Doctors Go Dot.Com:    page 2

CyberDocs.com goes all the way. For $50 to $75, you can schedule virtual appointments with doctors, exchanging information through keyboard chats or videoconferencing. The site, which has its own malpractice insurance, is intended for "minor" medical problems. Besides offering diagnoses and treatment recommendations, doctors will actually prescribe medications for common problems, such as allergies and high blood pressure.

These practices are, not surprisingly, controversial. CyberDocs CEO Dr. Tom Caffrey argues that certain medical practices can be performed more efficiently in cyberspace than in person. "Most of what a doctor does is talk to a patient," he says. But other experts insist that good care requires direct personal contact. "In five or 10 minutes face to face I can find out more about you than I can in an hour on the computer," says Dr. Thomas Reardon, president of the American Medical Association.

They may both be right. An online consultation is probably fine if you've got a question about your chronic insomnia, but it's a terrible idea if your child suddenly develops a high fever. If you're thinking of scheduling a session of your own, keep in mind that the person you talk to may not specialize in your condition. Check out the doctor's credentials (they should be posted), and if you have the slightest uncertainty about a recommendation, double-check it with a practitioner who knows you.

As you explore these sites you're sure to stumble into a pharmacy. Prescribing medications online can offer great convenience—but it's considered the true Wild West of the Web. Sites like drugstore.com and PlanetRx.com allow patients to fill prescriptions online that can be sent directly to their homes. But some other online "pharmacies," which now number in the hundreds, according to some estimates, prescribe Viagra and weight-loss drugs with virtually no screening or doctor consultation. In a complaint filed with the Federal Trade Commission, one woman reported that her teenage son bought Viagra online. And his young age was only part of the problem; the boy also had bipolar disorder and was taking blood-pressure medication at the time.

Now state and federal regulators are beginning to crack down. Last month a grand jury in Ohio indicted a local doctor for dispensing such drugs as Viagra and Propecia (for baldness) without an "appropriate medical consultation." (The doctor asserts he violated no laws.) Congress is considering legislation to regulate the practice, and the National Association of Boards of Pharmacy is planning to award a seal of approval to sites that meet strict criteria, not least of which is a license to practice. For now, it's up to patients to be careful. The best way to stay safe is to use the Internet solely for filling prescriptions written by your own flesh-and-blood doctor. Avoid using online pharmacies that don't provide contact information for their pharmacists. And keep in mind that overseas pharmacies may offer drugs not tested or approved in the United States.

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