Surgeon Dr. Kevin C. Petersen noticed a disturbing trend among the low income and uninsured patients he examined prior to providing reduced-cost operations in Nevada: about one-third of them suffered from hypertension.
He tried a variety of tactics to protect these patients from future heart attack and stroke, including counseling, urging them to contact a doctor at home and even prescribing blood pressure medication for three months and explaining that they'd need to see another doctor to get it refilled. In every scenario, Petersen found that "100 percent of them" weren't going see a physician for blood pressure treatment, generally due to the high cost of visits.
Eventually, the Las Vegas doctor sought to help address the national issue the Institute of Medicine calls a neglected disease of epidemic proportions by launching BPClinic.com, through which he provides patients a three-month blood pressure prescription that includes online and phone consultations with patients for a $50 fee. According to Nevada authorities, however, the practice of prescribing medications to patients he has not examined in person is against the law.
Petersen contends that he's on the right side of state statute NRS 453.3643, which he interprets to apply only to controlled substances such as prescriptions for addictive drugs for pain and to doctors prescribing medications through illegal Internet pharmacies.
In the other corner, Carolyn Cramer, general counsel of the Nevada State Board of Pharmacy, points out that the law also specifically states: "A practitioner who is located within this state shall not prescribe a prescription drug for another person located within or outside this state if: (a) The practitioner has not physically examined the other person within the 6 months preceding the date on which the prescription is issued."
It could be possible for Petersen to get a telemedicine license, where doctor and patient can see each other through Internet video, according to Douglas Cooper, executive director of the Nevada State Medical Board. But, he said, the doctor must have another medical practitioner at the other end with the patient. He acknowledged that the cost would defeat Petersen's idea of giving low-cost blood pressure treatment. "I have a certain amount of admiration for this doctor," Cooper said. "But there are definite risks in not examining a patient. It's definitely not the standard of care."
Under state law, if a patient suffers substantial bodily harm or dies as a result of a drug prescribed by a doctor who didn't examine him, the physician could face up to 15 years in prison and a $100,000 fine. Even without a patient suffering an adverse event, the doctor can lose his license to practice medicine for violating state statutes.
Petersen told the Las Vegas Review-Journal that he plans to continue BPClinic.com until authorities shut him down.
To learn more:
- read the article in the Las Vegas Review-Journal