Flu Medicine Flap Angers MD

Q. You answered a reader who was furious because her doctor wouldn’t prescribe flu medicine over the phone. As a physician myself, I was disappointed that you sided with her and didn’t appreciate the doctor’s rationale.
The word “flu” is vague, and people apply it to many different symptoms. A patient might become seriously ill or die from a disease mistaken for “the flu.”
Refusing to prescribe for a patient I have not personally examined is just common sense. It protects the patient, and it protects me from the possibility of a malpractice suit. No doctor wants to be questioned in court, “Did you personally examine this patient?” and have to answer “No.”
Any doctor who prescribes over the telephone is not practicing good medicine.
A. In this era of Internet access to Viagra and other prescription drugs, we applaud your caution about not prescribing for a patient you have never seen.
This reader had a long-standing relationship with her doctor, however. She was understandably dismayed when she couldn’t get an appointment to see him soon enough for a flu drug to do her any good. She was sick for weeks as a result of this delay.
Patients and physicians face a dilemma during a bad flu season. Obviously, patients at high risk should be immunized yearly. But if hundreds of people are stricken with respiratory illness at the same time during a flu epidemic, a doctor may be hard-pressed to examine them all within 24 to 48 hours of their initial symptoms. Current flu medicines are not helpful if started later than that.
Millions of people treat themselves for “flu” with over-the-counter medicines that do not speed healing. Tens of thousands die from influenza complications. Since there are effective prescription flu medicines, it seems a shame for people to suffer.
Many patients don’t realize there are drugs that actually do speed recovery (or prevent an infection) from influenza. They include oseltamavir (Tamiflu), rimantadine (Flumadine), amantadine (Symmetrel) and zanamivir (Relenza).