Dr Phil Hammond, GP and broadcaster

Should you be able to get prescription only medicines from an online doctor? Your gut instinct, I would guess, is to say no. There are so many rip-off merchants around. How would you know whether your cyberdoc has any qualifications higher than keystage 2 biology?

I know of someone who shelled out £20 on imported “slimming soap that washes away fat in seconds,” recommended by a “top doc”. And thousands of men paid through the nose for a toffee-like hair restorer “that really works” before the Office of Fair Trading stepped in.

The strength of the internet is also its weakness. It allows you to seek out answers to questions you’re too embarrassed to ask your doctor, but it also means that people can make all sorts of claims without scrutiny.

There are now online ‘pharmacies’ supplying prescription only medicines without a prescription. This is, of course, illegal in the UK, but if you register the website in another country and post the drugs from there, you bypass UK law.

As a result, overseas companies are targeting the UK market with a range of products, no questions asked.

But what if prescription only medicines were dispensed online only after you’d filled in a questionnaire to be scrutinised by a genuine online doctor who dispenses a genuine prescription to a genuine pharmacy?

This approach is widely accepted in America and is now available in the UK.The theory is that online consultation is safe for repeat prescriptions for chronic conditions when the diagnosis has been established with a face to face consultation.

It helps if patients provide accurate information. Of course, we know that people skimp on the truth when they want something, especially a lifestyle drug, and it’s easier to tell porkies to a cyberdoc than one who’s got your notes to hand.

That said, patients have to take responsibility for their actions, and if you want to lie about your nitrates to get hold of sildenafil, you have to accept the risks.

I don’t have a particular problem with online consulting provided there are safety checks and quality controls.

Personally, I’d like to see large well established pharmacies taking on the mantle of online prescribing. Alas, most prefer to have us hanging round in their stores while a box of pills is put in a bag because it encourages us to spend more money on talc and shampoo.

But successful online chemists are finding that many punters, when forced to fork out a minimum delivery charge, are filling up their baskets.

Online prescribing is the future, and when done well and ethically it can save a lot of time and embarrassment all round. Is an online consultation really that far removed from the telephone consultations we do every day?

And is it any less safe than the tick-box repeat prescribing that many GPs are forced to do through lack of time? Answers on a postcard please.

Guidelines in Practice, August 2003, Volume 6(8)
© 2003 MGP Ltd
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