What do you think about Signing opioid Rx written by PA/NP

[vitriol102]

Greetings!

Need you opinion. In my state, PA's/NP's are not allowed to write opioid Rx (yet).

I work for a spine surgeon and the PA/NP belong to him. I am not supervising them. PA/NP see spine surgeon patients and are now asking me to sign the opioid Rx they write. It's a matter of convenience for them when the surgeon is not around. I neither see the spine surgery patient nor decide what to prescribe. Fortunately, the PA/NP know how I feel about opioids and don't ask me to sign off on any heavy.

But non-the-less I don't feel comfortable doing this. Here's my questions:
1. is this correct
2. how can I get out of this arrangement (I am an employee)?

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[neutro]

dont do it.
no opiates unless you evaluate the patient yourself and decide if they should be on it or not.
if you agree with NP- fine. If not, then no. Cant tell until you evaluate.
In case something happens - you'll be liable since you signed off on opiate medication without a work up yourself.

things are getting tight. thankfully. and they should - its about time. we need to put an end to this epidemic.

 

[neutro]

just because you are employed by them, does not mean they can ask you to inappropriately prescribe opiates.
their employment contract is miniscule compared to your license, DEA number and credentials that you are solely responsible for. they don't own you nor you are their slave.

i was faced with a similar situation and I said no and parted ways from the practice.
Today its just 10 tabs of percocet, in one month it will be 180 tabs of oxycontin 60. Employee or not, establish boundaries from the get-go. you are a physician who can think independently.

good luck.

 

[Agast]

But non-the-less I don't feel comfortable doing this. Here's my questions:
1. is this correct
2. how can I get out of this arrangement (I am an employee)?

Tell them the patient must see you in clinic to have an opioid prescription written by you for anything stronger than Tylenol #3 or Tramadol. I'm willing to cover my colleagues with a schedule III script when they're unavailable, similar to what an on-call physician might do. If the patient really wants pain meds they will come see you in clinic. If they would prefer to wait for the surgeon to write it then they don't really need the script urgently.

The surgeons would never ever write your patients for narcotics if you were out of town, so there's no reason for them to expect you to do the same. And in today's climate I highly doubt they would find a good pain doc willing to do that for them.

 

[Ligament]

DO NOT DO IT.

If you want to prescribe controlled substances, see the patient yourself and make the decision. Do not under any circumstance prescribed controlled substances via an NP if it is not your patient and you've never personally met the patient.

 

[lobelsteve]

DO NOT DO IT.

If you want to prescribe controlled substances, see the patient yourself and make the decision. Do not under any circumstance prescribed controlled substances via an NP if it is not your patient and you've never personally met the patient.

If there is no supervisory agreement on file [in Georgia], and you have never seen the patient and have no relationship then this is unlawful prescribing. And the medical board would sanction.

 

[freddydpt]

If there is no supervisory agreement on file [in Georgia], and you have never seen the patient and have no relationship then this is unlawful prescribing. And the medical board would sanction.

Agree with above. It's considered unlawful if you did not perform the evaluation yourself.