A Canadian physician has been fined by a provincial medical society a maximum $25,000 for writing prescriptions for an Internet pharmacy in a growing crackdown by Canadian professional organizations on doctors who write prescriptions for patients they have not seen.
David MacKay of the Canadian International Pharmacy Association says the College of Physicians and Surgeons of British Columbia is trying to weigh in on a growing national debate but has instead overstepped its mandate and jurisdiction.
"They're trying to make an example of this doctor," MacKay said in a recent interview. "I think its political grandstanding. It's politically motivated."
The college fined Dr. Satnam Singh Gandham for failing to meet a required standard of care. Gandham admitted he was guilty of unprofessional misconduct when he wrote prescriptions on a commission basis for patients he did not personally examine.
Gandham is the first British Columbia doctor to be disciplined for participating in the burgeoning Internet pharmacy industry estimated to be worth about $1 billion US.
His fine, the college's maximum financial penalty, is also one of the largest handed to any doctor in Canada for a similar offence.
Pharmacists in most provinces need a doctor licensed to practice in Canada to sign off on a prescription sent by a U.S. physician. Most licensing bodies for physicians in Canada forbid doctors from signing prescriptions for patients they haven't seen. However, provincial regulating bodies for doctors and pharmacists have said connecting the dots to make a case for discipline is often difficult.
Last winter, a Manitoba doctor was reprimanded and fined $10,000 for co-signing more than 9,000 prescriptions for two Internet pharmacies.
Three doctors in Ontario and two Internet pharmacists in Manitoba are among those awaiting disciplinary hearings on similar charges.
Doug Blackman, M.D., insisted the college's decision was based on ethics, not politics.
"This kind of activity is outside the bounds of what is professional," said Blackman, the college's deputy registrar. ?Frankly, this is consumerism, pure and simple."
MacKay said Canadian doctors are serving as "an extra set of professional eyes" and often catch problems with original U.S. prescriptions such as interaction with other medications or allergies.
But Blackman called that argument "a stretch" to justify commercial interests.
MacKay said the industry is concerned that stiff fines could eventually deter some doctors from working with Internet pharmacies. But there has so far been no shortage of doctors willing to participate, he added.