Posted on Wednesday, 10th September 2008 by dcooley
Tim Knettler writes an interesting article over at CheckMd.com entitled “The Perils of Internet Prescribing.” The article mainly focuses on weeding out the safe, legit pharmacies from the bad and specifically mentions the “Ryan Haight Act.” This proposed legislation, currently introduced in Congress, would require a physical examination (or, as Mr. Knettler puts it, a doctor-patient relationship) before a prescription is issued. In other words, it would effectively outlaw online consultation services.
What is interesting is that Mr. Knettler is the “former Senior Vice President of the Federation of State Medical Boards (FSMB), the national association of state medical boards that licenses physicians and regulates medicine.” Contrary to the position of the DEA and the underlying basis of the Ryan Haight Act, the FSMB is clearly of the position that online consultations performed by doctors via internet websites do form a physician-patient relationship. FSMB’s “Model Guidelines for the Appropriate Use of the Internet in Medicine Practice” specifically state on page 4 that:
[a]lthough the Board recognizes that it may be difficult in some circumstances, particularly in an online setting, to define precisely the beginning of the physician-patient relationship, it tends to begin when an individual seeks assistance from a physician with a health-related matter for which the physician may provide assistance. However, the relationship is clearly established when the physician agrees to undertake diagnosis and treatment of the patient and the patient agrees, whether or not there has been a personal encounter between the physician (or other supervised health care practitioner) and patient.
It is hard to argue with the FSMB’s conclusion, especially given the fact that many online consultations are probably more thorough and longer lasting that your everyday five minute physical examination with your local general practitioner. I would be interested in hearing what Mr. Knettler’s position is regarding the Federation of State Medical Board’s conclusion.
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Tags: Doctors, FSMB, Internet Pharmacy Law
Posted in Doctors, Online Consultations, Pharmacies, Ryan Haight Act, Website Owners | Comments (4)
September 12th, 2008 at 8:26 pm
[...] Even if a doctor-patient relationship was required, why is an online consultation not one? A doctor, after thoroughly reviewing medical records probably has done more than one’s average GP doctor. Additionally, the Federation of State Medical Boards has expressley indicated that online consultation to constitute d…. [...]
September 23rd, 2008 at 2:17 am
[...] Either way, OCS website owners, doctors, and pharmacists can’t be prosecuted under the current law. If the former, then the reasoning is obvious. If the latter, there are serious issues regarding constitutional vagueness and notice. If Congress itself felt that the regulation was too vague, it seems entirely unreasonable to prosecute an individual and argue that they should have known what they were doing was illegal beyond a reasonable doubt. It is even implausible to assume doctors should have known better, given the fact that the Federation of State Medical Boards has specifically said that online consultations do constitute doctor-patient relationships. [...]
October 9th, 2008 at 4:50 pm
[...] running websites or writing prescriptions — especially in light of the fact that the Federation of State Medical Board’s Guidelines state that online consultations do constitute doctor-patient [...]
December 3rd, 2008 at 4:12 pm
[...] of State Medical Boards has admitted that online consultations, while not optimal, do constitute doctor-patient relationships. I admit that I do not know the specific facts of the internet pharmacy business model associated [...]