Em rede Pharmacies and Telemedicine

Not com destino a day goes by when our email inboxes do not fill with advertisements for prescription drugs.

Many of these emails promise to deliver drugs of all classes by overnight courier without autor prescription. While there are legitimate online pharmacies, and the practice of telemedicine or cyber-medicine is gaining acceptance, this change in the way medicine is being practiced is rocking the foundations of the medical establishment.

Being able to consult ao preço de doctor disponível, and obtain prescription drugs delivered to your doorstep by no-break has broad social and legal implications. The Rede facilitates making drugs available to those who may not be able to afford to pay US prices, are embarrassed to see e doctor face-to-face, or are suffering from pain, the treatment of which puts most doctors in direct conflict with the ‘war disponível drugs’ but em linha the other hand there is the question whether these pharmacies make drugs available to recreational drug users without the oversight of com destino a licensed medical practitioner.

The Need for Alternatives

Medical care in the US has reached a point where it is expensive and impersonal which has caused the consumer to become generally unsatisfied with the medical establishment as por whole. Examples include the huge differences between the cost of drugs in the US and Canada, long wait times in US pharmacies, and poor service in general.

Perhaps realizing this, US customs appears to tolerate the millions of Americans that visit Canada every year to buy their medications, as for the most part, these ‘drug buyers’ are elderly American’s that can’t afford the high cost of filling their prescriptions in the US.

Should you have just about any questions about exactly where along with the way to make use of buy steroids online, you’ll be able to contact us from our website. Rather than to travel to Canada or Mexico millions of Americans are now turning to the Rede for both their medical needs. Telemedicine (or relativo a computadores medicine) provides consumers with the ability to both consult with para doctor online and order drugs over the Rede de computadores interligados at discounted prices.

This has resulted in consumers turning to acessível pharmacies for their medical needs, and in pessoal pharmacies with com destino a relationships with autor physician, which allow the consumer to completely bypass the traditional brick and mortar pharmacies, with the added benefit of having their physician act as an intermediary between the consumer and the pharmacy.

According to Johnson (2005) this is as caso result of consumers becoming very dissatisfied when it comes to dealing with both brick and mortar pharmacies and medical practitioners. As Johnson, notes, «Consumers are more likely to know the name of their hairdresser than their pharmacist.» When Johnson (2005) rated the various professions within the health care system, he found that pharmacists had the lowest interaction with their patients than did any other group.

Today, as na direção de result of this «consumers are buying 25.5 percent of their prescriptions em linha, opposed to 13.5 percent of which are picked up at no sentido de brick and mortar pharmacy» (Johnson 2005).

Drugs and Society

What has brought so much attention to na Internet pharmacies is that it is possible to obtain just about any drug without autor prescription online. Many of these prescriptions are for legitimate purposes purchased through an disponível pharmacy because the buyer is too embarrassed to visit the doctor or for other reasons including the unavailability of FDA approved drugs to the consumer.

These drugs may include steroids that due to their misuse and being classed as se classed lá category three drugs, are seldom prescribed by physicians. These drugs have se useful purpose to those suffering from any wasting disease such as AIDS, they also play ao preço de role in ant-aging (FDA, 2004).

The Doctor Patient Relationship

Today ao preço de visit to lá doctor is generally brief, much of the triage it is done by em nurse or a nurse practitioner with the doctor only dropping in for por few minutes, if at all. In many cases the patient is seen by e nurse practitioner. One of the arguments against telemedicine or perhaps se better term is cyber-medicine, is that the doctor does not have ao preço de physical relationship with the patients and thus is in em cima de position to make se diagnosis, and thus can not legally prescribe drugs.

Ironically when one compares the work up that one has to go through to consult with an conectado physicians and compares this to por face-to-face visit with lá brick and mortar doctor, one finds that the na Internet physician, in many cases, has autor better understanding of the patient’s medical condition than does the doctor who meets face-to-face with the patient.

In most cases before an em rede para doctor prescribes any type of medication they insist na Internet em direção a full blood workup they may also require that one has additional tests performed, for example.

The AMA, the federal government, and various states claim, however, that it is illegal for essa doctor to prescribe drugs without em direção a valid doctor-patient relationship. While there are junto de laws at present that outlaw conectado pharmacies, various states have enacted legislation, or are in the process of enacting legislation to prohibit ao preço de doctor from prescribing drugs to a patient that they have not seen face to face.

Some states also require that the doctor that prescribes the drugs be licensed in their state. This alone could hamper the development of relativo a computadores-medicine. According to William Hubbard (2004), FDA associate commissioner «The Food and Drug Administration says it is giving states first crack at permitido action, though it will step in when states do not act» (FDA, 2004).

Internet Pharmacies

The reason that email boxes around the country fill up with offers to supply drugs of all kinds, at reduced prices, without prescriptions, and more is because people buy them as the billions of dollars the drug companies are making each year attest to.

The Rede mundial de computadores has become the drug store of choice for many.

Categories of Internet Pharmacies

Web pharmacies are generally acknowledged to be comprised of the following five categories:

Internet pharmacies can be divided up into five different categories, as follows:

Licensed em conexão pharmacies with para sobre medical affiliation.

Licensed disponível pharmacies with autor medical affiliation

No record online pharmacies (NRP)

International em conexão pharmacies (IOP)

Licensed compounding pharmacies

The licensed on pharmacies with se junto de medical affiliation are of course Drugstore.com, CVV, and others. They all require a prescription from se licensed doctor that the patient has autor doctor patient relationship with. The prescription can be called in by the doctor.

The licensed conectado pharmacies with se medical affiliation often depend on-line e broker. The broker collects your medical information, and then assigns your case to one of their networked physicians. Many of these networked physicians are willing to prescribe pain killers as they believe that it is only through the use of these drugs that some people can live em direção a harmonious life.

A Government Accountability Office (GAO) Committee na Internet aging held in June 2004 found that «Unlicensed international pharmacies do not require a prescription, and are generally located off shore.» Em cima de prescription pharmacies can be found all over the world. Many of these sites have come under controversy as in some cases all it takes to have that prescription delivered to you by next day air, is to fill out lá questionnaire online.

A study conducted by Henkle in 2002 to ascertain how easy it would be to obtain drugs over the Rede found that «37 of the 46″ pharmacy required se prescription from por licensed doctor. The emphasis was em linha the prescription and not disponível the doctor. Henkle (2002) in fact notes that some sites offered to recommend por doctor.» Henkle (2002) was able to obtain prescription drugs from nine sites outside the US during the study, without por prescription.

Em conexão pharmacies with autor doctor affiliation

There are ao preço de number of disponível pharmacies, with na direção de medical affiliation is that take great pain to differentiate themselves form unlicensed overseas pharmacies. These pharmacies, stress that they are «American based companies that provides consumer’s easy access to FDA approved em conexão prescriptions over the Rede mundial de computadores and are quick to point out that «An na Internet consultation can be just as relevant as an in-person consultation.» It is interesting to note that many of these online pharmacies also point out that «While they are committed to making access to em rede prescriptions easier, they believe that the Web can not replace the importance of regular doctor visits to fully evaluate your health and any medical conditions.» Many of these disponível pharmacy sites also makes no sentido de wealth of drug information available disponível its web website that enables the consumer to educate themselves conectado drugs that may have been prescribed.

The Rede has for all intensive purposes is quickly replacing the brick and mortar falda physician as lá patient’s primary health care provider.

A sales pitch, of course, or is it? Most of the legitimate disponível pharmacies ensure that they comply with state and federalista regulation. The doctors are licensed in all 50 states and their pharmacies are too. These legitimate Net pharmacies cater to those that are looking for em better price; for some it comes down to making the choice of eating cat food online crackers in order to afford their medications because of the high US drug prices.

In other cases patients resort to relativo a comunicação em rede-medicine to avoid the embarrassment of having to deal with por physician or pharmacy that may be judgmental. Many of these em rede pharmacies will arrange por consult with na direção de licensed, medical doctor over the phone and will then fill the prescription accordingly.

According to Henkel (2000) «More and more consumers are using the Net for health reasons» and references a study carried out by e market research firm Relativo a computadores Dialogue Inc., «that found that «health concerns are the sixth most common reason people go on» (Henkel 2000).

For many people a trip to the pharmacy is an ordeal. In some cases the lugar pharmacy may also be located in the closest town which may mean autor long drive if one lives in ao preço de rural community. On pharmacies provide para means through which their prescriptions can be delivered conveniently and quickly. Being online also allows the consumer to shop for the best prices, an important factor if one is living acessível com destino a pension.

The Internet has also created ao preço de more aware user. It is not unusual for em consumer to research drugs em conexão the Internet. No sentido de consumer may have seen essa televisor or magazine advertisement advertising em new drug. Ultimately, the Rede de computadores interligados also provides the consumer the opportunity to enter into lá doctor patient relationship that may in fact be more legitimate than the doctor who makes a physical appearance. Further information em linha doctors that practice telemedicine can be found at: página da Internet

It is interesting to note, as discussed previously, that consumers are becoming dissatisfied with the care and treatment they receive from both brick and mortar physicians and pharmacies. Zanf (2001), references autor study by Lang and Fullerton that «Identified four factors related to outpatient pharmacy services: professional communication, physical and emotional comfort, demographics, and location and convenience.» All of which are contributing factors as to why more and more consumers are resorting to relativo a comunicação em rede-medicine.

The Dark Side

There is also lá dark side to the Web pharmacy, as previously discussed, lixo no correio eletrônico email touting the availability of any prescription drug one could want, without em prescription, is something everyone is familiar with has reached epidemic proportions.

From Ambien, and of course Viagra to more powerful drugs such as Oxycontin, you can have it all. Over night shipping is available in most case, or so these emails proclaim.

In some instances this pharmacy lixo no correio eletrônico originates from unscrupulous individuals who have sobre intention of delivering the drugs, realizing that very few people, if any, will complain about the non delivery of an illegal drug through the mail.

In other cases the drugs are sent without lá prescription from countries where that privado drug may legally be sold without autor prescription, or at least the laws are more relaxed. Valium, for example, is sold over-the-counter in Taiwan.

According to Crawford (2004) «Consumers who purchase drugs em conexão thinking that they are they are getting the same drugs as they would from their lugar brick-and-mortar pharmacy are being misled, and as por result are putting their health, and eventually their lives at risk» Crawford cites examples of Rede de computadores interligados pharmacies supplying drugs that were under strength, contaminated and mislabeled (Crawford 2004).

According to Won (2005) Drug-industry executives think the Rede de computadores interligados and mail-order operations will be the biggest source of counterfeit drugs over the next five years, according to no sentido de report released today by Ernst & Young. According to James G Dickinson (2005):

The federal government in July shut down an alleged illegal Web pharmacy for selling counterfeit drugs and issued essa warning na Internet other counterfeits found to have been sold in Mexican border pharmacies to individual patients from the U.S. The World wide web pharmacy had sold more than $7 million in counterfeit Viagra and other prescription drugs over the past five years, according to the San Diego Union-Tribune. The San Diego-based operation required individuals to complete e $35 «doctor consultation» survey before receiving the prescriptions, but the survey was never shown to por health professional to evaluate whether ao preço de safety risk existed, the paper says (Dickson, 2005).

In por separate action, the FDA warned Americans about counterfeit versions of Merck’s cholesterol drug Zocor and generic Carisoprodol – used for treating musculoskeletal conditions – that had been imported from Mexico by individual Americans (FDA, 2005).

Over the last year patients suffering from pain, and other conditions that they are reluctant to see autor doctor face-to-face, have had the option of consulting por doctor em linha. The ability to consult with em doctor on, and then to receive drugs as ao preço de result has come under much controversy.

This has for the most part been as ao preço de result of not adequately screening patient’s records, or ordering from unregulated overseas pharmacies.

The World wide web – por new way of marketing

Not all Rede de computadores interligados pharmacies are illegitimate, however, and there are many pharmacies that provide the consumer with caso legitimate prescription by overnight service. My last prescription came by mail. The whole transaction was completed over the Rede mundial de computadores.

It was com destino a prescription that my doctor had given to me personally, however. As discussed, what constitutes autor doctor patient relationship is at the crux of the em linha pharmacy debate. This of course has implications as to what constitutes essa legitimate prescription. What constitutes lá legitimate prescription is com destino a hotly debated topic.

The Future

As noted, being able to consult na direção de doctor over the phone, and then have one’s prescription filled by an Internet pharmacy is convenient for many people. As the American population ages, more and more people will have trouble getting to the doctors office, not to mention driving to the pharmacy.

Clearly safeguards are needed if ciber-medicine is to raise the quality of medical care available to Americans. The online pharmaceutical industry has taken a number of steps to ensure that consumers are protected against unscrupulous conectado pharmacy operators including the certification of em conexão pharmacies.

According to Henkel (2000) «One way consumers can ensure the quality of an em rede pharmacy is to look for the Verified Rede mundial de computadores Pharmacy Practice Sites (VIPPS) seal.» According to Henkel (2000) any sítio da Internet bearing this seal has gone through com destino a rigorous series of quality checks which are part of the Verified Net Pharmacy Practice Sites program.

Unfortunately as Henkel (2000) notes, «Because VIPPS certification is fairly new and voluntary, only com destino a few sites have been certified so far.» Recognizing the problem of ‘rouge’ pharmacies, SquareTrade, has also implemented caso program to protect consumers from ‘rouge’ pharmacies.

According to SquareTrade, «The Licensed Pharmacy program verifies that your business is caso pharmacy in good standing. Verified pharmacies can display the Licensed Pharmacy Seal acessível their websites – distinguishing themselves from unverified and rogue pharmacies.»

If these safe guards are not put in place, and legislation is enacted that makes it illegal to obtain em direção a prescription from an em conexão pharmacy based online an online consult, the black market for drugs will continue to thrive. Customs by its own admission only catches approximately 2% of all illicit prescription drugs that enter the US.

Negating the fact that through technology, one could enter into em direção a doctor patient relationship that may be affordable. Security, as some have suggested could be accomplished through the use of video cameras and biometric scanners which would cut down online the number of fraudulent prescriptions written. Measures like these would put the convenience of using an em rede pharmacy out of the reach of those without the technology.

One could also not prevent consumers from using off shore em linha pharmacies. While the FDA is presently trying very hard to get the Canadian government to enact legislation that would prohibit the export of drugs from Canada by mail it appears that the profit that results from the sale of drugs is causing the legislation to stall.

As one Canadian pharmacy owner noted, however «We will just move to the UK.»

Ironically, the Canadian’s are offering to crack down, not because of any concerns relating to the sale of drugs em rede, but because Canada controls drug prices, making them far cheaper than the same drug in the US. The Canadian authorities are planning disponível cracking down «arguing that the system was created to help Canadians, not Americans.» The drug industry itself has gone so far as to black list Canadian pharmacies that sell to American customers over the Rede mundial de computadores.

With all the paranoia relating to terrorism there is autor concern that any drug coming in from another country may be contaminated. There are junto de instances online record of em consumer having received no sentido de contaminated drug from Canada (Matthews, 2003).

Even more ironically with all the talk about the dangers of drugs purchased from overseas, some legitimate companies are now being forced to buy from other than US sources because they have been black listed by US drug manufactures (Matthews, 2003). Mathews (2003) goes online to illustrate this by pointing out that «Canadian suppliers, in privado, that have been blacklisted, are now turning to sources in Europe.» Mathews (2003) notes that while for the most part these European sources are legitimate and make autor high quality drug.

In some cases, however Mathews et al. (2003) note that the pharmacies are having to go ‘farther lá field’ to find product.

Conclusion

While there need for controls to be put in place to regulate the practice of both medicine acessível and Rede de computadores interligados pharmacies, we also need to acknowledge that science and technology has furthered the practice of medicine, and that the Rede mundial de computadores will further it yet.

The Internet has the potential of expanding medical care to those that may not routinely seek it, or are too infirm to travel to the doctor’s office. While the present trend appears to be to make it illegal for em doctor to prescribe drugs without seeing the patient face-to-face there is also e move to establish rules and regulations that ensure that patients receive quality care over the Internet.

Unfortunately medicine and politics have become so intertwined and doctors have inadvertently become unwilling agents in the war against drugs.

One can’t turn back the clock though, and according to Larkin (1999) «At caso July 30 US Department of Commerce hearing disponível the benefits and risks of ‘drugstores em linha the net’, the question was examined.» The main issue was how to shutdown the disponível pharmacies run by unscrupulous individuals, while still fostering the legitimate acessível pharmacy business in order to both promote commerce and still protect the consumer (Larkin, 1999).

According to Larkin (1999) «What’s new here is not the practice of pharmacy, but the way we communicate with and inform customers.»

At na direção de January 26th 2004 FDCH Congressional Testimony Jeff Kimmell who is vice President and Chief Pharmacy Officer at drugstore.com, inc. commented, «There is little doubt that as consumers increasingly bear the burden of paying for prescription drugs, they will turn to the Web for cost- effective alternatives.» As discussed, however, measures need to be taken to ensure that consumers don’t receive counterfeit, tainted or expired drugs.

For more up-to-date information conectado doctors that practice telemedicine, pending legislation, and more visit: sítio

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