Who can prescribe?

[RexKD]

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Can all licensed doctors prescribe drugs?

If I become a radiologist or a pathologist, would I be able to write a simple script for antibiotics for myself or a friend?

I use the examples of rad and path since they are typically very far from direct patient contact.

 

[ORS]

Can all licensed doctors prescribe drugs?

If I become a radiologist or a pathologist, would I be able to write a simple script for antibiotics for myself or a friend?

I use the examples of rad and path since they are typically very far from direct patient contact.

Any MD or DO can prescribe. Special requirements for narcotics. So yes the path or radio guy can. Also, dentists, ect. can prescribe.

Radiology is becoming more and more patient care oriented with interventional radiologists performing in the general surgery arena (i.e. inserting G-tubes, biopsies....). Remember that interventional radiologist invented angioplasties 🙂

 

[kas23]

Can all licensed doctors prescribe drugs?

If I become a radiologist or a pathologist, would I be able to write a simple script for antibiotics for myself or a friend?

I use the examples of rad and path since they are typically very far from direct patient contact.

Yes, you can prescribe drugs to your friends, family, and yourself, but most insurance companies have a policy of not paying for scripts written for yourself or family members. So, you would likely have to pay out-of-pocket.

As for narcotics, I personally wouldn't go there. Don't they monitor narcotic script habits/patterns?

 

[RexKD]

Am I correct in thinking that there are two categories of drugs.

1. Controlled Substances (ie, narcotics such as vicodin, valium, etc.)

2. Non-controlled substances (ie, antibiotics)

Non-controlled substances aren't tracked very closely and doctors have little relectance prescribing them for themselves, friends, or family.

Controlled substances are tracked individually and thus doctors are reluctant to write such prescriptions. But even a radiologist or a pathologist could write a CS script for themselves or for others. It's just that few would want to do it.

Am I correct in my thinking?

 

[OldPsychDoc]

Am I correct in thinking that there are two categories of drugs.

1. Controlled Substances (ie, narcotics such as vicodin, valium, etc.)

2. Non-controlled substances (ie, antibiotics)

Non-controlled substances aren't tracked very closely and doctors have little relectance prescribing them for themselves, friends, or family.

Controlled substances are tracked individually and thus doctors are reluctant to write such prescriptions. But even a radiologist or a pathologist could write a CS script for themselves or for others. It's just that few would want to do it.

Am I correct in my thinking?

It's actually unethical to write any prescription if you're not maintaining a medical record on the patient. And you WILL be found out eventually if you are writing narcs, benzos, or stimulants inappropriately. Don't even start.

 

[RexKD]

I have no desire to start writing such prescriptions. My posting is completely theoretical as I am not a doctor.

The narcs, benzos, and stimulants would be considered controlled substances, correct?

So if one has to maintain a record for each patient one prescribes drugs for, wouldn't this deter a doctor for writing a basic prescription for his family member who has a simple case of bronchitis?

There has to be more to this than a simple prohibition against writing scripts for people whose records you don't keep. If not, this law must be ignored often because it's impractical for doctors to keep records on family members and close friends. For controlled substances such as narcotics, I understand completely. But not for simple drugs such as antibiotics.

 

[Winged Scapula]

You're right a lot of physicians do write scripts for family members, friends and co-workers; people they don't necessarily treat as a PCP. There's no law against it. Matter of fact, I will write my own scripts for some meds I take for chronic conditions as I usually forget to contact my own physician until I have no refills left and I'm out of meds. Some insurance companies will apparently not pay for scripts written by yourself, but I've never had a problem.

But, as noted above, I would refrain from doing so especially for friends and co-workers. Even simple antibiotics can have severe reactions and if there were a complication and you prescribed the med, you could held legally liable.

Nurses at work will often ask for a script; I just tell them I have a policy of not writing scripts for people that aren't my patients. Its gotten worse with friends now that I have a DEA number; for some reason everyone seems to need a "few" Percocet just in case!? 😡

 

[doc05]

you can of course write any prescription you want as long as you're licensed and have the DEA number. But writing prescriptions for family members is a tad unethical as you aren't their physician. More importantly, as a pathologist or radiologist so far removed from the clinical arena, you might end up prescribing the wrong therapy. the best thing you can do for your family and friends is to refer them to a good internist.

 

[doc05]

For controlled substances such as narcotics, I understand completely. But not for simple drugs such as antibiotics.

anitbiotics are by no definition "simple." when a patient dies of an allergic reaction due to an antibiotic, perhaps you will appreciate this fact.

 

[RexKD]

What does it take to get a DEA number?

Does one have to be a doctor who has his state medical license? If so, in some states, wouldn't doctors have to wait until after PGY3 in order to prescribe? (I believe there are some states in which you have to have 3 years post-MD in order to be licensed)

 

[docB]

What does it take to get a DEA number?

Does one have to be a doctor who has his state medical license?

Yes.

If so, in some states, wouldn't doctors have to wait until after PGY3 in order to prescribe? (I believe there are some states in which you have to have 3 years post-MD in order to be licensed)

Yes.

You also have to have a different DEA# (ie. pay an additional fee) for each state in which you want to practice.

 

[OldPsychDoc]

So if one has to maintain a record for each patient one prescribes drugs for, wouldn't this deter a doctor for writing a basic prescription for his family member who has a simple case of bronchitis?

There has to be more to this than a simple prohibition against writing scripts for people whose records you don't keep. If not, this law must be ignored often because it's impractical for doctors to keep records on family members and close friends. For controlled substances such as narcotics, I understand completely. But not for simple drugs such as antibiotics.

That's the basic idea. You've probably heard the old saw that "the lawyer who represents himself has a fool for a client." The same applies to doctors. We are notoriously bad patients ourselves, and treating family and friends is unprofessional at best.

Yes--I've written for amoxicillin for my child's ear infection myself--but she'd had it before, it was damned obvious that that was the problem, and we were headed out of town on a Saturday morning. Strictly it was still the wrong thing to do...

 

[gungho]

You also have to have a different DEA# (ie. pay an additional fee) for each state in which you want to practice.

You don't get a different DEA# in each state-the Drug Enforcement Administration is a federal agency and a physician is issued one number. Each state (at least each state I've been licensed in) does require a Controlled Substance license with its own number.

 

[AJM]

You don't get a different DEA# in each state-the Drug Enforcement Administration is a federal agency and a physician is issued one number. Each state (at least each state I've been licensed in) does require a Controlled Substance license with its own number.

Only half the states actually require a separate state-issued controlled substance license. In the rest of the states, the federal DEA# is sufficient.

 

[mamadoc]

So if one has to maintain a record for each patient one prescribes drugs for, wouldn't this deter a doctor for writing a basic prescription for his family member who has a simple case of bronchitis?

There has to be more to this than a simple prohibition against writing scripts for people whose records you don't keep. If not, this law must be ignored often because it's impractical for doctors to keep records on family members and close friends. For controlled substances such as narcotics, I understand completely. But not for simple drugs such as antibiotics.

Well, for one thing, "a simple case of bronchitis" is almost always viral and antibiotic therapy is inappropriate. Doctors writing scripts for their family and friends are almost certainly huge contributors to the overuse of antibiotics and the development of community resistance.

The point remains that recommending therapy (including writing scripts for antibiotics) for someone you do not examine or keep medical records on is unethical and below the standards of practice. Yes, we all do it to some extent but I think doctors are becoming way more cautious about this, and rightly so.

 

[MAC10]

Well even at our resdiency orientation, one of the things they told us is that we are all doctors and we can perscribe for our family and ourselves. We can also precribe for others that are not our patients but to do this with extreme caution and if we do it have some type of documentation. Ive had several nurses ask for persciptons for this and that but ive declined. Also I write my own persciption for a med that I take and occasional meds that I need and my insurance company pays for it 100%. Ive never had a problem...

 

[docB]

You don't get a different DEA# in each state-the Drug Enforcement Administration is a federal agency and a physician is issued one number. Each state (at least each state I've been licensed in) does require a Controlled Substance license with its own number.

When I moved from CA to NV I was told by the DEA that I could either get a new number for Nevada or move my old number. They told me if I moved my old number that I couldn't prescribe in CA without getting a CA number. I checked the DEA website and it's pretty confusing:
http://www.deadiversion.usdoj.gov/drugreg/faq.htm
The the answer is, I'm not sure.

 

[AJM]

When I moved from CA to NV I was told by the DEA that I could either get a new number for Nevada or move my old number. They told me if I moved my old number that I couldn't prescribe in CA without getting a CA number. I checked the DEA website and it's pretty confusing:
http://www.deadiversion.usdoj.gov/drugreg/faq.htm
The the answer is, I'm not sure.

They make it sound much more confusing than it actually is. If you are practicing in more than one state, you have to have a separate federal DEA number for each state that you are actively practicing in. If you are just moving, then you can simply change the address of your current DEA number, but then you can no longer prescribe in your previous state. That is why they told you that if you moved your old number from CA to NV, you could no longer prescribe in CA. If you wanted to keep active prescribing privileges in both states, you would have to get 2 federal DEA numbers (one for CA and one for NV). Most residents only practice in one state, so it's pretty straight forward to just submit a change of address form to the DEA, and not to worry about losing prescribing privileges in your old state.

BTW - CA does not require a separate state-issued controlled substance license, just the federal one. To find out the states that require separate state registration, there's a list of them on the DEA address change request form: http://www.deadiversion.usdoj.gov/drugreg/change_requests/addchange.pdf

 

[gungho]

They make it sound much more confusing than it actually is. If you are practicing in more than one state, you have to have a separate federal DEA number for each state that you are actively practicing in. If you are just moving, then you can simply change the address of your current DEA number, but then you can no longer prescribe in your previous state. That is why they told you that if you moved your old number from CA to NV, you could no longer prescribe in CA. If you wanted to keep active prescribing privileges in both states, you would have to get 2 federal DEA numbers (one for CA and one for NV). Most residents only practice in one state, so it's pretty straight forward to just submit a change of address form to the DEA, and not to worry about losing prescribing privileges in your old state.

BTW - CA does not require a separate state-issued controlled substance license, just the federal one. To find out the states that require separate state registration, there's a list of them on the DEA address change request form: http://www.deadiversion.usdoj.gov/drugreg/change_requests/addchange.pdf

Never heard of this. Currently licensed to practice in 3 states, licensed since '82, have had a single DEA # since original license. However, as previously mentioned, have had separate state Controlled Substance numbers. Maybe rules have changed?

 

[AJM]

Never heard of this. Currently licensed to practice in 3 states, licensed since '82, have had a single DEA # since original license. However, as previously mentioned, have had separate state Controlled Substance numbers. Maybe rules have changed?

Dunno. I'm just going by what the FAQs said as well as what I learned from my recent move from CA to MA. I'm still licensed in both states, but not planning on going back to CA for a while, so not planning on doing any prescribing there. I simply moved my DEA address to MA, because I was told that my listed federal DEA address has to be in the same state as the one I'm prescribing in. Maybe you can list more than one address for the same federal DEA number - I don't know. It was my impression that you can't, but I didn't ask specifically about it.

 

[gungho]

Dunno. I'm just going by what the FAQs said as well as what I learned from my recent move from CA to MA. I'm still licensed in both states, but not planning on going back to CA for a while, so not planning on doing any prescribing there. I simply moved my DEA address to MA, because I was told that my listed federal DEA address has to be in the same state as the one I'm prescribing in. Maybe you can list more than one address for the same federal DEA number - I don't know. It was my impression that you can't, but I didn't ask specifically about it.

Yeah, from my understanding, you can only have one address listed with the DEA, and I guess that is your primary business/practice address, but you only get one DEA prescribing number no matter where you live. For instance, I live in one state, moonlight in a neighboring state, have a State number for the moonlighting state, none for my home state, but only one DEA number. I'm sure glad we have bureaucrats (that we pay for) to keep us dumb doctors straight.

 

[docB]

They make it sound much more confusing than it actually is. If you are practicing in more than one state, you have to have a separate federal DEA number for each state that you are actively practicing in. If you are just moving, then you can simply change the address of your current DEA number, but then you can no longer prescribe in your previous state. That is why they told you that if you moved your old number from CA to NV, you could no longer prescribe in CA. If you wanted to keep active prescribing privileges in both states, you would have to get 2 federal DEA numbers (one for CA and one for NV). Most residents only practice in one state, so it's pretty straight forward to just submit a change of address form to the DEA, and not to worry about losing prescribing privileges in your old state.

BTW - CA does not require a separate state-issued controlled substance license, just the federal one. To find out the states that require separate state registration, there's a list of them on the DEA address change request form: http://www.deadiversion.usdoj.gov/drugreg/change_requests/addchange.pdf

OK. That is what I thought too. You have to get additional DEA #s for each state you want to actively practice in. If you're just moving you can just move your # but if you are going to say practice in one state and moonlight in another you're supposed to have a new number for the other state.

I think that this is made more confusing by the fact that in a lot of states (? all, I don't know) pharmacies will honor out of state Rxs. For example, I'm in NV but I know that if a tourist takes my Rx to CA they'll fill it on my DEA # that's linked to NV. If I go moonlight in CA I imagine they'd still fill my scripts and it might not ever get noticed.

Who'd of ever thought the government would create such a confusing system?

 

[Winged Scapula]

OK. That is what I thought too. You have to get additional DEA #s for each state you want to actively practice in. If you're just moving you can just move your # but if you are going to say practice in one state and moonlight in another you're supposed to have a new number for the other state.

I think that this is made more confusing by the fact that in a lot of states (? all, I don't know) pharmacies will honor out of state Rxs. For example, I'm in NV but I know that if a tourist takes my Rx to CA they'll fill it on my DEA # that's linked to NV. If I go moonlight in CA I imagine they'd still fill my scripts and it might not ever get noticed.?

Ok...so when I move to NV next year (hopefully finding a job after graduation) I can keep my DEA #, change the address to PA to NV, but will also require a state number for practice in NV?

Who'd of ever thought the government would create such a confusing system?

LOL! Yeah, our government is known for creating crystal clear legislation!

 

[f_w]

I am still wondering where RexKD is trying to get with his questions. He doesn't seem to be in medical education (at least not in this country), and the questions are all over the place. Not that there is anything wrong with that, but I am somewhat intrigued by it.

> How is it possible to get multiple board certifications?

> What are considered to be the top 10 medical schools in India?

> Does anyone here have their courses available for viewing online? Is
> this an accepted part of medical school curricula these days? Are
> the videos available all 4 years if you want to review? Or are they
> only available while the course is active?

> How difficult is it to obtain multiple medical licenses?

> How common is it for women or gays to enter urology?

> For an IMG to practice medicine in the US, is it necessary for
> him to do/redo his residency or is it possible just to do a fellowship?

> Can one work to 80? 90?



Just puzzled

 

[gungho]

OK. That is what I thought too. You have to get additional DEA #s for each state you want to actively practice in. If you're just moving you can just move your # but if you are going to say practice in one state and moonlight in another you're supposed to have a new number for the other state.QUOTE]
No, you get one DEA # that you use from now on. Then, depending on the state, you get a state # issued by the state for controlled substances for that state.

[QUOTE-docB]I think that this is made more confusing by the fact that in a lot of states (? all, I don't know) pharmacies will honor out of state Rxs. For example, I'm in NV but I know that if a tourist takes my Rx to CA they'll fill it on my DEA # that's linked to NV. If I go moonlight in CA I imagine they'd still fill my scripts and it might not ever get noticed.QUOTE]

Yes, when I lived in Utah, I called in rx's to NV, CA, and LA and the pharmacies accepted the rx. I even called in a controlled substance to CA once or twice for a patient from Utah who was visiting. I really don't know the law on this, but I provided all the numbers, etc. for the pharmacies and they were willing to accept

 

[gungho]

sorry for the formatting screw-ups

 

[AJM]

Ok...so when I move to NV next year (hopefully finding a job after graduation) I can keep my DEA #, change the address to PA to NV, but will also require a state number for practice in NV?

That is exactly what you can do -- it's a surprisingly easy change of address process considering that it's the federal government.

LOL! Yeah, our government is known for creating crystal clear legislation!

Haha - gotta love the US government and it's bureaucrats. Makes you realize, if you haven't already, that there are just too many lawyers in the government drawing up these kinds of "easy-to-read" guidelines.

 

[paz5559]

You're right a lot of physicians do write scripts for family members, friends and co-workers; people they don't necessarily treat as a PCP. There's no law against it. Matter of fact, I will write my own scripts for some meds I take for chronic conditions as I usually forget to contact my own physician until I have no refills left and I'm out of meds. Some insurance companies will apparently not pay for scripts written by yourself, but I've never had a problem.

But, as noted above, I would refrain from doing so especially for friends and co-workers. Even simple antibiotics can have severe reactions and if there were a complication and you prescribed the med, you could held legally liable.

Nurses at work will often ask for a script; I just tell them I have a policy of not writing scripts for people that aren't my patients. Its gotten worse with friends now that I have a DEA number; for some reason everyone seems to need a "few" Percocet just in case!? 😡

Well even at our resdiency orientation, one of the things they told us is that we are all doctors and we can perscribe for our family and ourselves. We can also precribe for others that are not our patients but to do this with extreme caution and if we do it have some type of documentation. Ive had several nurses ask for persciptons for this and that but ive declined. Also I write my own persciption for a med that I take and occasional meds that I need and my insurance company pays for it 100%. Ive never had a problem...

Boy, it's impressive how much misinformation one thread can have on it! It is both a medicare and state licensing board requirement that you maintain records for ALL patients under your care. Anyone you write a prescription for, yourself, family, friends, nurses, are considered under your care. Will the insurance company pay for it? Probably. If you are ever audited by the Medicare OIG, however, it will be a violation, and if it is for a controlled substance, can the DEA charge you criminally? You bet. Is it done all the time? Absolutely. but seriously, do you really want to take that risk?

The best advice I hae been given is that, if you want to write scripts for friends or family, make sure you have a chart on them in your office. It doesn't need to be extensive, and you don't have to charge them, but that puts you in a defensible position. Since we all are docs, we all know docs. NEVER write narcotics for friends and family, and ALWAYS have a collegue write a script for you, narcotic or otherwise. Are you likely to get caught if you don't folow my advice? Probably not. But do you REALLY want to have to defend yourself in court? IMHO, it just isn't worth the risk.

 

[docB]

Ok...so when I move to NV next year (hopefully finding a job after graduation) I can keep my DEA #, change the address to PA to NV, but will also require a state number for practice in NV?

Exactly. As a surgeon (ie. someone who already has >pgy 3 you can apply for your NV lic now. That's good to do because they're slow and you have to have the lic # to apply for your pharmacy # which takes time too.

Here's the NV Pharm Board site just to save you time.
https://nvbop.glsuite.us/renewal/glsweb/homeframe.aspx

 

[docB]

Since we all are docs, we all know docs. NEVER write narcotics for friends and family, and ALWAYS have a collegue write a script for you, narcotic or otherwise.

But the doc you ask to write you a script would have to make and keep a record just like you would.

 

[frank51]

I have a couple of questions, can interns write prescriptions on their own, or do they have to get it approved by their attending doctor, also I’ve heard that only psychiatrists and doctors in a couple of other specialties can prescribe psychiatric drugs, is this true?