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Saturday, July 08, 2006  
Online doctors dole out drugs blind

DOCTORS are approving powerful prescription drugs over the internet
for weight loss, impotence and baldness without seeing or actually
speaking to their patients.
An investigation by The Sunday Times has found three British companies
providing potentially dangerous medications including Viagra, the
sexual performance drug, Xenical and Reductil, the slimming drugs, and
Propecia, for baldness.

The British Medical Association, the doctors' professional body, said
a system in which registered doctors were paid to give online
consultations was open to abuse and misdiagnosis. Paul Cundy, its
spokesman on computers and general practice, said: "Doctors are
operating blind. It's not possible to have an online 'consultation',
because you can't see, speak to or enter into a proper dialogue with a
patient. It is very dangerous."

Online consultations are legal because of a loophole in the Medicines
Act 1968. The act says many drugs can be dispensed only after a
patient has had a consultation with a doctor, but it does not lay down
that this should be face-to-face.

A report by Envision, a web analysis company, estimates there are
nearly 2,300 sites selling prescription-only drugs direct to the
consumer.

In the space of a week a reporter obtained £400 of prescription drugs
after falsely claiming to be overweight, balding and suffering from
impotence in "free" online consultations. These amounted to little
more than a medical checklist in which the patient agreed to waive
medical responsibility.

One company, Online Clinic (UK), supplied four 50mg Viagra tablets and
a month's stock of Xenical. Viagra has been linked to cardiac problems
while Xenical has possible side effects that include severe breathing
difficulties, nausea and vomiting.

In the past two years the company has dealt with more than 20,000
consultations. Robert MacKay, its director, said he acted responsibly
and provided a "vital service" for people too embarrassed to see their
GP.

But Steve Bloomfield, a spokesman for the Eating Disorders
Association, warned that online consultations enabled people with
bulimia and anorexia to obtain slimming drugs.

The prescriptions for the drugs obtained from Online Clinic (UK) were
made by Dr Julian Eden, who runs an online prescription company called
e-med. Eden also approved a prescription for Viagra placed with
another website called MyOnline Doctor. In a statement he insisted his
company followed guidelines set by the General Medical Council (GMC)
and the Medicines and Healthcare products Regulatory Agency.

Jane O'Brien, head of standards and ethics at the GMC, said it was a
"grey area". She said the council would investigate any evidence of a
doctor prescribing irresponsibly but stopped short of supporting a ban
on online consultations.

The GMC has taken action against four doctors since 2002 for
prescribing drugs over the internet without a proper consultation.

A Sunday Times reporter also obtained nearly £200 of drugs from a site
run by Menscare (UK). It is half-owned by Mark Groombridge, who was
jailed for 12 months for providing Viagra without prescription in
2002.

After an online consultation the company provided a month's supply of
Reductil, which suppresses appetite, for £120. The drug requires
regular monitoring by a doctor, and possible side effects include
liver and kidney damage and pulmonary hypertension. The company also
charged £70 for four tablets of Cialis, an anti-impotence drug that
can be effective for 36 hours. It can cause back pain and headaches.

Menscare repeatedly refused to tell the undercover reporter the name
of the doctor who approved the prescriptions, in contravention of GMC
guidelines, advising him instead to return the drugs to the pharmacy
if there were concerns.

But a spokesman said: "We do not offer addictive drugs or drugs of
abuse (sic) and so there is no reason for patients to be deceitful to
obtain the drugs we supply through a registered pharmacy. All doctors,
however, are vulnerable to lying patients and will tell you it happens
every day in face-to-face consultations in surgeries."

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