What You Need to Know About Online Prescriptions and Online Doctor Consultations
We’ve all seen the changes in medicine over the course of our lives. If we were lucky enough to have lived during the turn of the century we witnessed the man with the little black bag fade off into the sunset with the days of the wild west. This transition was partly due to the invention of the telephone. No longer did anyone have to run to the neighbor or get on a horse in an emergency situation. They simply picked up the phone and the man with the little black bag would soon arrive at their door.
Later, as the population continued to grow and communities spread out for more than a few miles in every direction, the man with the little black bag decided it was best for his patients to come to him. The car was invented to help with that transition. They were faster, so people were able to get emergency treatment faster than ever before.
But the population continued to grow and visits to the doctor’s offices became long and complicated, often protruding into the lives of the patients. Waiting for hours didn’t serve anyone’s purposes well and the need to transition to a more efficient way of meeting medical needs became apparent.
We can see through the years, that the use of technology in treating patients is not a new one. One would venture to conclude that a careful search throughout history will reveal that technology on the part of medicine has been around as long as medical treatments have been used. So, we should not be surprised to see emerging trends in Tele-ICU care. A recent report from the California Health Care Foundation had this to say, “Recently, the traditional ICU model has been challenged by the increased demands of an aging population, too few critical care specialists to meet staffing targets, and heightened pressure from payers to demonstrate better quality and greater cost-effectiveness.”
Again, it is the same old issue that has interfered with getting quality health care for generations. More people put more demands on the current system and therefore force a change.
What is Tele-ICU?
Intensive care is one of the most important aspects of health care today. Every year more than 6 million people find themselves in an ICU somewhere in the country. Through Tele-ICU a communication network is set up which can relay vital sign monitors to communicate essential information for treatment in real time to a physician in a remote location. With the right information, consultation with a medical physician can insure that medical treatment starts much more quickly so that the patient does not receive delayed care.
In addition, physicians are not limited to the number of patients they can treat in this way, which can help to improve productivity levels and efficiency ratings for a medical team no matter where they are.
Where Can Tele-ICUs Be Used?
Tele-ICUs can be set up anywhere in the world. Having a connection to a Tele-ICU in remote locations could save many lives. In addition, they can also be used in larger cities where the population produces huge numbers of patients seeking treatment for a wide variety of conditions. As explained at the Center for Connected Health Policy, “Have the potential to address staffing shortages by electronically connecting ICUs to a central support center staffed by critical care specialists. The support center tracks patient statuses, issues alerts to on-site providers when a problem is detected, and recommends treatments via computerized decision support systems.”
The fact is that a Tele-ICU can be put in a wide range of settings even within the city limits. Aside from connecting to remote locations, specialists can treat a patient in another city (or even country) with the help of a Tele-ICU, triage situations can become more efficient in the event of a local or national disaster, and rural areas will be able to get emergency treatment at a much faster rate.
Improved Quality of Health Care
There is an added benefit to utilizing Tele-ICUs even in settings where a fully staffed ICU is already in operation. Through the course of several different studies, reports returned showing reduced mortality rates in ICU patients as well as shorter hospital stays as a result. This will over time translate into lower costs for patient care as well as for the medical institution. As explained in a report issued by Himss, “The benefits of Tele-ICU systems have been shown to reduce ICU length of stay and improve other patient outcome measures. For hospitals that have not yet implemented Tele-ICU but are considering the technology, it is important to realize that Tele-ICU has been documented to improve outcomes in numerous healthcare settings.”
Today, telemedicine is gradually becoming the service of choice in many scenarios. Its wide range of possibilities can be far reaching and can improve the quality of life for many people. With its ability to cover nearly every aspect of medicine from conducting regular patient visits, getting prescriptions via the internet, to managing life-threatening situations, patients are seeing a much better future when it comes to medicine.
As the population continues to grow and greater demands are imposed on the medical world, incorporating innovative technology like telemedicine into health care will be instrumental in keeping up with the growing needs of society. While very charming and quaint, no one really wants to go back to those days with the man and the black bag coming to the door. Our lives have grown far more demanding than that and modern technology is now the way we must all meet our needs.
Wondering if it’s legal to purchase your prescription online? The answer to this question isn’t all black and white, as the legality of buying prescription drugs online depends on a variety of factors. If you’re looking for a general answer, then you’ll find that within the United States it is legal to buy medication online if the source you are buying from meets the criteria set out by the government and individual state medical boards. However, not all online medicine retailers hold valid licensure for such a business.
So, what are these factors which determine whether you can buy your prescription online? Throughout this article, you will learn more about what validates telemedicine prescriptions, how online medicine services work, and how to choose the right service provider for your needs.
Filling a Prescription
Before you can fill an online prescription, you need to speak to a medical professional. That’s right, even online medical services require certified physicians to provide you with medication. As of 2008, and the passing of the Ryan Haight Online Pharmacy Consumer Protection Act, no online service may provide prescription drugs without a patient first being seen by a doctor, either through a physical examination or remotely via telemedicine. This act helps to make sure that the medicine patients receive is suitable for their condition, and coming from a legitimate resource.
Telemedicine first presented itself as a benefit in the 1970’s during NASA’s space program. Then, it was less about medication, and more about offering remote healthcare to astronauts who were otherwise unable to see a physician. Today, telemedicine has evolved to include a variety of services, including the ability to get a script. A systematic review published in 2011 further examines the way that this service has expanded, asking; “What do online pharmacies have to offer? From an analysis of the literature it appears that online pharmacies have become more and more complex as time passes; whereas 10 years ago they tended to sell principally lifestyle drugs such as sildenafil, it looks today as if they offer virtually anything.”
Some online services will mail your medication directly to your home address, but most states require that you still pick-up at a local pharmacy. This is another benefit for you, because it allows you to see where your medicine is coming from, and to know who has filled the prescription for you. This also lets your pharmacist verify the doctor the prescription is coming from, so you are doubly sure that what you receive is safe and legal.
Diagnosis and Refills
Direct mail or pharmacy pickup aren’t the only difference you’ll find between varying online medical services. Some doctors can diagnose and create new prescriptions, while others are only legally able to refill an existing prescription. The laws in your state will dictate which of these services is available to you. In most cases, obtaining a refill is offered by more online services than new prescriptions, because there is already a physician signature for your medication. This takes some liability away from the consulting doctor who is only able to meet with you online or over the telephone.
Online refill services work well for those in rural areas without access to a doctor, for individuals or families away from home without their medication, or for patients who have a family GP away on vacation. The services aren’t meant to replace the role of a practicing family doctor, but to provide an easy route to a prescription renewal when traditional methods aren’t available or convenient.
Ordering Medicine from Elsewhere
Telemedicine is legal in several countries around the world, but this doesn’t mean it’s legal for a U.S. citizen to obtain these services outside of the country. The U.S. Food and Drug Administration has forbidden Americans from ordering their prescriptions from other countries. This is another form of protection for citizens, as it decreases the chances of illegal narcotics, fake products, or drugs which have been tampered with. The U.S. Food and Drug Administration states; “Medicine that is approved for use in the United States has been reviewed for safety and effectiveness by the FDA. Medicine that may be approved in other countries or produced by unknown sources may have slight variations or different ingredients that could cause you to get sicker, develop a resistance to your medicine or cause new side effects.”
It is not recommended to use any new medication which includes unknown or added ingredients. When you use local online medication providers who transport your prescription to a nearby pharmacy, you minimize the risk of this occurring, and have the opportunity to ask the pharmacist about any ingredients which look out of the ordinary.
Laws for Intercountry Prescriptions
The laws in other countries permit substances for medical use which have been prohibited or are yet to be approved by the United States government. In rare cases, a drug may be approved if special permission is obtained from the government. The U.S. Government Publishing Office advises; “The Secretary may grant to individuals, by regulation or on a case-by-case basis, a waiver of the prohibition of importation of a prescription drug or device or class of prescription drugs or devices, under such conditions as the Secretary determines to be appropriate.”
This law includes medication coming from Canada or Mexico, although, medical trade between Canada and the United States is legal in cases where the business has been registered with the Secretary, and approved for transport of goods. If you’re unsure about whether you can legally obtain medication from a website, the U.S. Food and Drug Administration has a more in-depth review of what is and isn’t allowed to come across the border.
Choosing a Reputable Online Distributor
Before you select an online service through which to obtain your medication, consider whether the site requires you to speak with a doctor, or have a current prescription available for review. If not, the website may not be operating legally. You should also check on where the business is located. Even online businesses are based somewhere, and the state which the site operates out of may not have the same laws regarding online derived prescriptions as the state where you live. For example, if you’re in Montana, you may not be able to access services from Nevada or California. Finally, licensure is a huge factor in the choosing of an online medication provider. Are the doctors licensed, and are they based in the United States? Even if a business is located within the United States, if the physicians are from another country, and not licensed to operate within the U.S., your prescription could be written illegally.
Illegal Prescription Services
As with any broken law, obtaining illegal prescription services over the internet comes with its own set of ramifications, including fines and possible jail time. Fortunately, you can avoid problems with the law by choosing a site which uses licensed U.S. based doctors, is approved for prescription services within your state, and requires proper identification and patient/doctor interaction before a prescription is given. Reading online reviews, asking friends and relatives who have used similar services, and contacting the company directly are all great ways to gain insight on whether an online medication service is right for you.
There is no question that telemedicine has been able to save lives in many ways. It’s been used in remote areas where medical staff has been scarce to help people ward of illnesses, it has proved to be both a money and time saver for many in need of medical treatment all over the world. As more people are embracing the idea of using telemedicine as an alternative to the traditional means of getting treatment, concerns about how to monitor this growing industry begin to increase.
Evidence has made it clear that there are times when medical professionals will make entirely different decisions when dealing with a telemedicine patient than they would for an in-person visit. While this may work out better for the patient, there is also the risk of problems as a result of this inconsistency. According to a point raised in a recent article in JAMA in the case of prescription medications. It appears that, “The antibiotics prescribed during telemedicine visits raised some specific quality concerns that require further attention. … While the rates of prescribing were similar, the adjusted prescribing rate for broad spectrum antibiotics such as azithromycin, amoxicillin and levofloxacin was 86 percent for Teledoc versus 56% at physician offices.”
This evidence clearly shows some inconsistencies between the different types of medical treatments and the higher risks some patients may be exposed to when getting prescriptions online through telemedicine.
Causes for Concern
The disparity between the two has raised some major causes for concern. Without monitoring telemedicine more closely the issue of overuse can naturally become a problem. The ease in which a patient can reach medical help means they are more likely to take liberties in getting treatment, which could lead to higher costs.
In addition, people may find themselves taking medication more frequently than before causing patients to develop higher tolerance levels to certain drugs, and as a result decreasing their effectiveness in treatment.
It could also be an indication that telemedicine providers take a more conservative approach when it comes to providing prescriptions as opposed to the in-person patient. To cover their bases, they may be more apt to prescribe broader treatments simply because they are unable to put their hands on the patient directly.
And, the concern that medical professionals may not be able to properly diagnose a patient without a face-to-face contact is a major one. Many believe that they lack the needed insight in raising alarm bells across the medical community.
The Need for More Research
Many regulatory agencies are raising alarm bells and at the very least are opening the door to the need for more study in this area. As explained at the Center for Connected Health, “There must be a patient-provider relationship, presumed to be established in an in-person encounter, before a prescription can be written. By having all interaction occur online, questions are raised regarding whether the provider has enough information to make an informed decision regarding treatment.”
These concerns stem from whether the provider has enough information on the patient’s true health condition and medical history are foremost on many people’s minds. And they wonder how a physician will be able to confirm that the patient is honestly relating his true condition in any given situation. This is why some states have taken the step to prohibit any means of issuing or receiving prescriptions online without at least one in-person doctor-patient interaction first.
State Control
In the past, all that was needed for a prescription to be considered valid was a bona fide medical need that was verified by a physician during the course of his practice. However, in 2008, Congress prohibited the issuing of any controlled substances over the Internet without having a “valid prescription” with the passing of the Ryan Haight Online Pharmacy Consumer Protection Act.
Today, control of Internet prescriptions is regulated by each individual state, which adds to even more complications. There is no consistency across the board in regards to prescriptions obtained via telemedicne. It is up to each state to determine if the patient-provider interaction is adequate through telemedicine or if an in person visit is necessary. This leads to varying complications across the country as the chances can be quite high that the patient and the physician may not always be in the same state and therefore will fall under completely different guidelines when it comes to issuing or receiving prescriptions.
An example of this controversy is a case of an Idaho doctor that issued a prescription over the telephone. The State Licensing Board did not approve and issued sanctions against the doctor. As stated in Modern Healthcare, “But Idaho’s medical licensing board doesn’t approve and earlier this year punished a doctor for prescribing a common antibiotic over the phone. The sanctions against Dr. An DeJong are so severe that her board certification is threatened.”
The controversy has raised many issues that the largest telemedicine provider has chosen to pull out of Idaho because of these stringent regulatory issues. It is clear that there is strong promise in the future of telemedicine but the system has yet to be perfected. As long as there remains disparity between the states regulatory system, there will always be confusion as to the best way to proceed with telemedicine in the future.
It seems that there is a division on where this growing industry will go next. Those who live in remote areas where medical treatment may be far away are watching the transition with anticipation. They are the ones that look forward to getting the treatment they want without having to make a major journey from a remote location when they are already in poor health. Those on the opposite end feel just as strongly about their position.
Everyone is now in anticipation of the decisions that will be made at this coming conference on consistent regulation of telemedicine across the nation.
Like many other questions regarding prescription drugs, the legalities of online sales are not as cut and dry as they could be. There are many factors which go into the modern industry that is telemedicine, and its governing bodies. Can you buy online prescriptions? Absolutely, but not for everything, and not from anywhere.
Throughout this guide, you will get a closer look at the telemedicine movement and the difference it makes on the world, internet based prescription services, how the system has evolved, and what the procedure is to get your own medication over the internet.
Telemedicine and Prescriptions
When telemedicine first appeared on the medical scene, it was designed to give remote patients access to medical care that may otherwise be unavailable to them. Specifically, the program was designed to allow astronauts in the 1960 NASA space program access healthcare away from home. Since its debut, it has evolved, becoming a multifaceted industry which includes prescription services, and even telesurgery. mHealth Intelligence advises; “In more recent years, healthcare reforms and federal legislation has pushed forward the spread of telemedicine technology and other technological advancements like EHR systems, electronic prescribing, and mobile health tools.”
As technology advanced, so too did the ability for patients to receive additional medical attention without physically attending a doctor office. These online doctor services can now be obtained through the telephone, online chat, and video messaging. This allows physicians to hear symptoms, see a patient’s condition via a webcam, and diagnose or prescribe medication for an ailment.
Laws Regarding Prescriptions Online
While such services are now available in many countries around the world, the services are generally confined to each individual country. American citizens, for example, are forbidden from ordering medication from other countries, as the drugs could be mixed improperly, tampered with, or contain active ingredients which could be harmful. The FDA restricts the delivery from drugs from other countries to maintain quality control and the safety of patients in the country.
Aside from the laws governing online based prescriptions within the country, there are also laws which govern these services within each state. Some states provide more advanced telemedicine services and allow online doctors to diagnose and prescribe new medication, while other states only provide access to online refills, not new medication.
There are also laws revolving around the types of medication you can receive from an online service provider. Narcotics, stimulants, and pain relievers are not legally available online, due to the mishandling and abuse of many of these drugs. This means that patients requiring a prescription for OxyContin, Valium, or Adderall will need to visit a physical medical practice to receive a prescription and obtain medication. The U.S. Department of Justice writes; “Federal law prohibits buying controlled substances such as narcotic pain relievers (e.g., OxyContin®, Vicodin®), sedatives (e.g., Valium®, Xanax®, Ambien®), stimulants (e.g., phentermine, phendimetrazine, Adderall®, Ritalin®) and anabolic steroids (e.g., Winstrol®, Equipoise®) without a valid prescription from your doctor. This means there must be a real doctor-patient relationship, which by most state laws requires a physical examination.”
Meeting a Doctor Online and Other Prescription Requirements
Before you are legally able to retrieve a prescription over the internet, you must meet with an online doctor, or have a prescription handy from a local GP. This became law in 2008, after an act was passed which decreed that no patient could receive medication without first seeing and obtaining written consent from a physician. For this reason, online medical practices often provide one on one consultations with a doctor prior to prescription pickup.
It’s important to research the company you choose to work with on the internet, to determine that the physicians they use are certified U.S. based doctors. For your prescription to be valid in the United States, the attending physician must also be a U.S. doctor.
The Online Medication Process
To retrieve a prescription, most sites will ask you to fill out a questionnaire to gain insight on your personal information and the condition you need attending to. This part of the process takes only a few minutes, after which you may receive an email or account information to login. Once you are signed up, you will have access to a consultation with a doctor. He or she will speak to you about your condition, ask about your medical history and current ailment, and determine whether a prescription is required.
After your consultation, the doctor you’ve spoken with forwards the prescription to a local pharmacy for convenient pickup. Some internet pharmacy services will mail medication to your home, but this comes with further restrictions and can be dangerous if you don’t know where the medication is coming from. By attending a local pharmacy for pickup, you can see the pharmacist filling your order, ask questions regarding dosage, and learn about the brand you’ve been prescribed.
Benefits of Online Prescription Services
While there are still a few grey areas when it comes to retrieving medication over the internet, there are many benefits to consider. Many patients prefer this method due to mobility issues, whether confined to bed due to an illness, or living in a remote rural area without access to a doctor, individuals who can’t regularly attend a medical clinic are able to receive the care they need from the comfort of home.
Another advantage to these services is the money saved due to the decrease in physical staff, equipment, and structure. Without the need to pay rent, electricity, and unnecessary wages, online businesses can lower the price of medical services and products, making prescriptions more affordable.
Finally, using an online service offers convenience and privacy to patients. Most doctor offices work on a 9-5 schedule, making it difficult for day-workers to attend without losing pay to take time off for an appointment. Rather than live by the schedule of a doctor, online prescription services provide access to medical care on your own time, and from the comfort of home. They also offer some anonymity where pickup is concerned. No curious eyes as you wait in line to drop off a prescription, no needing to explain to the pharmacist why you’re there, simply pickup, get directions on use, and head home. Pharmacy Guide explains; “When ordering from online pharmacies, people don’t have to be in public to purchase medication. Some people have conditions that aren’t as socially acceptable as others, and would prefer to order medication in the privacy of their homes rather than risk exposure and humiliation in public. The added privacy provided by online pharmacies have definitely made an impact in the lives of people living with conditions that they don’t want the whole world to know of.”
The Truth About Internet Prescriptions
So, can you obtain a prescription legally over the internet? Yes, but there are restrictions to consider. Always check with your state to determine the telemedicine laws in your area before you proceed with an online service. It is recommended that patients use telemedicine practices in addition to services offered through a local GP, rather than as an alternative. Unless you are physically unable to access a medical clinic, seeing your doctor for regular checkups and treatments shouldn’t be avoided, although such prescription services do provide convenience.
WARNING: Limitations of Online Doctor/Medical Consultations and Online Prescriptions, QuickRxRefills Cannot and Will NOT Prescribe, Dispense, or Resell any and all medications Narcotics/Controlled Substances (this policy is fully enforced by the Drug Enforcement Administration (DEA)) for Anti-depressants, Pain, Anxiety, Weightloss, Sleep, ADHD/ADD, Anabolic Steroids, Testosterone Replacement Therapy and any and all Medications that contain GabaPentin or Pseudroephedrine including non-controlled substances or any medications that are considered controversial, Off Labeled (Growth Hormone aka HGH) or recalled in nature such (i.e. Retin-A, Accutane). Furthermore, QuickRxRefills is not a substitute for an office based physician in your location nor is it a substitute for Emergency Medical Care or 911. If you do experience a "true" medical emergency your are encouraged to pick up the phone and dial 911 as soon as possible.
