional conduct by persons authorized to practice medicine or to practice certain other healthcare professions.

60 Del. Laws, c. 462, § 1; 75 Del. Laws, c. 141, § 1.;

The following definitions apply to this chapter unless otherwise expressly stated or implied by the context:

(1) "Board" means the Board of Medical Licensure and Discipline.

(2) "Certificate to practice medicine" means the authorization awarded by the Board to a person who has been qualified to practice medicine in this State by meeting the requirements of this chapter.

(3) "Conversion therapy" means any practice or treatment that seeks to change an individual's sexual orientation or gender identity, as "sexual orientation" and "gender identity" are defined in § 710 of Title 19, including any effort to change behaviors or gender expressions or to eliminate or reduce sexual or romantic attractions or feelings toward individuals of the same gender. "Conversion therapy" does not mean any of the following:

a. Counseling that provides assistance to an individual who is seeking to undergo a gender transition or who is in the process of undergoing gender transition.

b. Counseling that provides an individual with acceptance, support, and understanding without seeking to change an individual's sexual orientation or gender identity.

c. Counseling that facilitates an individual's coping, social support, and identity exploration and development, including counseling in the form of sexual orientation-neutral interventions or gender identity-neutral interventions provided for the purpose of preventing or addressing unlawful conduct or unsafe sexual practices, without seeking to change an individual's sexual orientation or gender identity.

(4) "Distant site" means a site at which a health-care provider legally allowed to practice in the State is located while providing health-care services by means of telemedicine.

(5) "Division" means the Division of Professional Regulation.

(6) "Executive Director" means the Executive Director of the Board of Medical Licensure and Discipline.

(7) "Healthcare institution" means a facility or agency licensed, certified, or otherwise authorized by law to provide, in the ordinary course of business, treatments, services, or procedures to maintain, diagnose, or otherwise affect a person's physical or mental condition.

(8) "Medical group" means 1 or more physicians or other health-care practitioners who work together under the name of a professional corporation, a limited liability partnership, or other legal entity.

(9) "Medicine" means the science of restoring or preserving health and includes allopathic medicine and surgery, osteopathic medicine and surgery, and all the respective branches of the foregoing.

(10) "Originating site" means a site in Delaware at which a patient is located at the time health-care services are provided to him or her by means of telemedicine, unless the term is otherwise defined with respect to the provision in which it is used; provided, however, notwithstanding any other provision of law, insurers and providers may agree to alternative siting arrangements deemed appropriate by the parties.

(11) "Physician" means an allopathic doctor of medicine and surgery or a doctor of osteopathic medicine and surgery who is registered and certified to practice medicine pursuant to this chapter.

(12) "Practice of medicine" or "practice medicine" includes:

a. Advertising, holding out to the public, or representing in any manner that one is authorized to practice medicine in this State;

b. Offering or undertaking to prescribe, order, give, or administer any drug or medicine for the use of another person;

c. Offering or undertaking to prevent or to diagnose, correct, and/or treat in any manner or by any means, methods, or devices a disease, illness, pain, wound, fracture, infirmity, defect, or abnormal physical or mental condition of another person, including the management of pregnancy and parturition;

d. Offering or undertaking to perform a surgical operation upon another person;

e. Rendering a written or otherwise documented medical opinion concerning the diagnosis or treatment of a person or the actual rendering of treatment to a person within the State by a physician located outside the State as a result of transmission of the person's medical data by electronic or other means from within the State to the physician or to the physician's agent;

f. Rendering a determination of medical necessity or a decision affecting or modifying the diagnosis and/or treatment of a person;

g. Using the designation Doctor, Doctor of Medicine, Doctor of Osteopathy, physician, surgeon, physician and surgeon, Dr., M.D., or D.O., or a similar designation, or any combination thereof, in the conduct of an occupation or profession pertaining to the prevention, diagnosis, or treatment of human disease or condition, unless the designation additionally contains the description of another branch of the healing arts for which one holds a valid license in the State.

For the purposes of this chapter, in order that the full resources of the State are available for the protection of persons using the services of physicians, the act of the practice of medicine occurs where a person is located at the time a physician practices medicine upon the person.

(13) "Registration" means the entry of a certificate to practice medicine into the records of the Board of Medical Licensure and Discipline pursuant to the regulations of the Board.

(14) "Store and forward transfer" means the transmission of a patient's medical information either to or from an originating site or to or from the provider at the distant site, but does not require the patient being present nor must it be in real time.

(15) "Substantially related" means the nature of criminal conduct for which a person was convicted has a direct bearing on the person's fitness or ability to perform 1 or more of the duties or responsibilities necessarily related to the practice of medicine, the work of a physician assistant, of the practice of respiratory care.

(16) "Telehealth" means the use of information and communications technologies consisting of telephones, remote patient monitoring devices or other electronic means which support clinical health care, provider consultation, patient and professional health-related education, public health, health administration, and other services as described in regulation.

(17) "Telemedicine" means a form of telehealth which is the delivery of clinical health-care services by means of real time 2-way audio, visual, or other telecommunications or electronic communications, including the application of secure video conferencing or store and forward transfer technology to provide or support health-care delivery, which facilitate the assessment, diagnosis, consultation, treatment, education, care management and self-management of a patient's health care by a health-care provider practicing within his or her scope of practice as would be practiced in-person with a patient, legally allowed to practice in the State, while such patient is at an originating site and the health-care provider is at a distant site.

(18) "Unauthorized practice of medicine" means the practice of medicine as defined in paragraph (12) of this section by a person not authorized under this chapter to perform an act set forth in that subsection, unless excepted by § 1703 of this title.

(19) "Viability" means the point in a pregnancy when, in a physician's good faith medical judgment based on the factors of a patient's case, there is a reasonable likelihood of the fetus's sustained survival outside the uterus without the application of extraordinary medical measures.

60 Del. Laws, c. 462, § 1; 61 Del. Laws, c. 68, §§ 2, 3; 62 Del. Laws, c. 90, § 1; 62 Del. Laws, c. 112, § 1; 63 Del. Laws, c. 62, § 1; 65 Del. Laws, c. 490, § 1; 67 Del. Laws, c. 5, § 1; 67 Del. Laws, c. 434, § 1; 68 Del. Laws, c. 147, § 1; 68 Del. Laws, c. 152, § 1; 69 Del. Laws, c. 355, §§ 1, 2, 6; 70 Del. Laws, c. 186, § 1; 71 Del. Laws, c. 283, § 1; 74 Del. Laws, c. 262, § 27; 75 Del. Laws, c. 141, § 1; 77 Del. Laws, c. 319, § 1; 80 Del. Laws, c. 80, § 2; 81 Del. Laws, c. 35, § 1; 81 Del. Laws, c. 340, § 2.;

Provisions of this chapter pertaining to the practice of medicine do not apply to:

(1) A person providing service in an emergency, where no fee or other consideration is contemplated, charged, or received;

(2) Physicians of any civilian or military branch of the United States government in the discharge of their official duties;

(3) Advanced practice nurses, chiropodists, chiropractors, dental hygienists, dentists, emergency medical technicians, optometrists, pharmacists, physical therapists, physician assistants, podiatrists, practical nurses, professional nurses, psychologists, respiratory care practitioners, veterinarians, or persons engaged in other professions or occupations who are certified, licensed, or registered according to law and are acting within the scope of the activity for which they are certified, licensed, or registered;

(4) A person administering a lawful domestic or family remedy to a member of that person's family;

(5) A person fully certified, licensed, or otherwise authorized to practice medicine in another state of the United States who briefly renders emergency medical treatment or briefly provides critical medical service at the specific lawful direction of a medical institution or federal agency that assumes full responsibility for the treatment or service;

(6) A person who has earned a doctorate degree from a recognized college or university and who uses the designation of "Dr." in connection with that person's name or calls himself or herself "Doctor", except in matters related to medicine or health, in which case the type of doctorate held must be specified;

(7) The mechanical application of glasses;

(8) The practice of massage;

(9) The business of barbering, cosmetology, and manicuring;

(10) The practice of ritual circumcision performed pursuant to the requirements or tenets of a religion; provided, however, that a person certified and registered to practice medicine in this State certifies in writing to the Board that, in the person's opinion, the circumcision practitioner has sufficient knowledge and competence to perform a ritual circumcision according to accepted medical standards;

(11) The practice of healing by spiritual means in accordance with the tenets and practice of a religion by an accredited practitioner of the religion. In the practice of healing by spiritual means, an accredited practitioner may not use medical titles or other designations which imply or designate that the practitioner is certified to practice medicine in this State. A person engaged in the practice of healing by spiritual means may not perform surgical operations or prescribe medications, nor may a pharmacist or pharmacy honor a prescription drawn by the person. A person engaged in the practice of healing by spiritual means must observe all state and federal public health laws;

(12) A physician from another state or jurisdiction who is in this State to testify in a judicial or quasi judicial proceeding;

(13) The performing of delegated medical acts pursuant to subchapter VI of this chapter by a person who is licensed by the Board as a physician assistant;

(14) A person rendering medical, surgical, or other health services who is functioning as a member of an organized emergency program which has been approved by the Board of Medical Licensure and Discipline; who has successfully completed an emergency medical course; and who is acting under the supervision and control of a person certified and registered to practice medicine in this State or in a state contiguous to this State;

(15) A licensed registered nurse making a pronouncement of death and signing all forms or certificates registering the death as permitted or required by the State, but only if the nurse is an attending nurse caring for a terminally ill patient:

a. In the patient's home or place of residence as part of a hospice program or a certified home healthcare agency program;

b. In a skilled nursing facility;

c. In a residential community associated with a skilled nursing facility;

d. In an extended care facility; or

e. In a hospice;

and only if the attending physician of record has agreed in writing to permit the attending licensed registered nurse to make a pronouncement of death in that case;

(16) The provisions of subchapter II, Chapter 27 of Title 16, the Uniform Anatomical Gift Act;

(17) A medical student who is engaged in training;

(18) A person performing health care acts pursuant to Chapter 94 of Title 16 and § 1921(a) of this title;

(19) Notwithstanding the provisions of § 1702(12)e. of this title, a physician licensed in another state or the District of Columbia may render a written or otherwise documented medical opinion to a person covered by the State Group Health Insurance Program pursuant to any second opinion or diagnosis evaluation program offered by the State Group Health Insurance Program without obtaining a certificate to practice medicine in this State.

75 Del. Laws, c. 141, § 1; 70 Del. Laws, c. 186, § 1; 76 Del. Laws, c. 378, § 1; 77 Del. Laws, c. 319, § 1; 80 Del. Laws, c. 80, § 2; 81 Del. Laws, c. 340, § 2.;

If a law, rule, or regulation of this State requires the services or qualifications of a physician or surgeon, the requirement may be met only by a person registered and certified to practice medicine under this chapter.

60 Del. Laws, c. 462, § 1; 62 Del. Laws, c. 417, § 1; 75 Del. Laws, c. 141, § 2.;

No person licensed under this chapter shall perform any office-based surgery, as defined in § 122(3)y. of Title 16, in a facility unless such facility is accredited or licensed in accordance with § 122(3)z. of Title 16. For purposes of this section, "facility" and "office-based surgery" mean as defined in § 122(3)y. of Title 16.

78 Del. Laws, c. 80, § 3; 81 Del. Laws, c. 417, § 4.;