Web prescribing: How to set the standards

The AMA has guidelines that make clear the way to prescribe online.

Editorial. Sept. 1, 2003.

The reputation of Internet prescribing is often framed in terms of the seemingly endless number of shady sites ready to ship drugs in return for little more than a credit card number and the click of a mouse.

It shouldn't be this way. Internet prescribing can be an effective tool for physicians and a worthwhile service to patients, but there must be proper standards. With that in mind, the American Medical Association House of Delegates recently approved a report that offers guidance to physicians in how to handle Internet prescribing. The guidance covers not only online interactions with patients, but also online interactions with pharmacies.

The guidance stands in sharp contrast to the actions of the disreputable sites on the Web, which operate on the basis of sham exams, anonymous doctors and other practices that are at odds with responsible prescribing. It is clearly in the interest, and the purview, of the medical community to establish the rules of physician conduct, advising doctors on good uses of the Web while medical boards and others try to root out the bad.

A central idea behind the guidance, based on recommendations from the AMA Council on Medical Service, is the same notion that the Association and others have propagated since Internet prescribing first emerged: No physician should prescribe any drug to a patient whom that physician has not examined. As with any prescription, it should be provided in the course of treatment to a patient whom a physician has seen, has discussed treatment options and risks with and, as necessary, will then be followed up to assess the therapeutic outcome. Doing otherwise carries the direct risk of conduct that is unprofessional and outright dangerous.