Internet prescribing and the physician patient relationship.

MEDICINE & HEALTH/RHODE ISLAND In 1997, a young pharmacist who had gone on to medical school graduated from Jefferson Medical College in Philadelphia, PA. In 2000, he was licensed to practice medicine in the state of Rhode Island; in 2001 he earned Board Certification in Emergency Medicine. Several years later, he entered into an agreement with Rx Partners, an Internet pharmacy that employed physicians to approve prescriptions for patients who completed online questionnaires along with their medication requests via a website, conveniently named Speedyrxdrugs.com. Rx Partners would then fill the prescription and mail it to the patient. Available medications included several controlled substances. In 2007 a complaint was filed with the RI Board of Medical Licensure and Discipline. After an investigation, it was determined that this Internet prescribing violated the provisions of Rhode Island General Law 5-37 and constituted unprofessional conduct in the practice of medicine. The physician was sanctioned with a formal Reprimand and required to complete a Board approved personalized ethics curriculum. This was not the first Rhode Island physician to be sanctioned for illegitimate Internet prescribing. In 2001 another more senior physician had been sanctioned with 3 years Probation. Illicit online prescribing is not a problem unique to our State. It is an international problem that has grown exponentially with the Internet. “Rogue” online pharmacies operate through websites and provide customers with prescription medications. Prescriptions are written or approved by licensed physicians based upon perfunctory online questionnaires completed by so-called patients. Safeguards intrinsic to the physician-patient relationship are nonexistent. There have been numerous documented instances of patient harm, including death. Unfortunately, the lure of easy money coupled with the increasing demands of medical practice has attracted physicians nationwide. Physicians are generally paid between $2 and $50 per prescription. For example, one physician was paid approximately $250,000 over a 7-month period before having to surrender his medical license to the Texas Medical Board. This physician was also sentenced to 3 years in federal prison for his role in the medication-related death of an 18-year-old man. According to the Federation of State Medical Boards more than 150 physicians were disciplined nationally between 1999 and 2006 for unprofessional conduct relating to Internet preInternet Prescribing and the Physician Patient Relationship