Code of Medical Ethics 8.06 Drugs and Devices: Prescribing
1998-99

(1) A physician should not be influenced in the prescribing of drugs, devices, or appliances by a direct or indirect financial interest in a pharmaceutical firm or other supplier. Whether the firm is a manufacturer, distributor, wholesaler, or repackager of the products involved is immaterial.

(2) A physician may own or operate a pharmacy but generally may not refer his or her patients to the pharmacy. However, a physician may refer patients to his or her pharmacy if there is a demonstrated need for the pharmacy in the community and alternative financing is unavailable (as defined in Opinion E-8.032). Physicians may dispense drugs within their office practices provided there is no resulting exploitation of patients.

(3) A physician should not give patients prescriptions in code or enter into agreements with pharmacies or other suppliers regarding the filling of prescriptions by code.

(4) Patients are entitled to the same freedom of choice in selecting who will fill their prescription needs as they are in the choice of a physician. (See E-9.06 and E-8.03.) The prescription is a written direction for a therapeutic or corrective agent. A patient is entitled to a copy of the physician's prescription for drugs, eyeglasses, contact lenses, or other devices as required by the Principles of Medical Ethics and as required by law. The patient has the right to have the prescription filled wherever the patient wishes.

(5) Patients have an ethically and legally recognized right to prompt access to the information contained in their individual medical records. The prescription is an essential part of the patient's medical record. Physicians should not discourage patients from requesting a written prescription or urge them to fill prescriptions from an establishment which has a direct telephone line or which has entered into a business or other preferential arrangement with the physician with respect to the filling of the physician's prescriptions. Issued prior to April 1977; Updated June 1994 based on the report "Conflicts of Interest: Physician Ownership of Medical Facilities," issued December 1991. (I, II, III, IV, V)

Court case
Mo. Att'y Gen. 1982
State attorney general, citing Opinion 8.06 (1982), concluded that a physician who requires a patient to accept drugs dispensed by the physician and refuses to provide the patient with a prescription for the patient's use elsewhere violates state antitrust law and has engaged in professional "misconduct." A similar conclusion, again based in part on Opinion 9.06, was rendered regarding a physician who requires a patient to fill a prescription at a pharmacy in which the physician has a personal interest. Missouri Att'y Gen, Op. No 6 (July 8, 1982) (LEXIS State library, Mo. file).
Extracted from Code of Medical Ethicsby AMA 98-99
 

Why? Something that is a misconduct and conflict of interest is acceptable in Hong Kong. Unless those conflict of interests can be solved, the quality of pharmaceutical service can never be granteered!

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