STATE BOARD CITES DOCTOR IN ONLINE DRUG CASE

A Dublin doctor who was the first Ohio physician criminally charged with
prescribing dangerous drugs over the Internet has been told by the State
Medical Board that he could lose his license.

Dr. Daniel L. Thompson, a family-practice physician, was indicted in July
for prescribing diet, smoking-cessation, hair-loss and impotence drugs
online without meeting patients in person.

In a citation mailed to Thompson yesterday, the medical board told the
44-year-old doctor that he committed a felony by trafficking in drugs over
the Internet and said he failed to meet minimal standards of care.

The citation says that Thompson, who practices family medicine at 6400
Riverside Dr., Building E, in Dublin, sold so-called "embarrassment drugs''
over the Internet to at least 26 patients.

Max Kravitz, Thompson's attorney, said his client has not engaged in any
medical consultation or prescribed any medication via the Internet since
new medical-board regulations took effect Oct. 1.

The regulations prohibit a physician from prescribing or dispensing any
controlled substance or dangerous drug to a person whom a physician has not
personally physically examined and diagnosed.

"He is in complete compliance with whatever regulations went into effect
Oct. 1,'' Kravitz said. "I guess that is not good enough for them.''

Kravitz said he has not seen a copy of the citation but says the board is
trying to punish Thompson unfairly.

"If you have a problem, you should enact a rule,'' Kravitz said. "It seems
they want to apply the regulation retroactively to conduct that occurred
prior to the regulation going into effect.''

The medical board said other doctors -- including a Toledo pediatrician who
had sex with some of his patients' mothers -- have tried that defense.

"If he (Thompson) takes that weak argument, he's in for trouble,'' said Tom
Dilling, the board's government-affairs director. "This is a blatant
violation of the standard care of medicine.

"This guy was not practicing medicine. He was giving out drugs.''

In June, Kansas pharmacy and medical board authorities sued Thompson to
stop his Internet medical practice in that state. He also was investigated
in Virginia and Illinois, authorities said.

On July 9, a Franklin County grand jury indicted Thompson on 64 counts of
selling dangerous drugs and drug trafficking, fourth- and fifth-degree
felonies, respectively.

A week later, Thompson pleaded not guilty in Franklin County Common Pleas
Court and was released on his own recognizance.

His case is expected to go to trial in the spring.

Yesterday, the Medical Board said Thompson prescribed the diet drugs
phentermine and Meridia to patients without examinations, follow-ups or
correctly determining their body-mass index, a measure of obesity.

Ohio law states that patients must have a body-mass index of at least 30,
or 27 with other medical problems, before being prescribed the drug, and
that physicians must determine whether patients have made a "good-faith
effort'' to lose weight.

Physicians must weigh their patients every 30 days to determine whether
they are losing weight.

The board also said that Thompson prescribed the impotence drug Viagra to
patients without conducting physical exams, evaluating their conditions
before providing the drugs, or conducting follow-up exams.

It also said he prescribed the smoking-cessation drug Zyban to a patient
without examination, and the hair-loss drug Propecia without examining
another patient.

The Franklin County prosecutor's office said Thompson's Web site,
www.get-it-on.com, generated about $170,000 in gross sales of drugs from
September 1998 through January 1999. In March, Thompson suspended
operations.

Kravitz said he did not expect the medical board to take administrative
action against Thompson until after the criminal case in Franklin County
was resolved.

"I'm a little surprised by the timing,'' he said.

Kravitz said Thompson's legal troubles in other states are pending.

"But right now, he is not doing anything over the Internet anywhere,'' he
said.

Just how many Internet pharmacies are selling drugs online is unknown, but
at least nine state medical boards -- in Ohio, California, Illinois,
Kansas, Nevada, Texas, Washington, Wisconsin and Wyoming -- were
investigating or disciplining doctors for prescribing to patients they
never see.

Selling prescription drugs via the Internet is a burgeoning business.
Online pharmacies are full of drugs and skirt the hassles of visiting
doctors.

In most Internet pharmacies, customers log onto Web sites, fill out medical
waivers against lawsuits for side effects, complete consultation forms and
wait for approval.

Once they are approved, customers pay by credit card for the drugs, which
usually are shipped overnight. Though the drugs typically are sold at
retail prices, consultation fees can be as much as $75 per prescription.

The National Association of Boards of Pharmacies, however, estimated about
200 online pharmacies are dispensing, but not prescribing drugs. Most of
these sites require patients to fax drug prescriptions before drugs are
sent.

The association said the number of online pharmacies that prescribe drugs
"far exceeds'' the number that simply dispense drugs.

The American Medical Association's Council on Ethical and Judicial Affairs
is discussing online prescribing, and the Federation of State Medical
Boards created a special committee to come up with Internet practice
standards.

The State Medical Board likely will hold hearings concerning Thompson in
the summer. The board could do nothing, suspend his license or revoke it.