Firstly, I am well aware of my scope of practice, and I didn't say that podiatrists have an unlimited scope. Podiatrists have an unlimited license to prescribe drugs. You need to read more carefully.
Sure they do...assuming they are for a legit medical purpose.
Secondly, I don't expect you to be a legal expert.
Well, I just passed the PA and WV state law exams, which is a comprehensive examination on the prescribing and dispensing laws of the federal government and the aforementioned states. I'd suspect I'm much more of an expert than you at the very least.
Thirdly, I encounter these issues and I sit on our Podiatry State Board of Directors.
Yes, good for you. And maybe in YOUR state podiatrists can prescribe 30 days of Ambien without a medical license. In my state and every other state I know of...they can't.
You are wrong. If I think treating a condition is in my scope, then I have the legal ability to write a medication for it, regardless of it's FDA indication. That is what "off label" means. And you may not have any idea why I'm prescribing a certain medication. A phone call is fine to ask me why I'm prescribing a medicine, but ultimately I am the treating doctor.
No, YOU are wrong. If it's for a legitimate medical purpose, I'm fine with it. Say cimetidine for warts...FINE. Granted, I'd triple check that they aren't on any CYP P450 3A4 substrate drugs before filling it because a physician didn't write the script...but I'd fill it because it's for a legitimate medical purpose. I know more about drugs and their off-label use than you could ever imagine. I'm a freakin' drug specialist. I hold a PharmD. Lordy. Please shush with the condescending blathering from your soap box about how you are the super-magical "treating doctor." I'm the "treating pharmacotherapist" who is equally as liable for drug misuse, thanks. And I likely already know full-well the drug you are using has an off-label use....and when it doesn't....and you're right I WILL call you one it if it doesn't.
If it's something patently bizarre...such as a legitimate reason why a podiatrist would prescribe Ambien for 30 days pertaining to a SPECIFIC ankle/foot problem...then I'd ask for you have to back it up with a study, reference, or something as to why it affects the feet/ankles specifically. If it's prescribed without such a podiatry-specific use, then it is prescribing out of practice and I am OBLIGATED by state law (and in this case with a scheduled drug, federally obligated) to refuse to fill it. It's not that I don't want to, it's that I LEGALLY CAN'T. I will bust out the DEA Pharmacists' Manual and PA/WV rules and regs and show you the citation if you so please.
If you refuse to fill a legally written Rx, --- 1. I call your supervisor (which probably takes care of the issue), 2. I call your state board. 3. I direct my patients to a different pharmacy. Issue solved.
So let's go number by number here.
1) He'd agree with me because I'm legally correct. Case closed.
2) They'd ask you why you were prescribing 30 Ambien to a patient as a podiatrist and call the DEA. Great idea. Plus, I can legally refuse to fill any script for any reason I want. I am not subservient to some dude in a white labcoat somewhere who writes words on little pieces of paper that can be exchanged for goods and services.
3) A pharmacist that knows his law would do the same thing...unless they don't care...upon which they have broken the law and I guess it's their problem.