Do's and Do Not's with Training License?

[FamDocHS]

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I got a request from an individual today to sign off on a negative PPD result, saying that it can be signed by any healthcare professional. I can't find an answer of whether or not this is permissible.

I have recently graduated from medical school and received my license to practice as an intern/resident. I know this is not the same as prescribing to friends/family, but I'm a little weary of signing it without knowing for sure if it's allowed.

In addition, any other do's/don'ts you've encountered with the training license would be educational and greatly appreciated. Thanks!

 

[LucidSplash]

Depends on your state but typically training licenses allow you to practice in the capacity of a healthcare provider only under the supervision of a licensed physician in an accredited training program. So technically no, you can't sign that form and you would not be covered by insurance if you signed the form and the patient ended up having TB.

 

[45408]

Before you write any prescriptions for anyone, make sure you know what you're allowed to do. I don't think it's illegal in any state to write a script for amoxicillin for your kid's ear infection, but your program may prohibit it. You can't write for any narcotics until you have a DEA number. Don't ever write for narcotics or other scheduled drugs (benzos, ADD drugs, opiates) for someone that isn't your patient with a legitimate need for narcotics, ever.

In general, don't dispense any medical advice to anyone that you don't have a formal doctor-patient relationship with (family, friends, spouse, or anyone that is not a patient of one of your attendings). I'm happy to give general guidelines, but unless you're doing a formal H&P on these people, it will be inadequate care.

 

[Roguelyn]

We write for narcotics all the time as residents. I just use my resident's DEA...and I haven't had any problems.

Typically my nurses signs negative PPD but I have done it when she wasn't around. We get a ton of requests for these along with proof of positive titers or immunizations records for students in various medical education programs.

If you haven't started residency yet, I wouldn't sign anything.

 

[BADMD]

Realistically, you shouldn't do anything outside the bounds of your program. If there isn't a supervising physician, don't touch it.

 

[gutonc]

We write for narcotics all the time as residents. I just use my resident's DEA...and I haven't had any problems.

Typically my nurses signs negative PPD but I have done it when she wasn't around. We get a ton of requests for these along with proof of positive titers or immunizations records for students in various medical education programs.

If you haven't started residency yet, I wouldn't sign anything.

All of these things are state specific.

In some states, any trainee can write for narcs under a hospital's DEA license. In other states, only PGY2+ residents can do that. Still others require a personal DEA license to write for narcs.

The PPD thing will be even more specific. The card you're asked to sign will usually say something like "must be signed by a licensed healthcare practitioner" which can include a physician, nurse, pharmacist of a bunch of other people, or "must be signed by a licensed physician." Since this will be state or locality specific, the rules will vary.

 

[FamDocHS]

I appreciate everyones' replies. I'm confident I did the correct thing to not sign this form (I didn't actually get a chance to read it in person, just got the request via text). It's funny/scary how people start coming to you for various things once you get your MD, kinda like how you were expected to field medical questions from lay people at the start of medical school.

 

[meister]

I'd assume anything outside of your assigned duties via your residency program is no-go unless and until you get your own independent medical license.

 

[dpmd]

I'd assume anything outside of your assigned duties via your residency program is no-go unless and until you get your own independent medical license.

This. If your friend wants you to sign off on a PPD so they don't have to bother going in to get it checked-say no. If one of your co-residents wants you to sign off so they they don't have to go upstairs (or wherever you employee health is)-depends on the program, but if you are unsure enough to ask maybe best not to (do you even know how to read a PPD?). If it is your patient and the nurse is busy with stuff (and you know how to read them)-go for it.