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Date Posted: 23:34:47 12/17/03 Wed
Author: Billy
Subject: Physicians risk their licenses with online patients
In reply to: Billy 's message, "Online drugs a health risk, officials warn" on 03:29:51 12/16/03 Tue

Physicians risk their licenses with online patients
By Pete Alfano
Star-Telegram Staff Writer

Ranvir Ahlawat sounded surprised when I identified myself as one of his patients.

That's because Ahlawat and I have never met or had a previous telephone conversation. We have never even exchanged e-mails.

Ahlawat lives in Tom's River, N.J.; I live in Texas.

Ahlawat is a doctor licensed by the state of North Carolina less than a year ago. He was the prescribing physician when the Star-Telegram purchased the narcotic pain reliever Ultracet from www.vicodin.com-online.us. According to the prescription label, Universal Pharmacy Solutions in Huntingdon Valley, Pa., filled the order.

I had to complete an online questionnaire, which was then ostensibly reviewed by Ahlawat.

When I phoned Ahlawat, I asked whether he knew that he might be risking his license because he was writing prescriptions based on questionnaires for patients he never saw.

"I wasn't aware that there are specific regulations that require me not to do that kind of consultation," Ahlawat said.

He then quickly ended the conversation, politely declining to answer any other questions.

"I don't want to say anything more on the phone," Ahlawat said.

State laws

Most states, among them Pennsylvania, allow out-of-state doctors to write prescriptions. But the practice is not intended to facilitate Internet prescription drug transactions.

It is for special circumstances, said Carmen Catizone, executive director of the National Association of Boards of Pharmacy.

For example, if you live in Texas and forget your prescription medication when you visit your relatives in Pennsylvania for the holidays, a Pennsylvania pharmacy could fill your prescription.

But your doctor would have to verify that you are a patient and fax a prescription.

Doctors risk losing their licenses when they prescribe drugs for patients they have never seen. Federal and state laws require a doctor-patient relationship to include a face-to-face meeting and physical exam.

But for some, the chance to pad their bank accounts is an enticement too good to ignore.

Web site operators solicit physicians to approve Internet prescriptions. The operators tell doctors they could earn thousands of dollars a month if they review patient questionnaires and sign their names.

An article in a North Carolina medical board newsletter in 1999 noted that Web sites promised doctors up to $12,500 monthly for writing electronic scripts. It would take only a few minutes to review each questionnaire, the article said.

Four years later, the price has no doubt risen considerably. According to the Texas State Board of Medical Examiners, Dr. Robert C. Ogle of Rockwall made about $250,000 writing online prescriptions over a seven-month period. Ogle was caught because painkillers he prescribed for a California teen-ager, who lied about his age, resulted in the teen's death.

Dale Breaden, director of public affairs for the state medical board in North Carolina, said no one had alerted the board that Ahlawat, who received his license Dec. 19, was approving online prescriptions. But if he is writing prescriptions for Web sites based on questionnaires, he would be violating state law, Breaden said.

"It's not appropriate or professional," he said.

Although Breaden would not comment further, Ahlawat should not be surprised if he receives a phone call from the North Carolina Medical Board. It has taken action against five physicians who have approved Internet prescription orders in the past.

Authorities are also interested in Michael J. Millette, listed as the prescribing physician for a Prozac order placed by the Star-Telegram on www.OnlinePharmacy and filled by EZ Rx, a licensed pharmacy in Union, N.J.

The New Jersey Division of Consumer Affairs said there is no physician named Michael J. Millette licensed in that state.

According to New Jersey law, physicians are required to examine a patient before writing a prescription, said Jeff Lamm of consumer affairs.

"I can't say what will transpire," Lamm said of EZ Rx and Millette. "But in the past, we have taken action when state law is not followed."

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  • Easy access to powerful drugs is becoming increasingly deadly -- Jolly, 09:42:48 12/20/03 Sat
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