Your own prescription

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afterwords

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Hello Everyone,

I was wondering are interns/residents allowed to write prescriptions for themselves? I am not talking about scheduled/narcotics etc. I mean things like metformin/OCPs/HTN meds/oth Diabetes meds.

Thank you!

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Hello Everyone,

I was wondering are interns/residents allowed to write prescriptions for themselves? I am not talking about scheduled/narcotics etc. I mean things like metformin/OCPs/HTN meds/oth Diabetes meds.

Thank you!

I wouldn't do it though it is legal in many states I am sure. The reason being is that if you treat your family members, such as your father's hypertension, but are a pediatrician then you could get in trouble with the medical board for practicing outside of your area of expertise. Unless you are a board certified family practice physician or internist then you shouldn't treat yourself. The reason being is that as a resident you have someone supervising you, while if you treat yourself you aren't going to present yourself to your attending.

Even if you are a board certified internist, you should have your own doctor to objectively evaluate and treat your medical conditions.
 
Its perfectly legal to prescribe yourself such things. Physicians regularly write themselves for birth control, prn antibiotics, etc. Whether its a good idea or not has been the subject of multiple threads here.

However, if you have serious medical problems requiring anti-HTN and DM meds, you really do need a physician, and not just to write you scripts.
 
I wouldn't do it though it is legal in many states I am sure. The reason being is that if you treat your family members, such as your father's hypertension, but are a pediatrician then you could get in trouble with the medical board for practicing outside of your area of expertise. Unless you are a board certified family practice physician or internist then you shouldn't treat yourself. The reason being is that as a resident you have someone supervising you, while if you treat yourself you aren't going to present yourself to your attending.

Even if you are a board certified internist, you should have your own doctor to objectively evaluate and treat your medical conditions.

Board certification is quite different than prescribing rights and medical licensure. Although board certification in some ways defines scope of practice per se, it has more to do with hospital privileges and malpractice coverage.

I have a full, unrestricted medical license and DEA number yet I am not board certified. I can treat children, adults, pregnant women and prescribe them meds, and I am *not* going to get into trouble with the medical board for doing so, although I am not a pediatrician, internist, or obsterician.
 
I write for my own Flonase and Retin-A. I'll also give myself the occasional run of antibiotics (like after I spent the day with my best friend's kid who the next day came down with Strep throat). I have a PCP, but don't make it there very often.
 
I write my own flonase. As long as you have a full medical license (not just a provisional or training license), in most states it is not a problem for a physician to write a perscription for themselves for non-narcotics.
 
Not about self-prescriptions per se, but a related issue:

In one of our ethics lectures recently, the lecturer mentioned that in the US it is considered ethical for physicians with ill family members to act as a family member, rather than a physician (i.e., avoid looking at the medical record, avoid prescribing them medications, etc).

By contrast, in many EU countries just the opposite is the case. It is assumed that family members with medical training should act in a treatment capacity and be highly involved in their medical care.

Does anyone know more about this? I can see the argument for either case, and it is a sort of interesting contrast.
 
i prescribe my own flonase and imitrex--both of which i have been taking for over a decade. i would not prescribe myself anything else. the only time i have prescribed anything for anyone else was zofran for my pregnant, puking sister who took it without difficulty for previous pregnancies.
 
i prescribe my own flonase and imitrex--both of which i have been taking for over a decade. i would not prescribe myself anything else. the only time i have prescribed anything for anyone else was zofran for my pregnant, puking sister who took it without difficulty for previous pregnancies.
Three things:

1. If you wrote a prescription for your sister and there is no note in a medical record describing what you have done / why you have done it, you are most likely violating the medical practice laws of your state. If investigated (for this, or if this is found when they are investigating something else), you could lose your medical license over it.

2. If your sister lives in a different state than you, then you are practicing without a license.

3. You have absolutely no medmal coverage for this. No policy you own will cover you.

All of these things are unlikely. All of them can bring your career to a halt.
 
Three things:

1. If you wrote a prescription for your sister and there is no note in a medical record describing what you have done / why you have done it, you are most likely violating the medical practice laws of your state. If investigated (for this, or if this is found when they are investigating something else), you could lose your medical license over it.

2. If your sister lives in a different state than you, then you are practicing without a license.

3. You have absolutely no medmal coverage for this. No policy you own will cover you.

All of these things are unlikely. All of them can bring your career to a halt.

All very true.
 
2. If your sister lives in a different state than you, then you are practicing without a license.

So, if my sister who lives out of state visits me and gets a rx from me for her inhaler, would that be considered practicing without a license? Or is it more like me mailing her a script out of state?

I mean, I write rx for out of state people who I see in my state of licensure. That can't be illegal. Nor can trying to fill that script either instate or out of state be on me, since I have no control where they try to fill the script.
 
I know that in residency I ran into problems with people out of state trying to fill prescriptions (especially for scheduled drugs) outside of Pennsylvania. I had to tell patients that they needed to fill the prescription before they left the state; I have friends who have had the same experience. So you do have some control about where your patients fill their script as you need to tell them that it may not be filled out of state.

I'm not sure if its a licensing issue or if they cannot look you up in their computer system out of state, so they cannot verify if the script is real. I think its a chance people take when getting a script from a physician in another state...there must be a way around it, otherwise how do on-line pharmacies (who might be located in another state) work?:confused:
 
So, if my sister who lives out of state visits me and gets a rx from me for her inhaler, would that be considered practicing without a license? Or is it more like me mailing her a script out of state?

I mean, I write rx for out of state people who I see in my state of licensure. That can't be illegal. Nor can trying to fill that script either instate or out of state be on me, since I have no control where they try to fill the script.

If you actually see her in your state and write the script there, then all is legal. As WS points out, if it's a narcotic or other controlled drug then usually it would need to be filled in state (but in that case, you should NOT be writing it for your sister).

If you call in a prescription to another state without seeing her, you are technically breaking the law. The standard would be that you would see her in your office in your state, and generate a prescription. If your office was near a state border, it would be perfectly legal to call in a prescription to the other state. What wouldn't be legal is simply calling in a script for a friend who lives in a different state, that you haven't seen.

Let's not forget that these types of things happen all the time, and very few people get into trouble for them. The point is that you could get into trouble, so you should at least think twice about it. My rule of thumb is that I will write very short, emergency scripts for family members or visitors -- enough to get them through to when they can see their own doc. No narcs, no benzos, no stimulants. No refills.
 
I know that in residency I ran into problems with people out of state trying to fill prescriptions (especially for scheduled drugs) outside of Pennsylvania. I had to tell patients that they needed to fill the prescription before they left the state; I have friends who have had the same experience. So you do have some control about where your patients fill their script as you need to tell them that it may not be filled out of state.

I'm not sure if its a licensing issue or if they cannot look you up in their computer system out of state, so they cannot verify if the script is real. I think its a chance people take when getting a script from a physician in another state...there must be a way around it, otherwise how do on-line pharmacies (who might be located in another state) work?:confused:

I practice at an institution reasonably close to a state border, and I've never had this problem. I don't know if it's just this particular region, but I've even had multiple calls from pharmacies across the state line for clarifications and what not that didn't seem concerned that my license was only valid in my current state. I always wrote the prescriptions for patients seen in my state. It really can't possibly be illegal to have them filled out of state as long as you practice in state.
 
I have a federal DEA, but also a state dispenser's license. When I was in South Carolina, I was near the North Carolina and Tennessee borders. I always made it a point to tell patients for whom I had written a prescription for a controlled substance that the controlled med had to be filled in SC, since I was not license in NC or TN.

For uncontrolled meds, though, there's not an issue.
 
I practice at an institution reasonably close to a state border, and I've never had this problem. I don't know if it's just this particular region, but I've even had multiple calls from pharmacies across the state line for clarifications and what not that didn't seem concerned that my license was only valid in my current state. I always wrote the prescriptions for patients seen in my state. It really can't possibly be illegal to have them filled out of state as long as you practice in state.

I have a federal DEA, but also a state dispenser's license. When I was in South Carolina, I was near the North Carolina and Tennessee borders. I always made it a point to tell patients for whom I had written a prescription for a controlled substance that the controlled med had to be filled in SC, since I was not license in NC or TN.

For uncontrolled meds, though, there's not an issue.

Miami - you don't have a DEA yet, right? The issue was not with uncontrolled meds.

For uncontrolled meds, I never had a problem with patients filling them out of state. It was the post-op narcs. Like Apollyon I would have to tell patients to fill them in-state because of problems with pharmacies not filling them for out of state patients.
 
If you have completed residency and have your own state medical license and DEA number, and you write acne (topical Retin-A or Aclaro) prescriptions for yourself, would insurance companies still provide coverage so you would only have to pay a co-pay for the meds, rather than the entire cost?
 
If you have completed residency and have your own state medical license and DEA number, and you write acne (topical Retin-A or Aclaro) prescriptions for yourself, would insurance companies still provide coverage so you would only have to pay a co-pay for the meds, rather than the entire cost?

These two things don't go together. First is legally being able to write the prescription. Whether insurance will pay for it is a separate issue. There is no difference as to who is the prescriber in consideration for payment.

Actually, to refuse to pay for a medication solely because you prescribed it for yourself is probably illegal.
 
If you have completed residency and have your own state medical license and DEA number, and you write acne (topical Retin-A or Aclaro) prescriptions for yourself, would insurance companies still provide coverage so you would only have to pay a co-pay for the meds, rather than the entire cost?

I've never had a problem with it. The pharmacist just has to enter the "acne" indication and it goes through.
 
so if I call in for a prescription for an antibiotic for a friend and there is no documentation that I saw them will I get in trouble for that. Or what if I call in birth control for my GF with the same thing...no documentation. Do I get in trouble for this. I dont have my permanent license yet..just the temp. Thanks
 
so if I call in for a prescription for an antibiotic for a friend and there is no documentation that I saw them will I get in trouble for that. Or what if I call in birth control for my GF with the same thing...no documentation. Do I get in trouble for this. I dont have my permanent license yet..just the temp. Thanks

The pharmacist has no way of knowing whether or not this person is your patient. He doesn't know, for instance, that Mary Smith is your girlfriend, and not the patient from your 3 PM appointment.

If your GF has an anaphylactic reaction to the antibiotic or the OCP, then yes, you might be in for a world of hurt from the powers that be. Otherwise, it probably wouldn't even be noticed by the pharmacist, even if you have just a training license.
 
Miami - you don't have a DEA yet, right? The issue was not with uncontrolled meds.

For uncontrolled meds, I never had a problem with patients filling them out of state. It was the post-op narcs. Like Apollyon I would have to tell patients to fill them in-state because of problems with pharmacies not filling them for out of state patients.
Slightly off OP's topic, I have a panel full of patients who travel. These patients either work in other states and commute home, or are snowbirds to move south for the winter. Frequently I'll get a call from them asking for a refill in say FL or AZ.

They are my patients, I have treated them and they have side effects of treatment requiring ongoing medication. Can I legally renew their Rx in AZ? I've run into this in the past, but in the states in question, I was licensed in both. I am not in AZ. Most do not have sub-specialty physicians in their winter homes.
 
Slightly off OP's topic, I have a panel full of patients who travel. These patients either work in other states and commute home, or are snowbirds to move south for the winter. Frequently I'll get a call from them asking for a refill in say FL or AZ.

They are my patients, I have treated them and they have side effects of treatment requiring ongoing medication. Can I legally renew their Rx in AZ? I've run into this in the past, but in the states in question, I was licensed in both. I am not in AZ. Most do not have sub-specialty physicians in their winter homes.

Are you asking me to write their prescriptions? :D

I don't see why you couldn't renew their scripts, especially if you were the original prescriber. I am not sure why patients wouldn't take care of such things before flying south for the winter, but then I guess, once again, my expectations for patients are too high.

I have the same problem in reverse. I see the snowbirds who do not have a regular physician here and I need them to get clearance for their surgery. Some of these people are not medically maximized and they claim they have no one here would can clear them. I've had to find some PCPs who will see new patients on short-notice.
 
http://www.ncmedboard.org/position_..._family_members_and_others_with_whom_signifi/

"It is the position of the North Carolina Medical Board that, except for minor illnesses and emergencies, physicians should not treat, medically or surgically, or prescribe for themselves, their family members, or others with whom they have significant emotional relationships..."

Thats how it works in my state at least...

If you get to know medical boards, you'll find that the NCMB might be considered more intrusive and overbearing and not doctor-friendly (if not outright hostile) than many other jurisdictions. The wording of their position statement is not casual or random, is planned that way, and means that they would get on you for refilling your own insulin or ramipril or metoprolol (because they can, and would, make a case that what is being treated is not a "minor illness"). It sounds extreme or outrageous until it actually occurs.
 
When it comes to whether or not a prescription is legal and valid, you have to take into account the laws pertaining to both prescribing and filling in the state of origin and the state of filling. There is not any consistent answer as to what is or is not allowable because state laws vary so much.

In OR, a physician may legally write for a controlled substance for himself and there are no scope of practice limitations. In WA, he may not legally write for his own controls and he may only write for prescriptions within the scope of his field of practice. Meanwhile in IA, you can't legally write for yourself at all - supposedly.

Validity is a related but separate issue. A prescription has to be legal to be valid, but not all legal Rxs are valid. For example, you may write for a narcotic legally in PA, but if your patient takes it to a state that does not allow filling of out of state narcotic prescriptions, the Rx is not valid there. It is not illegal to present it to fill - you will just get declined. That is probably what was going in with WS's PA patients. Interestingly, in WA a prescription is deemed valid if it's valid in the state in which it is written. So, a controlled substance RX written legally in OR for a physician licensed in OR can be taken to WA and filled legally even though WA physicians can't self prescribe narcotics.

Slightly off OP's topic, I have a panel full of patients who travel. These patients either work in other states and commute home, or are snowbirds to move south for the winter. Frequently I'll get a call from them asking for a refill in say FL or AZ.

They are my patients, I have treated them and they have side effects of treatment requiring ongoing medication. Can I legally renew their Rx in AZ? I've run into this in the past, but in the states in question, I was licensed in both. I am not in AZ. Most do not have sub-specialty physicians in their winter homes.
You can legally prescribe for them just as you would in your home state. The pharmacist filling the Rx holds the responsibility for determining whether or not the Rx is valid and filling or declining the Rx accordingly. My recommendation would be to talk to the pharmacist in person if you aren't sure about the validity of the Rx you are calling in. They should alert you immediately if they are unable to accept an out of state Rx for whatever you are writing for.
 
If you get to know medical boards, you'll find that the NCMB might be considered more intrusive and overbearing and not doctor-friendly (if not outright hostile) than many other jurisdictions. The wording of their position statement is not casual or random, is planned that way, and means that they would get on you for refilling your own insulin or ramipril or metoprolol (because they can, and would, make a case that what is being treated is not a "minor illness"). It sounds extreme or outrageous until it actually occurs.

I actually noticed that they seem to make mountains out of mole hills. When I started to my application for med school my advisor went through and tried to introduce me what I was getting into when I pursued this career.

Some of the reasons that physicians have been disciplined that are listed on their website seem ridiculous. Do a search on their... they made a case against a guy for saying "He could do colonoscopy with his eyes closed" then jokingly acted like he was going to close his eyes while doing it... someone told NCMB and the med board published a report... how embarassing

Let me edit this before someone screams "You have no idea what you're talking about"... I'll go ahead and say I'm still in the application process and this at least seems ridiculous to me...
 
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