DrugBuyers.Com: New OP in R&D phase consider CII's

OK. Here's the complete scenerio . . . . (by the way as you all know this is the way it is currently set up, but for review so that we are all on the same page)

In Florida, which is heavily regulated, there are currently legally operating online pharmacies or "medical clinics". They request a copy of your medical records stating the condition you are requesting medication for and dated within the past 12 months. After you send these in, you are given a phone consultation with the doctor who in turn writes the script. I know they are writing CIIIs. They have not been shut down. (They did shut down a doctor and pharmacy that was grossly negligent and clearly operating illegally, but not the ones that are currently still open and operating.)

In my opinion after and exhaustive research of state and federal law, (agreed the doctor is pushing the ethics issue just a bit) this is OK at this time as long as the pharmacy is licensed in each state they are mailing drugs to and there is a doctor available in each state to do the consulting and prescribing to that state's residents. Or, like an earlier post stated, the patient comes directly to the doc in this state. Now, if these guys can operate here and are making it without using other doctors from other states, then it seems you can do this in most states and be ok.

There is another layer of fed/state conflict and that deals with the interstate commerce laws. Seems the states are hindering interestate commerce as stated by the feds, but at this time the feds are not willing to take on that battle and are bowing to the states to do what they want when it comes to the licensing laws of docs, pharmacists, pharmacies and who can send and prescribe to their residents.

What do you think?

Here is the actual Florida law . . . Note: no where in here does it state "face to face" but does address the medical records.

64B8-9.014 Standards for Telemedicine Prescribing Practice. (1) Prescribing medications based solely on an electronic medical questionnaire
constitutes the failure to practice medicine with that level of care, skill, and treatment
which is recognized by reasonably prudent physicians as being acceptable under similar
conditions and circumstances, as well as prescribing legend drugs other than in the course
of a physicians professional practice.
(2) Physicians and physician assistants shall not provide treatment recommendations,
including issuing a prescription, via electronic or other means, unless the following
elements have been met:
(a) A documented patient evaluation, including history and physical examination to
establish the diagnosis for which any legend drug is prescribed.
(b) Discussion between the physician or the physician assistant and the patient regarding
treatment options and the risks and benefits of treatment.
(c) Maintenance of contemporaneous medical records meeting the requirements of Rule
64B8-9.003, F.A.C.
(3) The provisions of this rule are not applicable in an emergency situation. For purposes
of this rule an emergency situation means those situations in which the prescribing
physician or physician assistant determines that the immediate administration of the
medication is necessary for the proper treatment of the patient, and that it is not
reasonably possible for the prescribing physician or physician assistant to comply with
the provision of this rule prior to providing such prescription.
(4) The provisions of this rule shall not be construed to prohibit patient care in
consultation with another physician who has an ongoing relationship with the patient, and
who has agreed to supervise the patients treatment, including the use of any prescribed
medications, nor on-call or cross-coverage situations in which the physician has access to
patient records.
(5) For purposes of this rule, the term telemedicine shall include, but is not limited to,
prescribing legend drugs to patients through the following modes of communication:
(a) Internet;
(b) Telephone; and
(c) Facsimile.
Specific Authority 458.309, 458.331(1)(v) FS. Law Implemented 458.331(1)(q), (t), (v) FS. HistoryNew 9-14-03.