An Illinois internet prescription malpractice case that I prosecuted beginning in 2004 opened my eyes to the widespread abuse of prescription drugs the internet facilitates. An unholy alliance has developed between physicians and the internet pharmacies that push drugs via spam e-mails and pay for click advertising. This is the first of what will become a continuing focus on the practice of physicians prescribing frequently abused drugs based solely on an on line questionnaire. This article is not meant to criticize or impede a patient with a lawful prescription from having it filled over the internet.
In April 2004, a 30 yr. old plastic salesman along with his newly pregnant wife had just moved into their new home in suburban Chicago. He was an active man who played golf and basketball regularly. He loved reading Dostoevsky and Hemmingway. His sales job required 70-hour work weeks and he drove over 60,000 miles per year servicing his customers. Stress was very high and his back was bothering him, but his family life and work prospects were promising.
Looking at his e-mails one day, he noticed spams offering the anxiety drug Xanax and painkiller Ultram. All that was required was to fill out an on line questionnaire and enter his credit card. Two doctors, one in Philadelphia and another in New Jersey then approved the salesman’s request for drugs. He neither saw nor spoke with either of the doctors.
American Medical Association policy requires that “physicians who prescribe medications via the Internet shall have established a valid patient-physician relationship.” Federation of the State Medical Boards of the U.S. states that: “treatment, including issuing a prescription, based solely on an on line questionnaire or consultation does not constitute an acceptable standard of care.” The Federation further states that physicians who prescribe over the internet must be licensed in the jurisdictions where the patient resides. This comports with the laws in most states.
The Illinois medical malpractice lawsuit filed against these doctors charged them with deviating from the standard of care in that they: (1) prescribed Xanax and Ultram to a patient they had never seen or examined; (2) prescribed excessive dosages; and (3) practicing medicine in the state of Illinois without a license. I will trace the path of this medical malpractice litigation in future articles. Holding physicians financially responsible for the harm they cause by prescribing over the internet may now be the most promising way to stop these drug dealing doctors and their pharmacy co-conspirators from the scourge of prescription drug abuse.