Viagra on the 'Net

Timothy B. McCall, M.D.

It used to be that if you wanted to get a prescription you had to visit the doctor.

But now, thanks to the Internet, a credit card is just about all you'll need. YOU CAN GET (to have) medication like the impotence drug Viagra, the weight loss pill Xenical or the baldness remedy Propecia prescribed to you without ever leaving the comfort of your keyboard. This may be a growth industry but Marketplace Medical Commentator Dr. Timothy McCall advises caution.

A couple of weeks ago I was--shall we say, propositioned--via email. It wasn't the usual spam offering a hot stock tip or nude pictures. This solicitation was from an online pharmacy that wanted me to become a one of those MDs who will, for a fee, approve prescriptions online for patients they've never met

"Pardon me for the random intrusion..." the email began. "I saw you on line under 'Physician' on AOL."

The letter promised that, "Doctors will make up to $12,500 per month for script approvals." Specifically, they'd pay me $20 each time I said yes. Of course, if I didn't think a drug was appropriate for a particular patient, I'd get nothing for my time.

Now normally, doctors receive no extra compensation for prescribing drugs. In fact, in many HMOs, doctors are penalized if they frequently give patients expensive pills like Viagra, Xenical and Propecia. But online docs who sign up for this deal know that the only way they're going to get paid is to be accommodating.

There are safeguards in a normal medical practice that decrease the likelihood of inappropriate prescribing. You know, things like actually laying eyes--and maybe even hands--on the patient. In real life, a guy who's 25 and wants to party "longer and harder" with Viagra can't get away with claiming he's a 60 year old diabetic with erectile dysfunction. But on the Internet he can.

Now don't get me wrong. I think online pharmacies are going to play a bigger and bigger role in coming years and present many advantages. The problem isn't Internet drugstores, it's prescribing by some doctor you'll never meet with God knows what level of competence who's only in it for the money.

Of course, there's never been any shortage of MDs willing to prostitute themselves by prescribing medication inappropriately -- from Valium to Quaaludes to Viagra. Just think of the mills that sprang up to supply the diet drug combo fen-phen once it was clear there was a buck to be made.

The Internet simply helps link willing patients and doctors like never before. Online prescribing—it’s the medical equivalent of an escort service.

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