§453-2  License required; exceptions.  (a)  Except as otherwise provided by law, no person shall practice medicine or surgery in the State, either gratuitously or for pay, or offer to practice medicine or surgery in the State, or advertise or announce one's self, either publicly or privately, as prepared or qualified to practice medicine or surgery in the State, or append the letters "Dr.", "M.D.", or "D.O." to one's name with the intent to imply that the person is a practitioner of medicine or surgery, without having a valid unrevoked license or a limited and temporary license obtained from the Hawaii medical board.

     (b)  Nothing herein shall:

     (1)  Apply to so-called Christian Scientists; provided that the Christian Scientists practice the religious tenets of their church without pretending a knowledge of medicine or surgery;

     (2)  Prohibit service in the case of emergency or the domestic administration of family remedies;

     (3)  Apply to any commissioned medical officer in the United States armed forces or public health service engaged in the discharge of one's official duty, including a commissioned medical officer employed by the United States Department of Defense, while providing direct telehealth support or services to neighbor island beneficiaries within a Hawaii National Guard armory on the island of Kauai, Hawaii, Molokai, or Maui; provided that the commissioned medical officer employed by the United States Department of Defense is credentialed by Tripler Army Medical Center;

     (4)  Apply to any practitioner of medicine and surgery from another state when in actual consultation, including in-person, mail, electronic, telephonic, fiber-optic, or other telehealth consultation with a licensed physician or osteopathic physician of this State, if the physician or osteopathic physician from another state at the time of consultation is licensed to practice in the state in which the physician or osteopathic physician resides; provided that:

          (A)  The physician or osteopathic physician from another state shall not open an office, or appoint a place to meet patients in this State, or receive calls within the limits of the State for the provision of care for a patient who is located in this State;

          (B)  The licensed physician or osteopathic physician of this State retains control and remains responsible for the provision of care for the patient who is located in this State; and

          (C)  The laws and rules relating to contagious diseases are not violated;

     (5)  Prohibit services rendered by any person licensed under part II of this chapter to provide emergency medical services, or any physician assistant, when the services are rendered under the direction and control of a physician or osteopathic physician licensed in this State except for final refraction resulting in a prescription for spectacles, contact lenses, or visual training as performed by an oculist or optometrist duly licensed by the State.  The direction and control shall not be construed in every case to require the personal presence of the supervising and controlling physician or osteopathic physician.  Any physician or osteopathic physician who employs or directs a person licensed under part II of this chapter to provide emergency medical services, or a physician assistant, shall retain full professional and personal responsibility for any act that constitutes the practice of medicine when performed by the licensed person or physician assistant;

     (6)  Prohibit automated external defibrillation by:

          (A)  Any first responder personnel certified by the department of health to provide automated external defibrillation when it is rendered under the medical oversight of a physician or osteopathic physician licensed in this State; or

          (B)  Any person acting in accordance with section 663-1.5(e); or

     (7)  Prohibit a radiologist duly licensed to practice medicine and provide radiology services in another state from using telehealth while located in this State to provide radiology services to a patient who is located in the state in which the radiologist is licensed.  For the purposes of this paragraph:

               "Distant site" means the location of the radiologist delivering services through telehealth at the time the services are provided.

               "Originating site" means the location where the patient is located, whether accompanied or not by a health care provider, at the time services are provided by a radiologist through telehealth, including but not limited to a radiologist's or health care provider's office, hospital, health care facility, a patient's home, and other non-medical environments such as school-based health centers, university-based health centers, or the work location of a patient.

               "Radiologist" means a doctor of medicine or a doctor of osteopathy certified in radiology by the American Board of Radiology or the American Board of Osteopathy.

               "Telehealth" means the use of telecommunications, as that term is defined in section 269-1,  to encompass four modalities:  store and forward technologies, remote monitoring, live consultation, and mobile health; and which shall include but not be limited to real-time video conferencing-based communication, secure interactive and non-interactive web-based communication, and secure asynchronous information exchange, to transmit patient medical information, including diagnostic-quality digital images and laboratory results for medical interpretation and diagnosis, for the purpose of delivering enhanced health care services and information while a patient is at an originating site and the radiologist is at a distant site.  Standard telephone contacts, facsimile transmissions, or e-mail texts, in combination or by themselves, do not constitute a telehealth service for the purposes of this paragraph.

     (c)  Nothing in this chapter shall prohibit healing practices by traditional Hawaiian healers engaged in traditional Native Hawaiian healing practices, both as recognized and certified as such by any kupuna council convened by Papa Ola Lokahi.  No person or organization involved with the selection of kupuna council members, the convening of a kupuna council, or the certification process of healers under this subsection shall be sued or held liable for any cause of action that may arise out of their participation in the selection, convening, or certification process.  Nothing in this chapter shall limit, alter, or otherwise adversely affect any rights of practice of traditional Native Hawaiian healing pursuant to the Constitution of the State of Hawaii. [L 1896, c 60, §1; am L 1905, c 48, §1; am L 1909, c 124, §1; am L 1919, c 22, §1; am L 1920, c 37, §2; am L 1921, c 14; RL 1925, §1022; am L 1925, c 26, §1; RL 1935, §1200; am L 1939, c 183, §1; RL 1945, §2501; RL 1955, §64-2; am L 1959, c 271, §1; am L Sp 1959 2d, c 1, §19; HRS §453-2; am L 1969, c 257, §1; am L 1973, c 111, §1; am L 1976, c 219, §6; am L 1977, c 167, §12; am L 1978, c 148, §2(2); am L 1982, c 112, §4; am L 1983, c 92, pt of §1(1); am L 1984, c 168, §7; am L 1985, c 68, §14; am L 1987, c 147, §1; am L 1988, c 110, §1; am L 1993, c 163, §1; am L 1997, c 364, §3; am L 1998, c 160, §1 and c 162, §§3, 6; am L 2000, c 209, §1(2); am L 2001, c 304, §§1, 3; am L 2005, c 153, §1; am L 2007, c 91, §1 and c 255, §1; am L 2008, c 5, §3 and c 9, §3; am L 2013, c 189, §2; am L 2014, c 159, §8; am L 2016, c 226, §10; am L 2021, c 119, §4]




  Papa Ola Lokahi; definitions and other related matters.  L 1998, c 162; L 2000, c 209; L 2001, c 304; L 2005, c 153.

  L 2007, c 255, §3 provides:

  "SECTION 3.  Nothing herein shall be deemed to permit a radiologist without a license to practice medicine in Hawaii, wherever located, to provide services to a patient who is located in Hawaii."


Attorney General Opinions


  There is no prohibition against the use by unlicensed doctor of the letters "Dr." or any synonym thereof if the possibility for deception is removed.  Att. Gen. Op. 63-55.

  Foreign professional (medical) corporation cannot transact business in Hawaii as a foreign corporation.  Att. Gen. Op. 80-5.


Case Notes


  Prior to enactment of chapter, both license and certificate from board of health were necessary.  4 H. 9 (1877).

  Treasurer cannot revoke licenses issued on recommendation of board of health.  15 H. 273 (1903).

  L 1905, c 48, requiring applicant to pay fee held invalid.  17 H. 389 (1906).

  City and county cannot pass an ordinance injuriously affecting the status of territorial licenses.  29 H. 422 (1926).

  Pleading and proof in prosecution for practicing medicine without license.  21 H. 465 (1913).