NML has reviewed the above article by Elliott B. Oppenheim, MD/JD/LLM Health Law, president of coMEDco, Inc.TM. He says that "never in the history of mankind has so much information been available at the click of a mouse! For physicians, internet pharmacies present a professional risk of unparalleled proportion. It is this combination of consumerism and people’s perceived need to obtain pharmaceuticals, placing physicians as the required legal intermediary, which has created a professional risk which may not even occur to licensed physicians, which may place their livelihood at stake. This is a story of greed; physicians who would place profits ahead of patient safety."

The article is about an e-commerce company, Netmedical, that recruit physicians by promising $12,500 per month for script approvals! They said there would be only 5 doctors per state who would be able to provide these services so a prompt response was required.

On the legalities the e-mail company, Netmedical, said: "It will set your mind at ease, you can check the laws in your local state … 1936 law states that it is suggested that a doctor have ‘interaction’ with his patient which we have set up here for you. Not that a doctor must see his client face to face to write a prescription." This company will provide everything including malpractice insurance.

Oppenheim reviewed the history of the Federal government actions to stop more than 250 internet pharmacies. He said the reason is simple, medical licensure laws are circumvented by internet pharmacies. He describes the American Medical Association procedures for internet prescribing, which include five important criteria: (1) there must generally be an examination of the patient to determine a specific diagnosis and whether there is actually a medical problem; (2) there must be dialogue between the physician and the patient to discuss treatment alternatives and to determine the best course of treatment; (3) the physician must either establish a reliable medical history or have access to the medical history; (4) the physician must provide information to the patient about the risks and benefits of treatment of the prescribed medication; (5) the physician must follow up with the patient to assess the therapeutic outcome.

Further, he mentioned there are appropriate places and ways to use the internet for prescription drugs, but pointed out enforcement actions in Kansas, Ohio, Virginia, and other areas by medical boards and pharmacy boards. He cautioned physicians who become involved.

According to one expert, Oppenheim said, ten states, Arizona, Colorado, Connecticut, Illinois, Nevada, New Jersey, Ohio, Texas, Washington and Wyoming, have begun licensure actions against physicians who participate in internet prescribing.

Oppenheim asked "What is the busy financially beleaguered practitioner to do? There is a saying in medicine familiar to all practitioners,

‘If you hear hoofbeats, look for horses.’ The ‘hoofbeats’ in the internet prescription industry is a medical scam. The prudent road for any practitioner would be not to ‘throw out the baby with the bathwater,’ and to simply continue practicing medicine in the traditional sense until state legislatures catch up with the internet. Otherwise, a physician may risk criminal and civil liability and the loss of the medical license. The ‘writing is on the wall’ that the states are going to target physicians who place their profit over patient safety; a cyber-disaster."

And Oppenheim said he tried to contact Netmedical for their reaction to his article, but he was unsuccessful. He concludes that it is certain, that, unless a doctor follows the AMA guidelines, the states will interpret the failure to meet the accepted medical criteria in the worst way.

NML readers can contact Oppenheim at POB 1100, Tesuque, NM 87574 or 505-984-2598 or by E-mail at coMEDcoINK@aol.com or Website: www.comedco.com

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