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Banking, transportation, and retail have each been transformed by technology enabling on-demand access 24/7 at lower prices. This trend has not yet revolutionized the medical field, but on-line physician services are increasingly common in Canada and have the potential to change the way care is delivered. In this article, we will describe the state of on-line physician services in Canada and outline associated ethical considerations, including autonomy, beneficence, maleficence, and justice. We will suggest steps to mitigate risk so that these services add value for patients and the health system as a whole