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Internet Prescribing - Information for Physicians

Drugs on the Information Highway

Excerpted from February 2004 Action Report, Page 4
By Joan Jerzak, Chief of Enforcement, Medical Board of California

Notwithstanding the fact that there are legal and beneficial uses of the Internet in providing healthcare services (telemedicine or the filling of properly issued prescriptions), there has been renewed concern about the legitimacy of prescribing drugs via the Internet. At the same time, many consumers are routing copies of their spam email to the Board's attention to inquire if something in the law has changed.

The brazen offers selling Viagra, Vicodin and other drugs at discounted prices do appear to suggest that the drug market is wide open, if you want to purchase on the Internet.

What does the law say about this? The short answer: it's illegal to prescribe without an appropriate examination. This requirement (Business and Professions Code section 2242) existed long before the Internet was created and is the cornerstone of why Internet prescribing is illegal when a legitimate physician-patient relationship does not exist.

Some physicians have attempted to legitimize their Internet prescribing by engaging in the review of questionnaires, which Internet users will complete, although there is no way to confirm the patient is reporting accurate or truthful information.

In-person examinations not only enhance the opportunity to confirm if a patient needs the identified medication or to rule out other medical conditions, but ensures the patient is advised of alternative treatment options and is aware of potential side effects. For some patients, certain drugs are contraindicated and serious injury, including death, can follow.

Senator Jackie Speier authored Business and Professions Code section 2242.1 which became effective in January 2001. It specifically states no person may prescribe, dispense or furnish dangerous drugs or devices via the Internet without an appropriate prior examination and medical indication therefor. A violation of this section may result in the issuance of a citation or civil penalty with a $25,000 fine per occurrence.

Internet prescribing has flourished because there is such a financial gain for the involved participants including the site operator, the physician and the pharmacist (or wholesale drug supplier). Violations occur in the state where the patient is located.

The Board has taken action against California physicians and licensees from other states for prescribing over the Internet without an appropriate prior exam, and continues to investigate cases as it becomes aware of the practice.

California patients deserve good medicine, which begins with good healthcare providers. The MBC Enforcement Program is one of many agencies that are asked to actively pursue this illegal practice in its mission to provide public protection. Unaware physicians may be asked to participate in many different business enterprises. We urge you to read the law before engaging in any Internet practice.

Please share this information with your patients and colleagues who may have questions about receiving or providing a prescription over the Internet.