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Why Can’t North Carolina Residents Get Prescriptions Over the Internet?

Imagine this: You awake on a weekday morning to ready the kids for school and prepare for your workday. Yet, as you look in the mirror, you are greeted with what appears to be a nasty case of pink eye. You could schedule an appointment at the local clinic for later in the day or you could log onto your laptop and meet with a waiting physician via a telehealth video service to quickly receive a diagnosis and prescription before continuing your day.

Receiving prescriptions via telehealth services is becoming more commonplace in certain areas, but not in North Carolina. According to the North Carolina Medical Board’s policy, prescribing drugs to an individual a prescriber has not personally examined is inappropriate except under certain circumstances.

“As telemedicine becomes more widely practiced, health care practitioners must remember that they have an obligation to provide care that meets acceptable standards, regardless of how care is delivered. That is the Medical Board’s bottom line, expressed in its formal position statement on telemedicine,” says Janice Huff, president of the North Carolina Medical Board.

Yet, with the state boasting one of the world’s longest-running telemedicine programs at East Carolina University’s Telemedicine Center, some telemedicine advocates are left questioning whether the medical board’s policy should be updated to allow for low-risk drug prescribing via telehealth systems. The following are arguments from both sides of the issue.

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In Support of Telehealth Prescribing

In a recent high-profile case, state regulators gave a Wilmington psychiatrists’ group the green light to write prescriptions for patients after internet-based consultations, eliminating the need for in-person visits. While the decision was minor when weighed against North Carolina’s overall healthcare scene, telehealth advocates are hoping the case will pave the path toward future telemedicine shifts. Here are their arguments…

  • Better rural care – Advocates for allowing low-risk drug prescribing via the internet argue that the shift will allow for better patient care in rural areas where physicians are often limited. Rather than visiting a local clinic, patients could log into a telehealth video or phone service to receive a diagnosis and, possibly, a prescription from an in-city doctor.
  • Increased convenience – At the heart of many arguments for online medication prescribing is the increased convenience this practice offers physicians and their patients. Rather than traveling to a hospital or clinic, patients can quickly and efficiently receive diagnoses for their ailments. Telemedicine is also argued to relieve demands on medical facilities and pharmacies.
  • Better patient compliance – Patients who would otherwise put off receiving treatment for their medical issues are argued to be more compliant when receiving care via telehealth services. With the increased convenience of online prescribing, patients could be more likely to take the prescriptions they need.

A Case for Caution

While telemedicine is often praised for bringing innovation and convenience to North Carolina’s healthcare industry, opponents argue that opening the door for online medicine prescribing is a slippery slope. Here are a few top concerns being cited:

  • Technical difficulties – What happens if, in the middle of an online consultation, the connection between patient and physician is severed and can’t be re-established? Can a diagnosis still be made and medication prescribed despite low-quality video? Some argue that these and other technology questions must be answered to advance telemedicine in the best manner.
  • Increased risk of system abuse – Those who wish to limit the prescribing of medications online cite concern over the increased risk of medical system abuse by patients and practitioners. Prescription drug addicts will find a way to fulfill their addictions, argue opponents, and telehealth may provide easier access to those drugs.
  • Chance for misdiagnoses – A main reason for the policy in North Carolina of requiring in-person visits to prescribe medications is to lower the risk of misdiagnoses. Whether conducted via phone or online video, opponents argue that telehealth services leave the door wide open for medical mistakes.
  • Patient privacy – How secure are telehealth services? Worries regarding the safeguarding of patient privacy often surround the opposition to telemedicine.

 

Opinion clashes are waiting at each turn of the NC telemedicine discussion.

Opinion clashes are waiting at each turn of the NC telemedicine discussion.

From the possibility for better rural patient care to concerns regarding system abuse, clashes between the opinions of those advocates for and opponents of prescribing medications via telehealth in North Carolina remain strong. “It is clear to me that much more dialogue and time is needed to determine the best way forward for telemedicine in North Carolina,” explains Huff.

Don Amerman has spent more than three decades in the business of writing and editing. During the last 15 years, his focus has been on freelance writing. For almost all of his writing, He has done all of his own research, both online and off, including telephone and face-to-face interviews where possible. Don Amerman on Google+