As most everyone knows, you can get just about everything you want these days through the Internet. Obtaining prescription medications both legally and illegally is no exception. There are many pharmacies that have legitimate Internet websites and conduct their business in a professional and legal manner. My concern is that they are in the minority today and the public's safety is at stake. Young people are especially at risk from the ease of access to potentially dangerous medications when used inappropriately.

Some people might think that Internet prescribing shouldn't be taken too seriously because it is just some people trying to obtain lifestyle drugs like Viagra without having to go see a physician (there can be serious complications with Viagra as well). But, take the case of Ryan Haight, a 17 year old student. Ryan was able to obtain controlled substances over the internet by replying to an online questionnaire. He overdosed on the pain killer, Hyrodocodone and Morphine. The physician who prescribed the medication for Ryan did so without having met him or performing a history and physical. Thousands of others have just filled out a questionnaire over the Internet and been able to obtain prescription drugs. The prescribing physician in Ryan's case had his medical license revoked by the Texas State Medical Board and the online pharmacy is no longer operating. Ryan's parents have set up a website, www.ryanscause.org to educate the public, especially young people, about this problem and to advocate for better regulations. Legislation, called the "Ryan Haight Act" has been introduced in Congress which would require a physician-patient relationship be established before any medication is prescribed.

In this day of the Internet, for every pharmacy that closes or is shut down several others go online. These online pharmacies can be located anywhere in the world which limits enforcement of pharmacy and prescribing laws. Problems with drug interactions, counterfeit drugs, mislabeled or adulterated medications, make the online pharmacy environment a dangerous one. The National Association of Boards of Pharmacy has developed an accreditation program for Internet pharmacies called, "Verified Internet Pharmacy Practice Sites" or VIPPS. The VIPPS accreditation program has 19 criteria points that are evaluated, an on-site inspection, an annual review once accredited and allows the Internet pharmacy to put the VIPPS seal of approval on their website. You can go to the NABP's website, www.nabp.net to see which pharmacies are accredited. This program is a voluntary program so those pharmacies that comply really have an interest in quality and patient safety. People that want to use an online pharmacy for convenience and confidentiality should check out the quality procedures of that pharmacy by comparing them to VIPPS' quality criteria. Comparing your local or online pharmacies can be life saving as well as money saving.

Checking out your prescribing physician is also imperative whether obtaining a prescription in the physician's office or by ordering medications online. It is important to know that your physician is licensed, properly trained and board certified in the area that he/she is treating. Making sure that your physician does not have a disciplinary history, and getting other people's opinion about him/her can bring some peace of mind and give you confidence in the majority of our country's dedicated quality physicians. Knowledge and communication is the key to keeping you and your family safe when it comes to your health and your healthcare purchases.

Tim Knettler is a Consultant to checkMD and will be a speaker on September 18, 2008 for the American Bar Association/Health Law Section's CLE session titled, "Telemedicine & E-Prescribing: Evolving Ethical, Licensing & Reimbursement Rules & Realities." http://www.abanet.org/cle/programs/t08tee1.html

Tim Knettler is a former Senior Vice President of the Federation of State Medical Boards, the national association of state medical boards that licenses physicians and regulates medicine. Prior to the Federation, Mr. Knettler was a Unit President/Regional Director of Omnicare, the largest pharmacy service provider to long term care in the United States.

For the presentation given at the American Bar Associations Health Law Secion on Telemedicine and e-Prescribing, click here.