Self prescribing

[VeeSee]

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Can physicians self prescribe CIII-CV for themselves in the state of Pennsylvania?

Let's say if a doctor wanted to write Ambien for himself, could I dispense that?

 

[ancienbon]

Nope. I think it is against cvs policy.

 

[Wheresmyaricept]

I don't care what state that is, I would not fill it. How can you justify a physician patient relationship? Is he keeping adequate medical records about this? Seems shady and can open the gateway to addiction. Refill too soon? "Im the physician and authorizing an early refill!"


No.

 

[radio frequency]

I have filled for antibiotics or maintenance medications for physicians, but never would for a controlled substance.

 

[VA Hopeful Dr]

Generally speaking, I wouldn't ever fill a controlled substance a doctor writes for himself (nor should a doctor be doing that, I certainly don't). I would consider leniency if its like for 2 ambien or something, its a doctor you know, and they explain themselves. Like "my mother just had a stroke and died, can I get two ambien to get me through the weekend".

 

[VeeSee]

Can't find anything in the PA code regarding if its "legal" or not

 

[Digsbe]

It might be "legal" but I wouldn't do it. It's technically legal for dentists or others to prescribe whatever they want too. We've turned down dentist scripts that were favors for friends like refilling maintenance meds and the like.

Honestly, I'd advocate laws that limit prescribing only to patients seen in a clinic setting or where a professional practitioner-patient relationship is established. They shouldn't be legally allowed to write for themselves or others (like family or friends) that they see outside clinic and do as "favors" without proper evaluation or follow up. I think there is liability concerns, conflicts of interest, and general bad practice behind that. As a pharmacist I wouldn't fill my own meds and be the one verifying them.

 

[Lnsean]

it is not illegal...but it is immoral and against professional ethics. I would not fill it and I don't know any pharmacist that would.

 

[Lexington2012]

It should be done with extreme caution. We had one doctor come in and write himself a benzodiazepine prescription. He only wanted 2 tablets and he said that he was going to a dentist appointment later that day. That seemed fine and his script got filled. I don't know about PA, but it is legal to do this in my state.

 

[Old Timer]

It is legal in Pennsylvania with no restrictions. PA, is so lenient they let them keep their license in an active retired state so they can still treat their family members and have full prescribing privileges but they don't have to have malpractice insurance. I have no issue with it as long as it's not cash or early refill or high dose or dangerous combinations Like Narc+Soma+Xanax. I always counsel them about the importance of keeping medical records. When I was a youngin oh so many years ago we had a patient who saw a neurosurgeon and was prescribed Demerol injection. After a while, her physician husband began to prescribe for her. One day a State Board inspector comes in and wants to see all of the rxs the husband wrote for the wife., Turns out the wife was in a car accident. They found the Demerol in her possession and they started digging. The brought the husband/doctor up on charges before the medical board for not keeping medical records. No problem with prescribing for a spouse, no issue for the pharmacy.

As an aside, it is a violation of CVS policy, so if your work for Big Red, don't do it.

 

[SELDANE]

It's not illegal for physicians to prescribe medications for themselves. As for my opinion about the "morality", that really doesn't factor into the equation. Unless I have some sort of standing for not filling the prescription (proof of diversion, refill to soon, whatever) then I don't see any legal issue filling the prescription. If your employer has a clause about you not filling self-prescribed prescriptions then that's an issue between you and your employer. But legally I see no problem. And yes I would fill the prescription.

 

[npage148]

Glad this situation is explicitly illegal in NY. No CS for themselves or family member.

Similar situation. Before ambien was around some stupid md resident came in and asked what was good for insomnia. I said some random benzo and he said ok and left. 5 min later he came in for an rx for it that his other resident friend in the car wrote for him. It was so blatant it really pissed me off and I scared the crap out of him when I said I was calling the med school and and the hospital to talk to the director

 

[BenJammin]

I don't see how this is a big deal if it's done properly. Would you deny a doctor who wrote himself 2 oz of cheratussin ac even if they were clean on the PMP? Madness.

 

[croquemonsieur]

Go see a prescriber like everyone else, cheap-o. Prescribers are not special and pharmacies aren't their personal candy shops. I love (/sarcasm) when prescribers come into the pharmacy thinking they should get special treatment because they are Dr Bigshot. My thought: no, you're not a doctor here--you're just another customer.

Writing controls of any schedule for oneself is illegal in my state, so hard no. Writing controls for family members isn't illegal but unethical, so I do it on a case-by-case basis and only for a few days' supply.

 

[npage148]

Think I'd get a special treatment if I walk into their office? No way. The only doctor that gives me special tx is our pediatrician and that's because he's our neighbor

 

[VeeSee]

And LOL @ the morality/ethics argument

It's just another case of not practicing what you preach

Seen enough out of these "physicians" to completely laugh that off

I have just started this job and I've heard ridiculous stuff out of these people ... From reports of harassment to them trying to tell me to fill narcotics early (2 weeks early in one case!! do i look like an idiot??!) to complaining about prior authorizations

Clearly these medical schools are doing a sub par job if they are pumping out these kinds of "doctors" ... Especially DOs

 

[EML9255]

This is sort of a VRA but I just had an MD trying to call in cyclophosphamide for his dog.

I told him no and he was fine with that just seemed a little annoyed but I def don't feel comfortable filling a script for an animal written By an MD. Seems a bit out of scope for a family med md

 

[npage148]

It's also illegal to prescribe out of scope. This goes of OD, DPM, and DDS. Some think they have free reign

 

[Digsbe]

This is sort of a VRA but I just had an MD trying to call in cyclophosphamide for his dog.

I told him no and he was fine with that just seemed a little annoyed but I def don't feel comfortable filling a script for an animal written By an MD. Seems a bit out of scope for a family med md

Isn't that technically practicing veterinary medicine without a license?

 

[BidingMyTime]

Isn't that technically practicing veterinary medicine without a license?

Yes, it is. Vets can't prescribe for humans, and md/do can't prescribe for animals.


IL recently made it illegal for doctors to prescribe controls for themselves. This will help prevent a lot of iffy situations.....lets be honest, most doctors have lots of doctor/APN/PA friends (how many doctors don't have a work partner these days? very, very few), if one of their friends or work partners won't write a prescription for them, why should a pharmacist be asked to fill a prescription that they wrote themselves? The OP mentioned the doctor writing himself benzos before a dentist appt, is there a reason why the dentist wouldn't give the doctor a RX for it?

 

[radio frequency]

This is sort of a VRA but I just had an MD trying to call in cyclophosphamide for his dog.

I told him no and he was fine with that just seemed a little annoyed but I def don't feel comfortable filling a script for an animal written By an MD. Seems a bit out of scope for a family med md

I've seen MDs "practicing" veterinary medicine multiple times. Magic words: I don't feel comfortable filling prescriptions prescribed outside the prescriber's scope of practice.

 

[BidingMyTime]

I've seen MDs "practicing" veterinary medicine multiple times. Magic words: I don't feel comfortable filling prescriptions prescribed outside the prescriber's scope of practice.

While there are a lot of gray areas with "scope of practice", a MD prescribing for a dog is clearly illegal, no gray area about it. For a prescription to be legal, there must be a legitimate patient/doctor relationship, a MD can have no legal doctor relationship with a dog, so any prescriptions they write for a dog are illegal. If you know you are filling for a dog, then you are knowingly filling an illegal prescription and could get in trouble for that.

 

[EML9255]

I've seen MDs "practicing" veterinary medicine multiple times. Magic words: I don't feel comfortable filling prescriptions prescribed outside the prescriber's scope of practice.

Yeah this is exactly what I told him. The vet called it in later so then I filled it. he came to pick it up and was nice and said he understood it was out of his scope of practice etc but he had a friend that did it so he thought he would just ~give it a try~

 

[image187]

I think legally, CS is much different than non-CS. For non-cs drugs, I think that the legislation is purposely vague because it is always a judgment call on the part of the MD/pharmacist on whether or not it is ok to prescribe/fill self-written drugs based on the individual case. Some things (emergencies, maintenance Rxs in a pinch, etc..) are usually clearly ok, some things are clearly not, and some things aren't so clear at all. For controlled substances, at least in the state I practice in, it is always illegal to prescribe for yourself or immediate family and for all cs Rxs there must be a "bona fide physician-patient relationship" and documentation of the prescription in a medical record