A suburban St. Louis physician should be disciplined for filling a prescription over the Internet without properly examining the would-be patient, a Missouri tribunal ruled late last month, but it left open the question of whether some Internet patient examinations would be acceptable as a basis for physician-prescribing.
The "patient" was an undercover Connecticut drug-control agent who got a prescription in 2000 from William Thompson, M.D., for the diet drug Meridia by filling out a questionnaire through online pharmacy ePrescribe.com.
Thompson never physically examined or talked to fictitious patient "Kim Davis." But Thompson, of St. Charles, Mo., told the independent Missouri Administrative Hearing Commission that he got all the information medically needed before prescribing the drug.
Looking to curb such sales, a measure introduced earlier this year by Reps. Tom Davis (R-Va.) and Henry Waxman (D-Calif.), among other things, would bar domestic Internet sites from writing and filling prescriptions without seeing patients.
That measure has the backing of state medical boards, doctors' groups and many pharmacists.
In the Missouri matter, the commission noted that issuing prescriptions online "is an evolving area of medicine and law," and that the panel was "sympathetic" to Thompson, licensed by Missouri since 1987 as a physician and surgeon. "This decision does not limit the concept of a sufficient examination to a face-to-face contact in every situation," June Striegel Doughty wrote for the commission in the case brought in April 2002 by the state's Board of Registration for the Healing Arts.
But, Doughty said, state law says an examination "requires more than a questionnaire."
Thompson may sue to challenge the ruling. Messages left with his attorneys were not returned.