If a MD asked his MA to propose Rx for controlled substance for another MD without a visit or even records.
What's the best action in this situation?
What's the best action in this situation?
Ethical question please help
- Thread starter SNAMJ
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So the doc had his MA write a script for pills for another doc off the record?
I'd weigh your pros and cons of saying something and not saying anything before you make a decision. How are you related in this situation? Are you the MA?? Would you be wise to look the other way and not get in others' business? Or do you risk taking a stand and mentioning this to somebody important? Maybe just wait to see if it occurs again?
If you feel that what has happened could somehow put someone at risk, then I'd certainly speak up. Otherwise, it may not be worth it. Maybe the doc is helping the other doc out and it's totally legit. I've known docs to do this (infrequently) before as long as it's for a legitimate medical complaint. Maybe the doc has been treating the other doc for quite a while and there was a visit long ago for what has now become a chronic problem? Contrary to popular opinion, pain meds do alleviate pain in people who have pain and aren't solely used illicitly.
Of course, the exact opposite could be true too. There's so many what if's in this situation. Get more info first. A lot depends on how you're related in the situation.
I'd weigh your pros and cons of saying something and not saying anything before you make a decision. How are you related in this situation? Are you the MA?? Would you be wise to look the other way and not get in others' business? Or do you risk taking a stand and mentioning this to somebody important? Maybe just wait to see if it occurs again?
If you feel that what has happened could somehow put someone at risk, then I'd certainly speak up. Otherwise, it may not be worth it. Maybe the doc is helping the other doc out and it's totally legit. I've known docs to do this (infrequently) before as long as it's for a legitimate medical complaint. Maybe the doc has been treating the other doc for quite a while and there was a visit long ago for what has now become a chronic problem? Contrary to popular opinion, pain meds do alleviate pain in people who have pain and aren't solely used illicitly.
Of course, the exact opposite could be true too. There's so many what if's in this situation. Get more info first. A lot depends on how you're related in the situation.
D
deleted480308
Propose?
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It still needs the md signature so I don’t think it matter. Maybe the md saw the patient alone . Still the ms should have just don’t it themselves.
The ma has no script writing privileges so it doesn’t really matter .
The ma has no script writing privileges so it doesn’t really matter .
D
deleted889094
I'm wondering if they just mean the MA is being told to put it into the EMR. But then yeah, the MD would still have to sign it.
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Yeah I’d let it be. The MD still has to sign it and it will be tracked under their DEA.
As for writing controlled substances without an in person visit, there are varying state laws about this. I used to write them on call for post op patients all the time without seeing them so long as the story made sense, but once my state made that illegal I’ve stopped and had to tell people to come in and be seen. So I personally don’t think that aspect of things is a big deal at all because there are countless situations where I don’t need to see patient I know already to know why they’re in pain. If I move to a state where it’s legal I will absolutely do it again.
As for writing controlled substances without an in person visit, there are varying state laws about this. I used to write them on call for post op patients all the time without seeing them so long as the story made sense, but once my state made that illegal I’ve stopped and had to tell people to come in and be seen. So I personally don’t think that aspect of things is a big deal at all because there are countless situations where I don’t need to see patient I know already to know why they’re in pain. If I move to a state where it’s legal I will absolutely do it again.
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Consider the fact that sometimes, MDs see other MDs after hours without a paper trail in the EMR.
As long as the MD kept his own paperwork, this isn't against the rules.
For what it's worth, they do this to protect the other MDs privacy but also because medical boards can be nosy little ****ers and those records can be subpeoned to make a case against your safety as a physician. For instance, if you've ever seen a psychiatrist, it's always better if your psychiatrist's note just says "patient has anxiety. Describes frequent worry and panic attacks. Will give one time script for Ativan" instead of all the detail you'd expect in the EMR.
Now if the MD makes a habit of prescribing benzos for all his friends/colleagues, that's a different story. But a one-time thing I think you have consider that perhaps the MD saw the patient
As long as the MD kept his own paperwork, this isn't against the rules.
For what it's worth, they do this to protect the other MDs privacy but also because medical boards can be nosy little ****ers and those records can be subpeoned to make a case against your safety as a physician. For instance, if you've ever seen a psychiatrist, it's always better if your psychiatrist's note just says "patient has anxiety. Describes frequent worry and panic attacks. Will give one time script for Ativan" instead of all the detail you'd expect in the EMR.
Now if the MD makes a habit of prescribing benzos for all his friends/colleagues, that's a different story. But a one-time thing I think you have consider that perhaps the MD saw the patient
Thanks for all Replies, I just refused to propose the Rx and let the MD do it himself. I made him grumpy but I think that I did the right thing especially when the co-worker nurse heard and said that's unethical.
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CITI and IHI modules are pretty clear about this. report and let leadership determine the facts.
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deleted480308
The nurse agreeing doesn’t mean anything unless they have more information than you gave. What do you mean by propose?
