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Telemedicine

How To Get A Telemedicine Prescription

Dr. Joe Pazona

Sometimes all you need is a quick prescription. You know what’s going on, because you know your body better than anyone else. Or maybe you’ve run out of refills of a medication you’ve been on for years and it’s time for your doctor to authorize another batch.

Why then, is it so darn difficult to get a hold of your doctor? Why does our broken healthcare system require you to make 15 phone calls just to be told by some rude staff member, “the doctor requires you to come into the office for a visit to receive a prescription.” Ugh. There has to be a better way.

There is a better way. Telemedicine. Remote access to a licensed provider who can send a telemedicine prescription to your pharmacy. Telemedicine removes many of the barriers of getting a prescription from your doctor by allowing:‍

  • Easy access
  • No wait times
  • No travel
  • Lower cost

 

But, maybe you’re new to telemedicine prescriptions and have some questions such as:

  1. What medications can telemedicine prescribe?
  2. What drugs cannot be prescribed online?
  3. Can telemedicine doctors prescribe antibiotics?
  4. Are there online doctors that prescribe controlled substances?

At VirtuCare we are urology experts who also have expertise in telemedicine prescriptions. Let us guide you through some of the medical and legal hurdles that we face when prescribing medications via telemedicine. This way you can decide if a telemedicine visit is right for you!

How does telemedicine for prescriptions work?

Think of telemedicine as a virtual visit. Essentially, the only difference between telemedicine and an in-person visit, is you’re not physically in the same room as the doctor. Instead you’re having a live audio-visual visit via a secure telemedicine platform.

Once your doctor obtains a relevant medical history, he or she can perform a video exam if necessary, and then prescribe appropriate medications (with some caveats as we’ll get to later on). The doctor will then e-prescribe or call in the medication to your pharmacy. You go pick up the prescription and voila! You just received a telemedicine prescription.

This is at least how we function at VirtuCare, however there are alternative telemedicine prescription models. Some digital pharmacies like Roman, hims and GoodRx will in some cases use a secure messaging platform to “establish a doctor/patient relationship.” This makes getting a telemedicine prescription even easier. Since these platforms are also pharmacies, they will ship you their branded medications to your home.

State laws determine where and when a secure chat with a doctor constitutes the establishment of a patient/physician relationship. Some states require an in-person or live video visit before telemedicine prescriptions can be sent.  At VirtuCare, we feel it’s important for the doctor and patient to meet face-to-face, at least virtually. This allows our telemedicine doctors to obtain a more thorough history and answer any questions.

What medications can telemedicine prescribe?

The type of medications that can be prescribed with telemedicine varies by service, doctor and state. There are legal restraints which we will address shortly. But, there’s also the comfort level of the doctor. It’s not that we’re trying to be difficult. Practicing medicine is complex. There may be some nuances and unintended negative consequences to telemedicine prescriptions that you may not appreciate.

That being said, you shouldn’t have any trouble finding a new telemedicine prescription for the following medical conditions:

  • Acne
  • Erectile dysfunction
  • Hair loss
  • Premature ejaculation
  • Birth control
  • Herpes
  • Weight loss medications

You also have options If you’re on a chronic medication and looking for refills:‍

  • High cholesterol
  • Hypertension (high blood pressure)
  • Thyroid medication
  • GERD (acid reflux)
  • Diabetes (some medications)
  • Anxiety or depression

As experts in telemedicine urology, VirtuCare doctors can prescribe medications for:‍

  • UTIs
  • Erectile dysfunction
  • Premature ejaculation
  • Overactive bladder
  • Enlarged prostate (BPH)
  • Kidney stone pain (non-narcotics)

Every telemedicine service is different so it’s important that you research each one carefully before deciding on a visit. You don’t want to head into a telemedicine visit expecting (or demanding) a medication, only to find out that the provider is not permitted to write the telemedicine prescription you were hoping to receive.

What drugs cannot be prescribed online?

There are a number of medications that you may have trouble receiving via a telemedicine prescription. This may be due to a variety of reasons including:

  • Cost
  • Requires intravenous administration
  • High risk medications requiring close monitoring of drug levels (e.g. transplant medications)
  • High risk medical condition making a prescription potentially dangerous
  • Uncommon medication requiring specialist care
  • Potential for abuse
  • Prohibited by state or federal law

The most commonly asked about medications are controlled substances. Controlled substances are medications that have some potential for abuse, addiction and harm to the person or others. As a result, these medications are tightly regulated and may not be eligible for a telemedicine prescription. Some examples include:

  • Narcotics (codeine, oxycodone, hydrocodone, morphine)
  • Stimulants (amphetamines like Adderall®)
  • Benzodiazepines (Xanax®, Valium®)
  • Anabolic steroids (testosterone)

Most national telemedicine companies have policies forbidding telemedicine prescriptions for controlled substances as well. So don’t expect to dial up Teladoc and get some Adderall® or Vicodin®.

Speaking from personal experience as a practicing physician, unless we’ve already established an in person relationship, I would not feel comfortable writing a telemedicine prescription for controlled substances either. I would suspect most of my colleagues outside of behavioral health feel the same way. There’s too much liability and risk for abuse. You may have a legitimate medical indication for a narcotic but there are too many bad apples abusing the system. Sorry.

Are there online doctors that prescribe controlled substances?

In 2008 Congress passed the Ryan Haight Act to limit the ability of providers to order telemedicine prescriptions of controlled substances after the 18 year old namesake died from a hydrocodone overdose. During the COVID-19 pandemic, the rules surrounding telemedicine prescriptions of controlled substances have loosened. A telemedicine prescription can be issued IF:‍

Despite these changes, you’ll likely still struggle to find an online doctor that prescribes controlled substances. You may have some luck if you are looking for care with a telemedicine psychiatrist for conditions like anxiety, substance abuse and ADHD. Otherwise, don’t expect to get a telemedicine prescription of oxycodone for your chronic back pain.

Can telemedicine doctors prescribe antibiotics?

Yes. You can get a telemedicine prescription for antibiotics. Antibiotics may be prescribed for the following infections due to BACTERIA (remember antibiotics don’t treat viruses!):‍

  • Urinary tract infections (UTIs)
  • Cellulitis (skin infections)
  • Pneumonia
  • Sinusitis
  • Ear infection

However, antibiotics may be the most controversial class of medications prescribed by doctors. Why would that be?

The medical community is seeing an epidemic of multidrug resistant infections and bacteria. The primary reason for this is the indiscriminate use of antibiotics. Everytime bacteria are exposed to antibiotics, there is a potential for mutation. This means they can adapt and become resistant to the effects of a particular antibiotic. If this happens enough, then we “breed super bacteria” who don’t respond to ANY antibiotic. That is scary.

As a result, us medical professionals have a duty called antibiotic stewardship that requires us to be extremely thoughtful as to when we prescribe antibiotics. If everyone with a runny nose or cough received a telemedicine prescription for antibiotics, then we’d be doing more harm than good for all of us. Therefore, if you have a telemedicine visit and we don’t prescribe you antibiotics, please understand we’re not being douches. Instead, it’s our medical opinion that you don’t need antibiotics.

Another reason you may not get a telemedicine prescription for antibiotics is the need for further testing. As a urologist, I see a number of patients for burning with urination. This may be caused by a UTI, STI (sexually transmitted disease) or something that’s not an infection. Without a urine sample, and urine culture ideally, I’m just guessing as to whether you need antibiotics, and guessing which is the correct antibiotic. You don’t want your doctor to guess, do you?

That being said, the decision to authorize a telemedicine prescription for antibiotics is made on a case by case basis. Sometimes the physician will feel antibiotics are the best choice, and other times they may require an in-person evaluation. So rather than scheduling a telemedicine consultation demanding antibiotics, place trust in the telemedicine doctor to make the best decision for your health.

Telemedicine Prescriptions – Next Steps

Hopefully we’ve clarified how to get a telemedicine prescription. Now the next time you can’t get a hold of your in person doctor, maybe you’ll consider a virtual visit to provide immediate access to a licensed physician in your state. You might just save a lot of time, money and frustrations.

Cheers!

Dr. P

CEO and founder of VirtuCare

P.S. If you’re in need of any telemedicine prescriptions for your prostate, bladder, or best buddy in your pants (guys you know what I’m talking about), then a VirtuCare specialist would be happy to help.

ABOUT THE AUTHOR

Dr. Joe Pazona

Dr. Joseph Pazona is the founder and President of VirtuCare, a telemedicine solution for connecting patients with physician experts. He can be reached at joe@myvirtucare.com.
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