Issue 2: May 2023

In the absence of an established relationship with the patient, physicians must not prescribe medications for a patient solely on the basis of mailed or faxed information or an electronic questionnaire.

The College recently revised its prescribing standard to address prescribing in the absence of direct patient contact. The standard was reviewed in response to physician living the U.S. and holding a Nova Scotian licence allegedly was prescribing thousands of Ozempic prescriptions for diversion to American patients. These prescriptions were sent online to pharmacies in BC for fulfillment.

On this point the College standard directs physicians as follows:

1. in the absence of an established relationship with the patient, physicians must not prescribe medications for a patient solely on the basis of mailed or faxed information or an electronic questionnaire.
2. physicians must not countersign a prescription issued by another physician or surgeon, without direct patient contact.

Physicians are encouraged to review the following resources:

• CMPA’s Prescribing to non-patients a risky activity
• Professional Standards Regarding Virtual Care
• Professional Standards Regarding Initiation of Opioid Therapy for Acute Pain