CNN has been doing a pretty good job of digging into the issue of “online consultations.” CNN’s article last week a woman whose husband died after overdosing on Soma, a drug acquired from an online pharmacy.
CNN got the issue right: it’s not that the drugs came from an Internet pharmacy, but that they were “prescribed” over the Internet when the physician had never laid eyes on the patient. That’s called an online consultation that you have to do is fill out a form. Pharmacies that fill prescriptions based only on an “online consultation” do not meet LegitScript’s Internet pharmacy verification standards.
Why are online consultations such a bad idea? There are several reasons:
1. Some drugs should not be used if you have a certain medical condition, and often the medical condition cannot be detected without a physical examination by a physician.
2. As in the case of Nancy Fitzpatrick, a doctor can evaluate whether the person has another issue, such as suicidal tendencies or other mental health issues, that need to be addressed professionally.
3. Some drugs should not be used with other drugs, and it’s simply better for the physician to ask in person what other prescriptions a person is taking — not inquire through a questionnaire.
4. Prescription drug abuse is a growing problem, and an in-person examination allows the physician to ensure that the patient has a real medical condition, and is not feeding a drug habit.
5. Most obviously, the physician can physically examine the person to find out the cause of the problem.
A good example: numerous rogue websites “prescribe” Viagra through online consultations. But one of the standard exams a physician will conduct in assessing erectile disfunction is a prostate exam, to ensure that cancer isn’t the cause. (It’s a little difficult to conduct a prostate exam over the Internet).
We’ll be watching CNN’s continued coverage of this issue over the coming days.