Pharmohaulic

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For instance, if a podiatrist has a patient with a thyroid condition or an anxiety disorder, can they legal prescribe that patient their synthroid or klonopin if they need it since it is outside the scope of the lower extremity?
 
Jul 31, 2016
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You can write for any medication as DPM but the answer is no. Even an orthopod will not write you the script for your thyroid. You will be referred back to your PCM. Stay in your lane. You can write for anxiety if you are doing a procedure related to surgery/procedure.
 
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Pharmohaulic

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You can write for any medication as DPM but the answer is no. Even an orthopod will not write you the script for your thyroid. You will be referred back to your PCM. Stay in your lane.
What would happen if they prescribed the synthroid for the patient with hypothyroidism or klonopin for the patient with anxiety?
 
May 28, 2016
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Probably nothing if they do it once a year for a good medical reason. If a pattern develops you may get audited (esp if you're doing it thru Medicare)
 
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NatCh

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May 20, 2007
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With a DEA license to prescribe from schedule II - V, technically yes, we can write for anything on those schedules. Realistically though, it doesn't happen (at least much) because why would we want to? I have no desire to manage and take responsibility for someone's thyroid condition.

If we have a reason to use a drug we can do so. For example, I've written for anxiolytics before in the case of pre-operative acute anxiety but won't manage it long-term. I prescribe gabapentin before surgery as a part of multi-modal anesthesia even though it's an anti-epileptic drug and seemingly outside of scope.

I like Lifepod's phrase, "stay in your lane."
 

ldsrmdude

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What would happen if they prescribed the synthroid for the patient with hypothyroidism or klonopin for the patient with anxiety?
Either the pharmacist would fill the prescription or they wouldn't. I'd like to think that if there was a question with the prescription the pharmacist would give me a call to discuss it. I've had a few pharmacists call to clarify something or to discuss a potential interaction and I like that.

As far as prescribing, if I'm treating a condition within my scope of practice and a medication is indicated for treatment, then yes, I will prescribe it. It might be a stretch to prescribe Synthroid, but I could see a benzo for pre-procedure anxiety. Like @NatCh said, why would we want to manage those things? Most of the podiatrists I know (myself included) would much rather leave that to the PCP and stick to dealing with the foot and ankle
 

ExperiencedDPM

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Nov 23, 2015
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I agree with the comments above and also like the line "stay in your lane". Additionally, you must always document. Don't get in the habit of writing an antibiotic for your neighbor for his sinus problems, especially if you don't have a chart on the patient. I have real charts (EMR) for my family in case an Rx needs to be written on a weekend, etc. I won't even write an Rx for an NSAID for my wife without documentation in my EMR. If you write ANY Rx for ANY med, make sure it's documented in your EMR. You don't have to impress your neighbor at the risk of getting slapped by the DEA.
 

ldsrmdude

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