Is working as a "cyber doctor" illegal??

[Mr. Eastern Medicine]

Hi everyone. I recently visited this website. This site sells prescription drugs over the Internet and claims that they have US licensed physicians and pharmacists. And I guess they are also currently recruiting US licensed physicians. And at first, I thought it would be a nice 2nd or even 3rd income for many physicians. It also says that many of their "cyber" physicians' avg salaries are $1500-$2500 per month. But my question is, is practicing medicine over the Internet legal or illegal?

Just go to this website and see for yourself.
<a href="http://e-scripts-md.com/physic.asp?Referrer=0" target="_blank">http://e-scripts-md.com/physic.asp?Referrer=0</a>

Any facts, comments or thoughts?

Thanks~

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[UCMonkey]

I think if its not illegal it should be. At least in California, and I would imagine in other states as well, giving advice over the phone is illegal, since you haven't evaluated the patient.

Legality aside, I think this pracitce is almost certainly unethical - I think it is a disservice to the patient to provide them with medications without a full history and physical exam. The only motivation I could possibly see for this practice is money.

 

[johnM]

Is this site issueing scripts or just filling them? I think that there is probably a big difference (legally and ethically).

Example, if you go to a doctor, and get a prescriiption and just buy it over the Internet, then I don't think that's such a big deal, so long as they are somehow verifying everything. But if it's something like "you tell us how you feel and we'll send you something for it" then that's another story.

 

[mpp]

Very bizzare. Apparently they do a physical exam, prescribe the medication, and then send it to you. A quote from their website:

"Both research and practical experience indicate there is no reason to suggest that an in-person review of patient medical history is any more relevant than an online consultation and that, for the majority of individuals, the Internet is a safe, confidential and convenient place to seek treatment."

They say they are a U.S.-based company with U.S.-trained physicians.

 

[johnM]

•••quote:•••Originally posted by mpp:
•Very bizzare. Apparently they do a physical exam, prescribe the medication, and then send it to you. A quote from their website:

"Both research and practical experience indicate there is no reason to suggest that an in-person review of patient medical history is any more relevant than an online consultation and that, for the majority of individuals, the Internet is a safe, confidential and convenient place to seek treatment."

They say they are a U.S.-based company with U.S.-trained physicians.•••••This sounds like a load of crap to me. First, if they are reviewing the patient's med history, then this is assuming that a medical history came from somewhere... maybe a 'real' doctor?
So why didn't treatment for his/her problem start there, be it a prescription or something else?

Also, nobody goes to a doctor to get an "in-person review of patient medical history" in the first place. They go to get something new or something that has changed looked at. If you need a Rx for a recurrent problem that you have had in the past, you can call your doctor's office and get it without seeing him/her. For example, if you get seasonal allergies, you don't have to go in every April an tell the doctor about it, you just call the office and get a new Rx.

 

[Mr. Eastern Medicine]

You know, this is how I personally feel about this. I personally don't see anything wrong with this website. What's the difference between going to a doctor for a prescription of Celebrex for their arthritis pain and Tell those "cyber" doctors that you have an arthritis pain??
In my personal experience, I only spend about 5 minutes with my doctor. And it would probably take about only 5 minutes to type my medical history and answer their medical questions over the Internet. So what's so unethical about it?
I don't get any physical exams in my doctor's office when I go there for a prescription of Zyrtec.

Well, some people might say that these websites are not good, because perhaps many patients might lie about their symptoms just to get those prescription drugs. But you know, you can still physically go to your doctor's office and still lie about your symptoms in front of your doctor just to get those prescription drugs. So what's the difference?

Note that these websites do not carry EVERY kinds of drugs. They only carry a certain types of drugs. I guess these types of drugs are not considered "dangerous" drugs...

Whether practicing over the Internet is ethical or unethical, that's another story, but I am still trying to find out if practicing medicine over the Internet is legal or illegal.

 

[CoffeeCat]

It definitely depends on what they're dispensing and if you have previously had a perscription for it. They should not perscribe anything addictive or dangerous or anything that does need a physical examination or blood work to confirm. There are many drugs that don't fit into this category and if it's saving people time and money to get things perscribed this way, there's nothing wrong with that. Don't be so quick to judge.

 

[Long Hair and a Beard]

I think it is a very dangerous idea. I do not know about the legal issues in US about telephonic or online consultations, but I do think this website is unethical.

The website does not take any detailed history at all, or even ask questions to confirm the diagnosis. All it asks about the current condition is: Please list any current medical conditions: Taking an example of acyclovir for herpes infection, I have the following questions about the whole thing:

a) Is the patient supposed to know that he/she has got herpes? Apparently, after reading the Patient Responsibility statement, I got this impression that the patient has to do the whole reasoning from rash to diagnosis of herpes to deciding that acyclovir is suited for herpes of the severity that he/she has got to deciding the dosage and the duration of treatment. He/she is supposed to have read available text about the disease and the drug to be sure that he/she needs it, and won't mind taking it. This is all complete BS. What is over-the-counter if not this?

b) What if the patient does not have herpes, but some other viral rash? A doctor would have diagnosed the presence or absence of herpes at a glance, but which the site is not bothered to check the patient's self-diagnosis.

c) Acyclovir reduces GFR in patients with kidney disease. What if an elderly patient, with so many complaints he can't keep track of, forgets to mention his prostatic hypertrophy. Who will be responsible for any adverse effects? The site cleverly absolves itself, saying it is the patient. Needless to say, the family practitioner looking after this patient would at least remember his BPH, and modify dose or change the medication.

In short, it is like justifying the over-the-counter sale of acyclovir by saying that there is a doctor that will screen patients for any contraindications to the use of medicines that the patients demand, for ailments that the patients have diagnosed, in past/present medical conditions that the patients enumerate. Does not look ethical, does it?

And an odd thing that I noted. Before opening the website, a notice came on my screen, saying that the license of this website was for a duration exceeding the validity of the licensing authority. I donot know what all this means, but it does add to my list of uncomfortable feelings.

 

[Brandon]

Being previosly a systems administrator the U.S. Federal govt., here's my understanding on this. Many start-up websites failed b/c there are numerous state laws regarding practicing/prescribing medication within their states. Therefore, most websites must abide by these laws so most physicians supporting these sites are from the state where the patient is. There's been lawsuits, etc. so this issue is still up in the air. I'm sure the website is advertising for physicians but are specifically looking for those from states that they have customers only.

 

[none]

These sites have their place. That place, however, is extemely limited.