Guest CMBPAC Posted March 3, 2009 Share Posted March 3, 2009 Hello, I am a newly certified PA and have my DEA. I am wondering what the law is as far as writing prescriptions for yourself. I am not talking about any controlled substances. I am just wondering about everything else - for instance, if I know I have a UTI, can I just write myself some Macrobid? Or can I refill my birth control Retin-A? Anyone have an answer for me? Greatly appreciated! Thank you! Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted March 3, 2009 Moderator Share Posted March 3, 2009 generally considered poor form. have 1 of your colleagues do it for you and have them scribble a short note in your chart.: uti sx x 3 days. no fever/flank pain/n/v O: afebrile, no cvat ua: 3+ leuks, + nitrite a: uti P: macrobid #14 Link to comment Share on other sites More sharing options...
Ridiculopathy Posted March 3, 2009 Share Posted March 3, 2009 in florida, NO....the board of medicine doesnt like it Link to comment Share on other sites More sharing options...
unewillow Posted March 4, 2009 Share Posted March 4, 2009 In some places you can but it's generally considered a no-no. In CT you can, but your attending has to co-sign it and the pharmacy and the board looks VERY closely at the Rx. Link to comment Share on other sites More sharing options...
mdebord Posted March 4, 2009 Share Posted March 4, 2009 On a similar note, what about writing prescriptions for family members? Still nothing controlled, but let's say I know my kid needs routine antibiotics. Do I have to take him to the pediatrician to have them tell me exactly that, or is it ok? Link to comment Share on other sites More sharing options...
JustinPA Posted March 4, 2009 Share Posted March 4, 2009 If it's not a narcotic or anything like that I'm curious why it would matter? I'm sure it's probably easier to have a colleague do it however I don't understand what the harm would be if a PA who had something like asthma wrote themselves an albuterol rx? Granted I know nothing about the prescribing laws, I'm just curious why there would be a law against a health care provider who is allowed to prescribe medications prescribing themselves a drug that is used to treat a common medical condition. Obviously it makes sense to not be allowed to prescribe yourself narcotics though. Link to comment Share on other sites More sharing options...
physasst Posted March 4, 2009 Share Posted March 4, 2009 You all need to remember that we are NOT independent prescribers. Our prescriptive authority is derived from the supervisory agreements with our physicians. This is an important little factoid to keep in mind. Can you write a script for yourself or family? Sure.... HIGHLY unethical, and in some states, depending on the wording in your supervisory agreement, and the boards interpretation of current statute, possibly even illegal. As far as treating your family. There is a reason medical ethics forbids you from treating your immediate family. You cannot be objective, and you will be doing them a disservice. My wife asks me questions all the time about my daughter or herself, I'll answer most of her questions, but otherwise, when she wants specific advice, or an examination, I just tell her to see her physician. Link to comment Share on other sites More sharing options...
Iain1028 Posted March 4, 2009 Share Posted March 4, 2009 I tried writing myself for some Ketamine anasthetic gas after I got my student loan bills. Sweet dreams..... Link to comment Share on other sites More sharing options...
Evan Posted March 4, 2009 Share Posted March 4, 2009 I had a former co-worker call me the other day for an ABX script... I sent her to urgent care. Not a good idea to write stuff for folks that you haven't seen in clinic. You have no physical exam or hx to back up what you did. You are opening yourself up to trouble, IMHO. Also: I write scripts for LIVING... I get paid to do that... sure I like to help out my friends but I also like to eat and pay my mortgage. Link to comment Share on other sites More sharing options...
kittryn Posted March 4, 2009 Share Posted March 4, 2009 in MA you are not allowed to write controlled substance for yourself or family members. I have no problem (nor does our pharmacy) writing myself or my family routine meds that we use on an ongoing basis -- hydrocortisone cream, omeprazole, ibuprofin, cipro for that annoying UTI every once in awhile... but anything that needs a diagnosis or culture or other test to confirm - I would not write anything that can't be supported by a work-up or if I hadn't seen the person as a patient. Link to comment Share on other sites More sharing options...
Contrarian Posted March 4, 2009 Share Posted March 4, 2009 On a similar note, what about writing prescriptions for family members? Still nothing controlled, but let's say I know my kid needs routine antibiotics. Do I have to take him to the pediatrician to have them tell me exactly that, or is it ok? No such thing as "routine antibiotics"... Is the bug gram + or -... ? Will your family member tell you how they "really" got that throat iritation...?? Will they clue you in on the STD masqurading as a UTI...??? Will your family member discuss the infidelity... drugs... or orgy...??? Will they need the morning after pill....??? What about OBJECTIVITY AND PATIENT AUTONOMY...???????? Is it Asthma or Pnuemonia or TB or a PE...??? Some insurance companies won't pay for the script... Its ILLEGAL in many states... If it's not a narcotic or anything like that I'm curious why it would matter? I'm sure it's probably easier to have a colleague do it however I don't understand what the harm would be if a PA who had something like asthma wrote themselves an albuterol rx? Granted I know nothing about the prescribing laws, I'm just curious why there would be a law against a health care provider who is allowed to prescribe medications prescribing themselves a drug that is used to treat a common medical condition. Obviously it makes sense to not be allowed to prescribe yourself narcotics though. See above... "A physician who treats himself has a fool for a patient."—Sir William Osler. http://www.webmm.ahrq.gov/case.aspx?caseID=71 https://www.msu.edu/~eisthen/yeast/MD.html http://www.eurekalert.org/pub_releases/2004-04/ohs-orc041204.php Link to comment Share on other sites More sharing options...
jmj11 Posted March 4, 2009 Share Posted March 4, 2009 I thought this was timely. This is from my hometown (where I was born . . . not where I live) paper. Johnson City physician's assistant accused of writing prescriptions for himself By NET News Service Published February 25th, 2009 | 2 Comments ELIZABETHTON — A Johnson City physician’s assistant was arrested Monday on prescription fraud charges following an investigation by the Elizabethton Police Department. Allen R. Powell, 46, 208 Hillside Drive, Johnson City, was charged with four counts of obtaining a controlled substance by fraud. The charges stem from a complaint filed on Dec. 2 by the office of Dr. Gamal S. Boutros, Northeast Tennessee Associate Neurology, 329 Wesley St., Johnson City. Powell, an employee of the office, is accused of writing fraudulent prescriptions for himself and a friend who was not a patient of Boutros. Investigator Willard Johnson said he found that on April 4 and April 15 Powell wrote a prescription to a man who was not a patient of Boutros. The prescriptions were for Lortab, Soma and Roxicodone. The prescription’s recipient told Johnson he did not pick up the medication from the April 15 prescription. He said he had picked up the first prescription Powell had written for him. He said Powell wrote the prescriptions because he was in pain from his disabilities. Johnson interviewed Powell on Jan. 16 and said Powell admitted to writing prescriptions for himself because of an addiction to pain medication. He said he had picked up the prescription on April 15 at Rite Aid Pharmacy in Elizabethton and used it himself. Johnson said further investigation revealed Powell had written another prescription in his friend’s name for Roxicodone on June 7 that he filled at Burgie Drug Store and which was for his own use. Johnson said there was a fourth prescription written by Powell for himself on June 23. The prescription for Tramadol and Soma and was picked up at Rite Aid in Elizabethton. Powell is scheduled to answer the charges in Sessions Court on March 16. Link to comment Share on other sites More sharing options...
Evan Posted March 4, 2009 Share Posted March 4, 2009 I know how bad is sucks to have a kid who gets sent home from school cause a teacher dx'ed him with "pink eye"... And not be able to write the note to get him back in... yup... it cost us a co-pay to get a note from a doc... I'm real careful to let the teachers know now when the boy is having trouble with his allergies... I'd love to be able to write for myself and my family but that is just not how it works... Link to comment Share on other sites More sharing options...
Guest Walden 0 Posted March 5, 2009 Share Posted March 5, 2009 Wow, I'm surprised that such a question is even being asked! Beyond the obvious ethical considerations, I'd say that everyone should be familiar with details of the prescribing regulations in their states. Link to comment Share on other sites More sharing options...
Moderator ventana Posted March 5, 2009 Moderator Share Posted March 5, 2009 in MA you are not allowed to write controlled substance for yourself or family members. I have no problem (nor does our pharmacy) writing myself or my family routine meds that we use on an ongoing basis -- hydrocortisone cream, omeprazole, ibuprofin, cipro for that annoying UTI every once in awhile... but anything that needs a diagnosis or culture or other test to confirm - I would not write anything that can't be supported by a work-up or if I hadn't seen the person as a patient. write for myself and family for the simple little things - but not pain control or controlled meds used to work with a new grad doc that I had to sit down and tell him to STOP writing vicodin for his wife - was an odd conversation - but needed to happen. (this was not a resident but a board certified attending) no matter what the rules/laws are I think you should just not write a script for narcotics for a family member.... IMHO Link to comment Share on other sites More sharing options...
v_chicky Posted March 6, 2009 Share Posted March 6, 2009 won't write for self or family. was awkward with mom and her back/shoulder pain, but nope, not happening. i find it isn't really necessary, my pa collegues are more than willing to take a peek at me or daughter and write if necessary. usually little things like nasonex, allegra, zofran, amoxil once for daughter's ear after 3wks of cough/fever/congestion and once for me for flexeril from back strain after deciding to rearrange furniture. anything more i prefer to keep private, don't necessarily want coworkers knowing my hx. Link to comment Share on other sites More sharing options...
PADad Posted March 7, 2009 Share Posted March 7, 2009 Can PA's write prescriptions for themselves? No No No Though it may be occasional practice by some, and they get away with it, no prescribing for yourself or family members. Some were right to note that the PA prescribing authority comes in association of the physician. If the prescription you write, even for a friend, is out of the typical scope of practice of your supervising physician, that could be a problem. All docs are licensed to prescribe essentially anything, even if it might be out of their typical scope of practice and knowledge area. If anything goes wrong, and you write an Rx out of your specialty area (e.g. asthma meds if you work in derm), that could be considered out of your scope of practice. The paper prescribing system is very loose and flawed. This is the government interest in pushing and eventually requiring all e-Rx within a couple years. E-prescribing systems will link the PA and supervising physician name together, making it a little more difficult for both physicians and PAs to prescribe outside their specialty area and practice. Link to comment Share on other sites More sharing options...
Border Posted March 7, 2009 Share Posted March 7, 2009 If anything goes wrong, and you write an Rx out of your specialty area (e.g. asthma meds if you work in derm), that could be considered out of your scope of practice. careful with thoughts like that - Doc's can write pretty much anything they are comfortable with - and since we are dependent on them - and there certainly is a basic "core" of medical knowledge simple meds outside of your immediate day to day practice are not by default out of your medical knowledge. We are not talking using theo for Asthma management here - but simply writing an albuterol inhaler as a Derm PA is not unreasonable if you posses the basic medical knowledge and your supervising Doc does also and they are okay with it...... It is really very individual to each PA-Doc relationship - heck I have written simple BP meds for SP in past when he ran out by mistake....... CAUTION with narc's (never write them) and I always make a quick office note and put it in the drawer with atleast Name, CC HPI PE A/P just to cya.... Link to comment Share on other sites More sharing options...
Guest darrenferrell Posted March 12, 2009 Share Posted March 12, 2009 Yeah, I would think noone would want to risk all they have worked for during their education for something like that..... Too bad though, I know it happens all the time. Link to comment Share on other sites More sharing options...
chatcat Posted March 12, 2009 Share Posted March 12, 2009 Medical Boards are pretty specific about guidelines concerning writing Rx for people who there isn't a professional relationship with which includes self prescribing. Here in NC there are usually several violations in the published newsletter of the NCBM for inappropriate prescribing practices. Link to comment Share on other sites More sharing options...
Guest Lorick Posted June 17, 2009 Share Posted June 17, 2009 Virgina Rules and Regs: 18VAC85-50-176. Treating and prescribing for self or family. A. Treating or prescribing shall be based on a bona fide practitioner-patient relationship, and prescribing shall meet the criteria set forth in § 54.1-3303 of the Code of Virginia. B. A practitioner shall not prescribe a controlled substance to himself or a family member, other than Schedule VI as defined in § 54.1-3455 of the Code of Virginia, unless the prescribing occurs in an emergency situation or in isolated settings where there is no other qualified practitioner available to the patient, or it is for a single episode of an acute illness through one prescribed course of medication. C. When treating or prescribing for self or family, the practitioner shall maintain a patient record documenting compliance with statutory criteria for a bona fide practitioner-patient relationship. ------------------------------------ That said, I generally call my boss and run the rx by him/her, just to (a) keep myself honest and (2) insure no potential perception of misconduct. In terms of treating co-workers: You would not treat a "normal" patient without a chart, both for history and for record keeping. Don't treat your colleagues WORSE than you treat the public. You may not elect to CHARGE them for the visit, but sit them down and do the right thing medically. Link to comment Share on other sites More sharing options...
mrpa Posted June 17, 2009 Share Posted June 17, 2009 Can you write prescriptions for your family members outside of the clinics like the nurse practitioners? Link to comment Share on other sites More sharing options...
physasst Posted June 17, 2009 Share Posted June 17, 2009 Can you write prescriptions for your family members outside of the clinics like the nurse practitioners? That's the point, NP's can't in many states either, and even in those in which it is not illegal, it is certainly unethical. Link to comment Share on other sites More sharing options...
yddub80 Posted June 17, 2009 Share Posted June 17, 2009 What annoys me is that the people I work with would all think I was nuts to make a doctor appointment and miss work for an antibiotic or whatever. Also my job has failed to give me the promised health insurance....so, what should I do?? And if I were to have a UTI, I wouldnt feel very comfotable telling the dr I work for that I have dysuria. He really isnt that friendly and doesnt care about any of my personal problems. Like right now I have horrible horrible poison ivy rash and I casually mentioned it to him and he blew me off. Should I tell them I need a day off from work to see some other family med doctor and then pay out of pocket (since I sill have no health insurance??) Also, i have been put in many very awkward situation in treating the entire staff for their medical problems. I had to do a pap on the office manager last week!! Talk about really uncomfortable! Sorry, to vert.....lol Link to comment Share on other sites More sharing options...
brookspa Posted June 21, 2009 Share Posted June 21, 2009 after you see something is unethical, which i consider to be the case here, you just do not do it. should a lawyer have himself for a client or a doctor have himself as a patient?? not so much. Link to comment Share on other sites More sharing options...
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