FYI:
http://www.gopbi.com/partners/pbpost/epaper/editions/saturday/business_e3d44cbba449e0a10067.html
Ban set for online prescribing

By Phil Galewitz, Palm Beach Post Staff Writer
Saturday, February 15, 2003

The state Board of Medicine, raising concerns of patient safety, wants to prohibit Florida doctors from prescribing drugs over the Internet without performing physical examinations.

A recent decision by the licensing agency attempts to stop Florida-based companies that are selling Viagra, Propecia and other drugs through online consultations and prescriptions.

If found guilty of violating the rule, a doctor could lose his license.

The new rule, approved by the board last weekend, could go into effect as early as April 1 unless someone requests a hearing.

"The rule will help ensure that patients receiving medications from physicians are actually physically seen by that physician," medical board spokesman Bill Parizek said Friday.

Current Florida laws are vague about Internet prescribing of drugs, saying only that doctors must "evaluate" a patient before issuing a prescription. The new rule removes any ambiguity.

Under the rule, a doctor could still write a prescription for a drug without an examination but only if he or she has a prior relationship with the patient, Parizek said.

Florida would join 22 other state medical boards that have recently adopted rules or policies that specifically prohibit Internet prescribing without a physical examination.

Over the past year, prosecutors and medical boards across the country have attempted to target such Web sites, arguing the practice is unsafe and violates medical ethics.

However, because regulators can't enforce rules beyond their state boundaries, their actions often lack teeth.

If one state revokes a physician's or pharmacy's license, for example, the Web site usually still can operate in other states.

Not all Web pharmacies fill prescriptions based on online consultations.

Sites such as Drugstore.com, for example, require a prescription from a patient's "real-world" doctor before they will sell drugs to a patient.

Proponents of online prescribing say it's a convenient, confidential and cost-effective way for patients to interact with doctors in this era of managed care, when it's difficult to get time with a physician.

Some Web sites and physicians are fighting back. A group of medical Web sites recently formed the Council for Responsible Telemedicine, a Washington group that advocates online prescribing.

The founding members include AmeriMed Industries LLC of Boca Raton, which runs the online pharmacy AmeriMedRx.com.

At the 2-year-old site, customers are asked to complete an online medical questionnaire that is reviewed by an AmeriMedRx physician.

If the patient is found suitable for treatment, the pharmacy ships the prescription.

Montgomery L. Byers Jr., co-chairman of the council and AmeriMed's owner, said there's nothing wrong with selling "safe" drugs for minor conditions.

"Many people don't feel comfortable discussing certain conditions with a local doctor and pharmacy and would prefer the anonymity of the Internet," Byers said.