Prescribing for self and family members – never a good idea

On Friday, I am scheduled to speak to a group of third year medical students in Ohio about the Medical Board disciplinary process. I have given this talk several times, but for this particular group of students I thought I would look up some recent Medical Board disciplinary actions and try to highlight an area that might not be an obvious violation to most physicians.  One area that often surprises physicians is the prohibition against prescribing for self and family members.

The standard of care requires physicians to be able to use detached professional judgment in treating patients. This can not be done when prescribing to yourself or for a close family member.   The Medical Board in Ohio has a specific rule that prohibits the prescribing of controlled substances by physicians to themselves and to close family members. http://codes.ohio.gov/oac/4731-11-08

Physicians may only use controlled substances to treat a family member in an emergency situation. However, even in these instances, the physician needs to take the same care with the family member that they would with any other patient. The physician must conduct a physical examination and maintain a clear written medical record.  Physicians may not prescribe controlled substances to themselves. The physician may obtain an over the counter Schedule V controlled substance for personal  use, but must follow all state and federal laws that a non-physician would be required to follow.

Physicians may prescribe to family members in an emergency situation. However, when prescribing to a family member, the prescription must be for a short period of time until the patient can schedule an appointment with their regular treating physician. Prescriptions with multiple refills for family members are not considered for an “emergency” basis and will violate the Board’s rule.

Physicians have been disciplined by the Medical Board of Ohio for prescribing controlled substances to family members that have been initially prescribed by other doctors, for prescribing medications with multiple refills, and for failing to take and maintain an adequate medical record.

Although, OAC 4731-11-08 specifically addresses controlled substances, the Medical Board also does not approve physicians writing prescriptions to family members for non-controlled substances, such as birth control pills unless the physician has conducted a physical examination and also maintained a medical record.  The AMA has also addressed this issue in AMA Ethics Opinion 8.19, which discourages the treatment of self or family members. http://www.ama-assn.org/ama/pub/physician-resources/medical-ethics/code-medical-ethics/opinion819.page

It is never a good idea to prescribe to yourself or to family members. You and your family members should always seek treatment from your own treating doctor.

As always, if you have any questions about this post or any other questions about the State Medical Board of Ohio, feel free to send me an email at beth@collislaw.com or call me at 614-486-3909.

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