Online prescribing results in state criminal charges

In the Courts. By Bonnie Booth, AMNews contributor. Oct. 9, 2006.

More than half of the country's state medical boards have disciplined a physician for Internet prescribing.

In most cases, medical board officials discipline a doctor who is licensed in their state and has been prescribing through an Internet pharmacy by revoking or suspending the physician's license. Board officials rely on laws -- passed in most states -- that require a previous relationship with the patient or explicitly forbid physicians from prescribing based on a patient's answers on a medical questionnaire. AMA policy requires that "physicians who prescribe medications via the Internet shall establish, or have established, a valid patient-physician relationship."

Rarely, experts said, does a state's law enforcement agency charge the physician with a crime.

Federal government officials file most criminal charges for Internet prescribing, and a controlled substance is usually involved.

But states could find criminal charges a more attractive option for reining in largely unregulated Internet pharmacies if the San Mateo (Calif.) District Attorney's office is successful in its bid to bring to trial an out-of-state physician who prescribed an antidepressant to a 19-year-old California resident who later committed suicide.

In late May, the district attorney charged Christian Hageseth III, MD, of Fort Collins, Colo., with one felony count of practicing medicine without a valid California medical license.

While it is a crime in most states to practice medicine without a license from that state's board, the San Mateo district attorney's decision to use the California statute to prosecute Dr. Hageseth is a novel tactic, experts said.