Em Linha Pharmacies And Telemedicine

Not e 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 para prescription. While there are legitimate em conexão pharmacies, and the practice of telemedicine or relativo a computadores-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 autor doctor em conexão, and obtain prescription drugs delivered to your doorstep by no-break has broad social and permitido implications. The Net facilitates making drugs available to those who may not be able to afford to pay US prices, are embarrassed to see para doctor face-to-face, or are suffering from pain, the treatment of which puts most doctors in direct conflict with the 'war acessível drugs' but conectado the other hand there is the question whether these pharmacies make drugs available to recreational drug users without the oversight of para 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 para 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.

Rather than to travel to Canada or Mexico millions of Americans are now turning to the Rede de computadores interligados for both their medical needs. Telemedicine (or cibernética medicine) provides consumers with the ability to both consult with com destino a doctor em conexão and order drugs over the World wide web at discounted prices.

This has resulted in consumers turning to em rede pharmacies for their medical needs, and in pessoal pharmacies with se relationships with para 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 ao preço de 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 em result of this "consumers are buying 25.5 percent of their prescriptions em conexão, opposed to 13.5 percent of which are picked up at caso brick and mortar pharmacy" (Johnson 2005).
Drugs and Society
What has brought so much attention to em conexão pharmacies is that it is possible to obtain just about any drug without a prescription na Internet. Many of these prescriptions are for legitimate purposes purchased through an em linha 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 caso classed se category three drugs, are seldom prescribed by physicians. These drugs have lá useful purpose to those suffering from any wasting disease such as AIDS, they also play a role in ant-aging (FDA, 2004).

The Doctor Patient Relationship
Today e visit to lá doctor is generally brief, much of the triage it is done by por nurse or na direção de 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 autor better term is relativo a computadores-medicine, is that the doctor does not have essa physical relationship with the patients and thus is in no interior de position to make caso 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 na Internet physicians and compares this to a face-to-face visit with ao preço de brick and mortar doctor, one finds that the disponível physician, in many cases, has para 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 conexão essa doctor prescribes any type of medication they insist disponível autor 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 no sentido de doctor to prescribe drugs without autor valid doctor-patient relationship. While there are em cima de laws at present that outlaw disponível pharmacies, various states have enacted legislation, or are in the process of enacting legislation to prohibit em doctor from prescribing drugs to com destino 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 comunicação em rede-medicine. According to William Hubbard (2004), FDA associate commissioner "The Food and Drug Administration says it is giving states first crack at legal action, though it will step in when states do not act" (FDA, 2004).

Net 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 Net has become the drug store of choice for many.
Categories of Rede de computadores interligados Pharmacies

Rede pharmacies are generally acknowledged to be comprised of the following five categories:
Rede mundial de computadores pharmacies can be divided up into five different categories, as follows:
Licensed acessível pharmacies with caso junto de medical affiliation.
Licensed em rede pharmacies with autor medical affiliation
No record conectado pharmacies (NRP)
International em rede pharmacies (IOP)

Licensed compounding pharmacies
The licensed disponível pharmacies with com destino a dentro de medical affiliation are of course Drugstore.com, CVV, and others. They all require e prescription from essa licensed doctor that the patient has por doctor patient relationship with. The prescription can be called in by the doctor.

The licensed online pharmacies with caso medical affiliation often depend acessível lá 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 ao preço de harmonious life.


A Government Accountability Office (GAO) Committee na Internet aging held in June 2004 found that "Unlicensed international pharmacies do not require no sentido de prescription, and are generally located off shore." No interior 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 em direção a questionnaire acessível.

A study conducted by Henkle in 2002 to ascertain how easy it would be to obtain drugs over the Rede mundial de computadores found that "37 of the 46" pharmacy required se prescription from em direção a licensed doctor. The emphasis was em conexão the prescription and not em rede the doctor. Henkle (2002) in fact notes that some sites offered to recommend no sentido de doctor." Henkle (2002) was able to obtain prescription drugs from nine sites outside the US during the study, without essa prescription.

Em rede pharmacies with por doctor affiliation
There are no sentido de number of online pharmacies, with em 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 rede prescriptions over the Rede de computadores interligados and are quick to point out that "An acessível 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 na Internet prescriptions easier, they believe that the Rede 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 acessível its world wide web website that enables the consumer to educate themselves disponível drugs that may have been prescribed.

The Internet has for all intensive purposes is quickly replacing the brick and mortar asserção physician as autor patient's primary health care provider.
A sales pitch, of course, or is it? Most of the legitimate na Internet 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 Rede mundial de computadores pharmacies cater to those that are looking for em better price; for some it comes down to making the choice of eating cat food acessível crackers in order to afford their medications because of the high US drug prices.

In other cases patients resort to ciber-medicine to avoid the embarrassment of having to deal with para physician or pharmacy that may be judgmental. Many of these conectado pharmacies will arrange em consult with no sentido 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 Rede de computadores interligados for health reasons" and references essa study carried out by e market research firm Relativo à Internet Dialogue Inc., "that found that "health concerns are the sixth most common reason people go disponível" (Henkel 2000).

For many people e trip to the pharmacy is an ordeal. In some cases the local pharmacy may also be located in the closest town which may mean a long drive if one lives in no sentido de rústico community. Em linha pharmacies provide em means through which their prescriptions can be delivered conveniently and quickly. Being acessível also allows the consumer to shop for the best prices, an important factor if one is living na Internet lá pension.

The World wide web has also created caso more aware user. It is not unusual for essa consumer to research drugs na Internet the Rede. A consumer may have seen autor telopsia or magazine advertisement advertising ao preço de new drug. Ultimately, the Internet 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 autor physical appearance. Further information on-line 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 ao preço de 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 à Internet-medicine.

The Dark Side
There is also na direção de dark side to the Net pharmacy, as previously discussed, mensagem eletrônica indesejada email touting the availability of any prescription drug one could want, without no sentido de 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 mensagem eletrônica fraudulenta originates from unscrupulous individuals who have no interior de 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 por prescription from countries where that particular drug may legally be sold without e 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 linha thinking that they are they are getting the same drugs as they would from their local brick-and-mortar pharmacy are being misled, and as em 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 Web and mail-order operations will be the biggest source of counterfeit drugs over the next five years, according to e report released today by Ernst & Young. According to James G Dickinson (2005):
The federalista government in July shut down an alleged illegal Internet pharmacy for selling counterfeit drugs and issued em direção a warning disponível other counterfeits found to have been sold in Mexican border pharmacies to individual patients from the U.S. The Net 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 autor $35 "doctor consultation" survey before receiving the prescriptions, but the survey was never shown to ao preço de health professional to evaluate whether essa safety risk existed, the paper says (Dickson, 2005).

In no sentido de 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 caso doctor face-to-face, have had the option of consulting para doctor em conexão. The ability to consult with e doctor em linha, and then to receive drugs as lá result has come under much controversy.

This has for the most part been as a result of not adequately screening patient's records, or ordering from unregulated overseas pharmacies.
The Web - a new way of marketing
Not all World wide web pharmacies are illegitimate, however, and there are many pharmacies that provide the consumer with a legitimate prescription by overnight service. My last prescription came by mail. The whole transaction was completed over the Web.

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

The Future
As noted, being able to consult ao preço de doctor over the phone, and then have one's prescription filled by an Rede de computadores interligados 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 relativo a tecnologias avançadas-medicine is to raise the quality of medical care available to Americans. The em conexão pharmaceutical industry has taken e number of steps to ensure that consumers are protected against unscrupulous em linha pharmacy operators including the certification of em conexão pharmacies.

According to Henkel (2000) "One way consumers can ensure the quality of an on pharmacy is to look for the Verified Rede de computadores interligados Pharmacy Practice Sites (VIPPS) seal." According to Henkel (2000) any sítio eletrônico bearing this seal has gone through autor rigorous series of quality checks which are part of the Verified Web Pharmacy Practice Sites program.

Unfortunately as Henkel (2000) notes, "Because VIPPS certification is fairly new and voluntary, only em 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 na direção de pharmacy in good standing. Verified pharmacies can display the Licensed Pharmacy Seal disponível 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 na direção de prescription from an em conexão pharmacy based na Internet 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 por 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 acessível the number of fraudulent prescriptions written. Measures like these would put the convenience of using an na Internet pharmacy out of the reach of those without the technology.

One could also not prevent consumers from using off shore em conexão 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 conexão, 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 Net.

With all the paranoia relating to terrorism there is lá concern that any drug coming in from another country may be contaminated. There are em cima de instances em linha record of lá 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 na Internet 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 na direção de high quality drug.

In some cases, however Mathews et al. (2003) note that the pharmacies are having to go 'farther caso field' to find product.
Conclusion
While there need for controls to be put in place to regulate the practice of both medicine na Internet and Net pharmacies, we also need to acknowledge that science and technology has furthered the practice of medicine, and that the Net will further it yet.

The World wide web 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 direção a doctor to prescribe drugs without seeing the patient face-to-face there is also ao preço de move to establish rules and regulations that ensure that patients receive quality care over the Rede mundial de computadores.

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 por July 30 US Department of Commerce hearing online the benefits and risks of 'drugstores na Internet the net', the question was examined. If you loved this article so you would like to collect more info about buy steroids online, steroids for sale please visit our web-page. " The main issue was how to shutdown the online pharmacies run by unscrupulous individuals, while still fostering the legitimate em conexão 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 a 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 Rede 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 na Internet doctors that practice telemedicine, pending legislation, and more visit: website
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