Internet Prescribing Policy

At the December 8-11, 1999 Board meeting the Board established the following policy regarding internet prescribing:

Section 164.053 [of the Texas Occupations Code] authorizes the Board to discipline a licensed Texas physician for unprofessional conduct that is likely to deceive or defraud the public or injure the public. Section 3.08(4)(E) defines unprofessional or dishonorable conduct to include "prescribing or administering a drug or treatment that is nontherapeutic in nature or nontherapeutic in the manner the drug or treatment is administered or prescribed." Section 164.053 (a) (6) (A) defines unprofessional or dishonorable conduct to include prescribing, administering or dispensing in a manner not consistent with public health and welfare dangerous drugs as defined by Chapter 483, Health & Safety Code.

Section 3.08(18) authorizes the board to discipline a licensed Texas physician for professional failure to practice medicine in an acceptable manner consistent with public health and welfare.

It is unprofessional conduct for a physician to initially prescribe any dangerous drugs or controlled substances without first establishing a proper physician-patient relationship. A proper relationship, at a minimum, requires:

(1) verifying that the person requesting the medication is in fact who they claim to be;

(2) establishing a diagnosis through the use of accepted medical practices such as a patient history, mental status exam, physical examination and appropriate diagnostic and laboratory testing;

(3) discussing with the patient the diagnosis and the evidence for it, the risks and benefits of various treatment options; and

(4) insuring availability of the physician or coverage for the patient for appropriate follow-up care.

An online or telephonic evaluation by questionnaire is inadequate.