Online Rx: Be careful with Web prescriptions

The AMA House of Delegates will soon consider new guidelines for physicians who prescribe over the Internet.

Editorial. May 13, 2002.

The first telephone directory, just one page published in New Haven, Conn., appeared on Feb. 21, 1878. Listed among the subscribers are the names of three physicians. No word on when the first patient rang up and tried to get a doctor to prescribe over the phone, but Feb. 22 would be a reasonable guess.

Fast forward to the Internet age, and there are dozens, more likely hundreds, of sites onto which individuals can click and expect to log off with a prescription as good as in hand. It is a transaction that typically makes the necessity of talking with, let alone actually be examined by, the doctor as antiquated as the yellowed paper of that first telephone directory.

This is a case of an advance in technology that is not progress -- at least not in the medical sense. A prescription that results from little or nothing more than filling out an online form -- and many offshore sites don't even require that -- is a serious and dangerous corruption of what medicine should be about.

The AMA House of Delegates has examined the issues raised by online prescribing in the past and will do so again at next month's Annual Meeting. The AMA Board of Trustees has prepared a new report to provide guidance to physicians on Internet prescribing that carries recommendations for delegates to consider.

The report marks a timely return to the issue. The discussion on Internet prescribing has long been framed, and remains largely so, in terms of drugs for erectile dysfunction, or to promote weight loss or hair growth. But the near panic after last year's anthrax attacks showed how quickly the Internet could turn into an uncontrolled market for antibiotics, raising broad and serious public health concerns. [...]