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Antibiotic giveaways by a growing number of supermarket pharmacies have raised fears among some physicians that they could feel more pressure to prescribe the medications when they are not necessary.

Overuse of antibiotics is blamed for the growth of resistant organisms such as methicillin-resistant Staphylococcus aureus.

Several large grocery store chains with pharmacies have been marketing free 14-day prescriptions of generic versions of the most prescribed antibiotics as a way of helping parents in a flagging economy. Promotions typically run January through March, during the peak of cold and flu season.

The idea is not new. Walker, Mich.-based Meijer began offering free antibiotics -- including amoxicillin and penicillin -- in 2006. But the concept has picked up steam as the economy grows weaker, with more grocery chains jumping on board this winter. Among then are Lakeland, Fla.-based Publix; Giant Food, based in Landover, Md.; Rochester, N.Y.-based Wegmans; and Stop & Shop, based in Quincy, Mass.

Store executives are clear that it's an enticement to draw more customers. But they also say it's a service to families who might otherwise not fill a prescription or see a doctor because of cost concerns.

Parents are already pressuring physicians to give their children antibiotics, even though viruses cause the most common childhood infections, said Wayne Snodgrass, MD, PhD, chair of the committee on drugs for the American Academy of Pediatrics and professor of pediatrics and pharmacology at University of Texas Medical Branch at Galveston. Offers of free medication will probably even more pressure.

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As prescription drug abuse becomes a greater concern among governors and legislators, several states are turning to physicians to help curb the problem through prescription drug monitoring programs. Iowa is the latest state to adopt such efforts.

While the programs have the potential to place physicians in the unwitting position of law enforcement officials, several physician organizations, including the American Medical Association, have expressed support for them. They feel the programs could be a tool for physicians to identify patients in need of help.

According to Sherry Green, executive director of the National Alliance for Model State Drug Laws, there are 38 states with laws authorizing monitoring programs and 32 that have a program up and running. The number of states with monitoring programs has more than doubled since 2002 when the U.S. Dept. of Justice made grants available to create programs.

Under the programs, states create Web sites on which pharmacists report controlled substance prescriptions that are filled. Physicians can gain access to the site to identify possible doctor shoppers or addicts, or even those who might be involved in illegal drug diversion.

Jeanine Freeman, senior vice president of legal affairs for the Iowa Medical Society, said when Iowa received a grant to create a drug monitoring program two years ago the medical society's initial concern was that the program would be established under grant only with no statutory requirement.

[...]

Just weeks before a strict medical privacy law went into effect in California, another major privacy breach was uncovered at a large medical center there -- one that police say led to theft.

A former billing clerk at Cedars-Sinai Medical Center in Los Angeles was arrested in November 2008 and charged with stealing patient records and using the identities to steal from insurers.

James Allen Wilson, whose job authorized him to access to the hospital's electronic medical record system, allegedly set up a fake lab company then used stolen information from patient files to bill insurers. Investigators say the scheme netted Wilson at least $69,000, an amount expected to grow as the investigation continues.

Jane Robison, spokeswoman for the Los Angeles County District Attorney's office, said an insurer brought the alleged violations to the attention of investigators, who then alerted the hospital.

Investigators visited Wilson's home and found the records of more than 1,000 patients and actual workers' compensation claims, police said. The hospital sent letters to all patients involved alerting them to the scheme and advising them that it did not appear the stolen information was being used for anything besides the insurance fraud.

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