Prescribing to non-patients a risky activity

Originally published March 2004 / Revised March 2023

The availability of Internet prescribing as well as the attraction of cheaper Canadian drugs for American consumers has created a cross-border business in which some Canadian physicians are participating. Those doctors who sign or co-sign Internet prescriptions for persons with whom they have no prior recognized doctor-patient relationship are engaging in a risky activity that is considered unacceptable by provincial and territorial medical regulatory authorities (Colleges).

Risk of discipline

Colleges generally expect physicians to conduct the following activities before treating patients and prescribing medications in non-urgent situations: obtain an adequate history, perform appropriate physical examinations, make a diagnosis, obtain informed consent, and arrange appropriate follow-up care. Completion and maintenance of an appropriate medical record is also expected. Hence, physicians engaged in the inappropriate signing or co-signing of prescriptions are at risk of sanctions by their College.

CMPA assistance

The CMPA views the inappropriate signing or co-signing of Internet or cross-border prescriptions for persons with whom the physician has no prior recognized doctor-patient relationship as being outside the professional practice of medicine in Canada. As a result, the Association will generally not extend assistance to a CMPA member for any complaint, investigation, or legal action (whether inside or outside Canada) arising from this activity.

Group practices and on-call physicians

The CMPA will generally continue to assist members who prescribe or renew prescriptions for patients with whom they have a recognized doctor-patient relationship. This includes patients who are part of a group practice or patients who are being cared for by an on-call physician.