Questions linger over group's "responsible" prescribing

Members of an online pharmacy coalition still prescribe to patients they've never seen -- in opposition to AMA policy.

By Tyler Chin, AMNews staff. Oct. 14, 2002.

A Washington, D.C.-based industry group has emerged to buff the tarnished image of online prescribers, but organized medicine likely won't be taking a shine to its members.

Three Internet companies formed what they call the Council for Responsible Telemedicine as a way to differentiate themselves from "rogue pharmacies" that aren't committed to offering care in a quality manner, said Tania Malik, a CRT director and CEO of Virtual Medical Group, which has had several affiliated physicians disciplined by regulators in its home state of North Carolina.

The guidelines for CRT membership don't address the two major objections that the medical establishment and regulators have about many Internet consultation companies. Namely, the council doesn't require that CRT members and their affiliated physicians have an established physician-patient relationship with their online patients, nor that they examine patients in person before they prescribe or treat online -- both at odds with AMA policy.

"Our belief is that online consultations are and should exist within an existing physician-patient relationship," said Edward Fotsch, MD, CEO of Medem Inc., a company that recently added online consultations to the services it offers. "That is consistent with the AMA guidelines, liability carrier guidelines and the guidelines of the Federation of State Medical Boards."

As a result, Medem, a San Francisco-based company partly owned by the AMA, would decline to join CRT if asked, Dr. Fotsch said. [...]