By David Vilchez, Founder & CEO, Medical Staff Talent
→ Sports Physiotherapist (Manual & Movement Therapy) — Private Family, Dubai
A private family based in the Gulf rarely stays in one place: winter in Riyadh, spring in Dubai or Doha, summer between London, the south of France and a yacht, a week in New York. The clinician who lives with them travels too. So every Western-Trained doctor, nurse, midwife, physiotherapist and osteopath asks me: “In each of those places, what am I actually allowed to do?”
This guide answers it for clinicians registered in the UK, an EU/EEA country, Switzerland, Australia, New Zealand, the United States or Canada, using only official sources. Where a point could not be confirmed, I say “confirm locally”. For your own profession and destination, use the Where Can I Practise? checker.
The short answer
- Your home registration is not a licence anywhere else. In every destination covered here, practising a regulated profession generally needs local authorisation (in the UK, some professions are protected by title rather than by activity), unless a narrow, specific exemption applies.
- What you may do is decided by the law of the place where the patient is at that moment, not by where you trained, where you are registered or where the family lives.
- Where you are not authorised, you change role, not family.
- Reserved acts are done by a local licensed professional that the family’s office arranges, and everything is agreed in writing before you sign.
The universal principle: the patient’s location decides
Health professions are regulated territorially. In Saudi Arabia, Saudi law decides what you may do; in Paris, French law; on a yacht, the flag state and the waters it sits in. Your home regulator still governs your conduct everywhere, but it cannot authorise you to practise in someone else’s territory.
EU law binds a clinician serving in another member state to that state’s professional rules, including titles (Directive 2005/36/EC, Art. 5(3)). The GMC tells clinicians treating patients overseas remotely to check registration where they are and where the patient is, and to hold indemnity “in all relevant countries” (GMC remote prescribing principles).
The four-part model families use
1. Where you are authorised, you practise fully
Your home country; an EU/EEA country where you have filed the temporary-services declaration (EU/EEA nationals registered in an EU/EEA state; physiotherapists once any prior check of qualifications is complete); and, in Saudi Arabia, the UAE and Qatar, wherever the family’s office has arranged a local licence or licensed framework. A local licence is required to practise in all three.
2. Where you are not authorised, you change role, not family
- Doctors coordinate, accompany, ensure continuity and refer to a local licensed doctor. No diagnosis, prescribing or treatment.
- Physiotherapists and osteopaths limit themselves to what is not a reserved act in that place: non-therapeutic wellness and exercise, and massage only where massage is not reserved and needs no licence.
- Nurses and midwives work in a carer capacity without reserved nursing acts: generally no injections, and limits on medication that vary by country.
- Everyone can give emergency first aid (in France, Italy and Spain it is a legal duty).
- No one uses a local protected title.
3. Reserved acts are done by a local licensed professional
The family’s office arranges a locally licensed doctor, nurse, physiotherapist or clinic for anything reserved in that place. You brief them, share the history (with consent) and keep continuity.
4. Everything is agreed in writing before you sign
Your role in each country, who covers reserved acts, and professional indemnity. Medical Staff Talent does not cover professional indemnity, and home-country indemnity usually excludes work abroad (see the indemnity section below).
Medical Staff Talent introduces and verifies clinicians. The engagement is contracted directly between the family and the clinician, and all local arrangements (visa, licensed entity, coordination with local clinics) remain with the family’s own office and advisers.
Doctors
What you can do. Practise fully where you are licensed. Under EU law doctors have automatic recognition, so an EU/EEA host state cannot run a prior check; you file the declaration and can start (Commission User Guide, Q27). New Zealand is the one destination with a genuine accompanying-doctor exemption: an unregistered visiting doctor may diagnose, treat and advise only the people they travel with, for the visit, provided those people know the doctor is not NZ-registered (MCNZ policy).
What you can’t do. Where you are not authorised, you may not diagnose, prescribe or treat. The GMC states that you may not practise in the UK unless you are on its register; its temporary registration for team doctors covers only their own team (GMC). In the US, consultation exemptions such as NY Educ. Law §6526 let a doctor licensed elsewhere consult with a local physician, not treat the patient; no general accompanying-physician exemption was found.
How the rest is covered. You become the family’s medical coordinator: history, medication list, booking and briefing the local licensed doctor, accompanying the patient, and making sure prescriptions come from a locally authorised prescriber. Be careful with titles: in the UK, wilfully and falsely using the title of physician or implying GMC registration is an offence (Medical Act 1983, s.49), and France, Italy and Spain penalise use of the local title.
Nurses and midwives
What you can do. Practise fully where you are authorised; in the EU, general-care nurses and midwives have automatic recognition. In New York, a qualified nurse “of another state, province, or country” whose engagement requires them to accompany and care for a patient temporarily residing in the state is exempt, provided they do not hold themselves out as NY-registered (NY Educ. Law §6908). Other states: confirm locally. In the UK, a nurse or carer directly employed by, and under the control of, the family may not need CQC registration for nursing or personal care, but there is no such exception for treatment (CQC).
What you can’t do. Where you are not authorised: no injections or other reserved nursing acts, no use of the protected title, and in the UK no attending a woman in childbirth, which is reserved to registered midwives and doctors except in sudden or urgent necessity (Nursing and Midwifery Order 2001, Art. 45). In the UK, giving a prescription-only medicine by injection to another person is limited to an appropriate practitioner or someone acting on their directions (Human Medicines Regulations 2012, reg. 214). In the Netherlands, injections are reserved acts (KNMG).
How the rest is covered. You work as a carer: personal care, companionship and help with already-prescribed medication within local limits. A locally licensed nurse arranged by the family’s office carries out reserved acts. Where a family appoints nurses in pairs, the two of you can plan cover around who is authorised where.
Physiotherapists
What you can do. Practise fully where you are authorised. In the EU, physiotherapy is under the general system, not automatic recognition, so the host state may run a prior check of your qualifications before your first service (up to five months in the worst case): file well ahead, or use the European Professional Card (Commission User Guide). In the UK the HCPC regime protects the title rather than the activity: using the title with intent to deceive is an offence, and describing a service as “physiotherapy” can be an offence by implication (HCPC).
What you can’t do. Therapeutic physiotherapy where you are not authorised. In France, therapeutic massage given as part of treatment belongs to the physiotherapists’ monopoly (Ordre des masseurs-kinésithérapeutes, opinion CNO 2025-05). In New Zealand, anyone practising as a physiotherapist must be registered and hold a practising certificate, paid or voluntary (Physiotherapy Board of NZ). Cervical spine manipulation is restricted in Australia, as are high-velocity, low-amplitude techniques on the cervical spine in New Zealand (NZ). In the US, the FSBPT model exemption for foreign-credentialed physical therapists covers athletic teams and performing-arts companies, not private families (FSBPT).
How the rest is covered. You step down to non-therapeutic exercise and wellness, without the title and not presented as treatment. A local licensed physiotherapist arranged by the family’s office treats; you keep continuity.
Osteopaths
What you can do. Practise fully where you are authorised. In Europe, the GOsC lists osteopathy as regulated in the UK, France, Luxembourg, Switzerland, Denmark, Norway, Finland, Italy, Portugal, Iceland and Malta (GOsC, Osteopathy worldwide). Where it is not regulated, treating disease can still fall under reserved medical or physiotherapy acts. In Ontario, non-medical manual osteopathy is not currently a regulated health profession (Osteopathy Ontario).
What you can’t do. Use the title where it is protected: in the UK anyone describing themselves as an osteopath commits an offence unless registered (Osteopaths Act 1993, s.32); in Monaco the title is reserved to authorised persons (Monaco government); in Australia “osteopath” is protected. In the US, osteopathic practice is physician practice and the AOA says no programme outside the US qualifies graduates to practise there (AOA).
How the rest is covered. As for physiotherapists: non-therapeutic wellness and exercise only, no protected title, and a locally licensed professional for treatment.
Destination by destination
Simplified to the main points. “Confirm locally” means no official source confirmed the point.
| Destination | Home registration enough? | Temporary or visiting route | Without local authorisation | How reserved acts are covered | Official sources |
|---|---|---|---|---|---|
| Saudi Arabia | No. Local licence required. | Arranged by the family’s office. | Until then: step-down role and emergency first aid. | Local licensed provider arranged by the family’s office. | Law of Practicing Healthcare Professions, Art. 2 |
| UAE | No. Local licence required. | Arranged by the family’s office. | Until then: step-down role and emergency first aid. | Local licensed provider arranged by the family’s office. | Dubai Resolution 49/2024, Art. 7; Cabinet Resolution 67/2020 |
| Qatar | No. Local licence required. | Arranged by the family’s office. | Until then: step-down role and emergency first aid. | Local licensed provider arranged by the family’s office. | Official licensing policy |
| United Kingdom | Only if UK-registered. | Doctors: sports-event team doctors (own team) and eminent specialists only. Others: none found. | Coordination; personal care (CQC exception if directly employed); exercise and wellness without the title; in-home massage needs no London licence. | UK-registered clinicians or CQC-registered providers. | GMC; CQC; Richmond Council |
| EU/EEA | No, unless you file the host-state declaration. | Annual declaration (EU/EEA nationals registered in an EU/EEA state). Doctors, general-care nurses and midwives start on filing; physios may face a prior check; osteopaths only where regulated. Case by case. Not open on the basis of a UK, AU, NZ, US or CA registration. | Coordination, first aid, non-therapeutic wellness; wellness massage is outside the French monopoly. | Locally authorised clinicians. | Commission User Guide; Your Europe |
| Switzerland | No. Cantonal licence for practice on your own responsibility. | EU/EFTA nationals: 90-day declaration, self-employed or posted (not on a Swiss employment contract). Others: confirm locally. Or work supervised by a cantonal licence holder. | Coordination; health and sports massage needs no licence in Solothurn (cantons vary). | Locally licensed clinician or institution. | SERI list; SERI definition |
| Monaco | No. | Doctors: per-diem practice via a practice or institution. Osteopaths: events only. Nurses, physios: confirm locally. | Coordination; “osteopath” title reserved. | Locally authorised clinician. | Doctors; Osteopaths |
| United States | No. State by state. | Doctors: consultation with a local physician only. Nurses: NY exempts a nurse accompanying a patient; other states, confirm locally. Physios: team exemption only. Osteopaths: no route. | Coordination; emergency help. Massage licensed in 48 jurisdictions. Unlicensed staff generally may not inject. | US-licensed clinicians. | NY §6526; NY §6908; FL §458.303 |
| Canada | No. Province by province. | No accompanying route found. BC visiting physician licence is supervised and for education or teaching. Manitoba temporary physio registration for a specific purpose: confirm locally. | Ontario: emergency first aid; help with routine activities of living; manual osteopathy unregulated. | Provincially licensed clinicians. | CPSBC; Manitoba; RHPA s.29 |
| Australia | No. | No accompanying route found; limited registration is short-term and supervised. | Coordination; massage unregistered in WA; cervical manipulation restricted; titles protected. | Ahpra-registered clinicians. | Ahpra; Protected titles |
| New Zealand | No, except doctors treating only their travelling group. | Doctors: MCNZ visiting-doctor policy. Physios: registration required. Nurses, osteopaths: confirm locally. | Assistant or wellness work without holding out; massage outside the HPCAA. | NZ-registered clinicians. | MCNZ; PBNZ |
| Asia (Singapore, Maldives, Thailand, Japan) | No. | No accompanying route found. Local registration or licence required in each. | Coordination and emergency first aid. | Locally licensed clinicians. | SMC; AHPC; Thailand; Japan |
| Superyachts | Do not assume so. | Flag-state rules plus the law of the port or waters; recognition of foreign registration not confirmed. | Emergency first aid; radio medical advice. | Shore-side licensed clinicians, as the family’s office arranges. | ILO MLC FAQ; Cayman notice |
| Private jets | Do not assume so. | Jurisdiction unsettled: state of registry, location or licensing country. | Emergency assistance, the best-protected category. | Planned care on the ground by local clinicians. | CDC Yellow Book; Pub. L. 105-170 |
Notes: Singapore makes practising as an allied health professional without registration an offence; Thailand requires prior Medical Council permission for foreign doctors; Japan requires a Japanese licence for doctors and nurses; the Maldives requires registration and a licence. At sea, MLC 2006 requires ships carrying 100 or more people on international voyages of more than three days to carry a qualified doctor; it does not address care for owners and guests. The US Aviation Medical Assistance Act protects in-flight help on air carriers; private jets: not confirmed.
The EU/EEA temporary-services declaration, explained
Title II of Directive 2005/36/EC lets a professional legally established in one EU/EEA state serve “on a temporary and occasional basis” in another without joining its register. The host state may require a declaration before the first service, including insurance details, renewed once a year. Doctors, general-care nurses and midwives have automatic recognition and start on filing; physiotherapists may face a prior check. “Temporary and occasional” is judged case by case on duration, frequency, regularity and continuity: the Commission’s example of a ski instructor returning every season shows that a family’s annual summer can start to look like establishment, and Austria excludes doctors’ services under an employment relationship. The route is, in general, open only to EU/EEA and Swiss nationals (Swiss: 90 days a year). UK registrants lost it on 1 January 2021 (GOV.UK). Whether your home regulator will issue the attestation of establishment while you live in the Gulf: confirm locally.
The step-down roles and their limits
Stepping down works only if the new role really is different. Three traps:
- Massage is not always free. In the US, the FSMTB lists 48 jurisdictions where massage requires a licence, with California on voluntary certification and Vermont on registration (FSMTB). In France, the Cour de cassation confirmed in 2021 that wellness massage is outside the physiotherapists’ monopoly (Cass. crim., 29 June 2021; Sénat ministerial answer), while therapeutic massage stays reserved. In the Gulf, treat therapeutic massage as licensed and confirm locally for anything else.
- Carers’ medication limits vary. In France, anyone assisting with daily life may help a person take prescribed medication when it presents no particular difficulty of administration; injectables are outside what non-nurses may do. Florida’s rules for unlicensed staff in assisted living show the typical US line: help with routine oral medication and topicals, but no injections, no dose calculation and no “as needed” medication requiring judgement (Fla. Stat. §429.256).
- “Even in the presence of a doctor.” French law treats habitual participation in diagnosis or treatment as illegal practice even when a licensed doctor is present.
Protected titles
In a step-down role, your job title must match the role. In the UK, misusing “registered nurse” with intent to deceive (NMO Art. 44), “physiotherapist” with intent to deceive, or “osteopath” at all without registration is a criminal offence. France punishes usurpation of title with up to one year and €15,000, and illegal practice or use of the nursing title likewise (service-public.fr). Spain aggravates the offence when the person publicly claims the status (Código Penal, Art. 403). In Australia, “nurse”, “midwife”, “physiotherapist” and “osteopath” are protected. In New Zealand, a physio working as an assistant must not hold themselves out in any way as a registered physiotherapist. Agree a neutral job title in writing.
Professional indemnity: the gap most people miss
Medical Staff Talent does not cover professional indemnity, and the family’s package covers medical insurance, not your professional liability. Home-country cover rarely follows you. The MDU says claims-made membership “is not suitable for members who wish to work overseas” (MDU). Medical Protection provides no indemnity for proceedings started in the USA or Canada (MPS). The RCN scheme does not cover claims made in the US or Canada (RCN). The CSP scheme requires UK residence and caps overseas cover at 180 days in any 12 months (CSP). The main worldwide carve-out is Good Samaritan help in an emergency. For planned care abroad, you need specific international cover, and the US and Canada are the hardest places to insure. What to look for, provider by provider, is set out in our guide to professional indemnity for clinicians working for a private family abroad, and the Indemnity Cover Checker shows what applies to your profession and registration.
Questions to ask the family’s office in writing before you sign
- Which countries will the family spend time in each year?
- In which of those countries will I be authorised to practise, and who arranges the local licence or licensed framework?
- Until that is in place, and in every country where I am not authorised, what exactly is my role, and what job title will I use?
- Which local licensed provider covers reserved acts in each country?
- If I am EU/EEA-registered, will the contract allow me to file the annual temporary-services declarations, and does the pattern of stays fit “temporary and occasional”?
- Who prescribes and dispenses medicines in each country?
- What professional indemnity will I hold, for which countries, and is the US or Canada included?
- Who provides medical cover on the yacht and the jet?
A typical case (hypothetical)
Picture a physiotherapist registered with the HCPC in the UK, appointed permanently to a family that spends winter in Riyadh, spring in Dubai, summer between London and the Côte d’Azur, and a week in New York in the autumn. Before signing, the office sets out the four-part model for each place in writing. In Riyadh and Dubai, the office has arranged the local licensed framework, so the physiotherapist treats fully once it is in place; until then they lead exercise and mobility sessions and a local licensed provider treats. In London they practise fully on their HCPC registration. In France, as a UK registrant with no Title II route, they step down: wellness massage and exercise, no French title, and a local kinésithérapeute arranged by the office for any treatment. In New York, where massage is licensed, they limit themselves to exercise and coordination. Their indemnity schedule lists each country. All of it is agreed before the first flight.
Related guides and tools
What happens to your home registration over the years is covered in Your Home Registration While You Work for a Private Family and the Home Registration Checker. To see what you can do in each destination for your own profession and registration, use the Where Can I Practise? checker. To see where your salary may be taxed and when you may stop being tax-resident at home, use the Tax Residence Checker.
Frequently asked questions
Can I practise in the Gulf on my home registration?
No. Saudi Arabia, the UAE and Qatar require a local licence. The family’s office arranges the licensed framework; until then you work in a step-down role and a local licensed provider covers reserved acts.
Can I use the EU temporary-services declaration if I am registered in the UK?
No. Since 1 January 2021 the route is not open on the basis of a UK registration, nor to clinicians registered only in Australia, New Zealand, the US or Canada. It is for EU/EEA and Swiss nationals legally established in an EU/EEA state or Switzerland.
What can a doctor do where they are not licensed?
Coordinate, accompany, keep continuity, refer to a local licensed doctor and give emergency first aid; not diagnose, prescribe, treat or use the local title. New Zealand lets a visiting doctor treat only the group they travel with.
Can a physiotherapist or osteopath give massage anywhere?
No. Massage needs a licence in 48 US jurisdictions, and therapeutic massage is reserved in France. Non-therapeutic wellness massage is outside the French physiotherapy monopoly. Check the local rule before offering it.
Am I covered for professional indemnity?
Not by Medical Staff Talent, and usually not by your home-country scheme for planned care abroad. Arrange specific international cover before you sign.
Can I treat the family on their yacht or private jet?
Do not assume so. Flag-state rules, the law of the port or waters, and on aircraft the state of registry can apply. Emergency first aid is the safe ground; agree the rest in writing.
Send your CV in confidence
If you are a Western-Trained doctor, nurse, midwife, physiotherapist or osteopath considering a permanent, live-in role travelling with a private family, send your CV in confidence. I read every CV personally and arrange a confidential conversation when a background fits a current brief.
This guide is general information drawn from official sources as at November 2026. It is not legal advice. Rules change and apply differently to individual cases: confirm your position with the regulator of the country concerned.
Send your CV in confidence
