Digital Health: New Era for Dieticians and Clinical Psychologists

Article 13 of Law No. 1219 on the Practice of Medicine and Medical Professions ("Law No. 1219") defines clinical psychologists, nurses, midwives, physiotherapists, audiologists, dieticians as health professionals ("HCPs"). Law No. 1219 stipulates that the Ministry of Health will issue a regulation on the professional practices that can be carried out independently.

However, until the Regulation on the Independent Practice of Health Professionals ("Regulation") published in the Official Gazette dated 29.03.2025, there was no comprehensive regulation in this area. Until the promulgation of the Regulation, HCPs such as clinical psychologists and dieticians were experiencing hesitations and sometimes encountering obstacles while practicing their profession under self-employment, due to the lack of regulations. This Regulation regulates how the HCPs listed in the scope of the Regulation can practice their profession under self-employment.

First of all, according to the Regulation, HCPs such as dietitians and clinical psychologists can only practice their profession in "health profession service units", which are defined as private health institutions that meet the physical conditions stipulated in the Regulation. The first rule for HCPs to open a health profession service unit is to obtain a license from the provincial health directorates. HCPs may not, under any circumstances, provide consultancy, training, coaching or other health services under any other name without a licensed health profession service unit in their name.

One of the most important points of the Regulation is that "health profession service units" cannot be opened by legal entities. This means that it is not possible to open centers or start businesses with names such as "Nutrition Counseling Center" or "Psychological Counseling Center" registered in the name of a legal entity, nor is it possible to issue invoices for the health services provided through the legal entity.

HCPs have been granted a transition period of 3 months to comply with the Regulation, with the exception of health cabinets. It is expected for HCPs who have been practicing their profession in self-employment for the past years and already working in certain offices/clinics/spaces will meet the physical standards (building condition and spatial standards), personnel standards, service standards and signage standards stipulated in the new Regulation within this transition period. It is thought that this period may be extended by taking into account the demands of the sector.

At the same time, the Regulation regulates rules such as the opening of health profession service units by more than one HCP together, supervision of such units, registration and archive obligations. Meanwhile, various restrictions such as the prohibition of advertising by HCPs and the obligation of the physician to plan treatment in the provision of health services to patients have been underlined again.

Online Counseling Services (Delivery of Distance Health Services)

With the development of the digital health ecosystem, HCPs such as dietitians and clinical psychologists regularly convene with their clients through online systems to the extent that it is appropriate with the nature of the health services they provide.

The Regulation on the Provision of Distance Health Services ("Distance Health Regulation") was published in 2022. Within the scope of the Distance Health Regulation, all healthcare professionals involved in the provision of distance healthcare services are listed. Article 4 of the same Regulation defines "health institutions and organizations authorized by the Ministry within the scope of this Regulation to provide distance health services" as a health facility, and stipulates that the Ministry will issue a distance health service activity permit to a "health facility" which wishes to provide distance health services, if said facility meets the necessary conditions.

Until the publication of the Regulation, there was uncertainty for dietitians and clinical psychologists practicing their profession under self-employment. Since the offices/clinics of dietitians and clinical psychologists, who can operate with a license to open a workplace, were not defined as "health institution/health facility" within the scope of the legislation and there is no document such as "license/permit/registration certificate for the opening and operation of the health facility" required among the application documents, there were hesitations whether these offices/clinics needed to a distance health service activity permit.

However, at this stage, since the new Regulation defines "health profession service units" that can be opened with a license obtained from provincial health directorates as private health institutions, it seems indisputable that dieticians and clinical psychologists who practice their professions in self-employment must also obtain a distance health service activity permit and provide distance health services through a Distance Health Information System registered with the Ministry.