Friend asking for a Zofran script

[JBH11]

My good friend from childhood asked me if I would write a script for Zofran before he goes away on a trip where he expects to be drinking a lot of alcohol and likely winding up nauseous. 

 

I respectfully declined his request. Although it's not a schedule I or II, I still felt funny about writing it given that it's not a medical necessity and can have potential harmful effects. Also, I would be ignoring the situation of this particular friend maybe needing to cut back on their drinking which is not something I would do for my patients. Has anyone had any similar experiences? I do have to say I wouldn't mind writing myself some Zofran from time to time but am fearful of any possible consequences. 

[Boatswain2PA]

Your good friend is asking to be your patient.  Always be cautious with that for reasons discussed many times here.   As long as you maintain records, and your SP is aware then you're okay.  I'll write some rx's for some friends/family some of the time (acute care type things) but always write a SOAP note and file it in my home office.  SP is aware that I (rarely) do that and is okay.

I have written for Zofran before for patients who are traveling.  It's a good med to have.  I wouldn't do it for this case though.  Sorry...don't want to have a hangover?  Don't drink so much.  Big difference between that and avoiding food in Mexico to avoid diarrhea.

NEVER, EVER, EVER rx yourself. 

[sas5814]

I suspect we have all had similar experiences and this type thing has been discussed here in detail. The bottom line is don't....doesn't meet medical standard of care, no documented visit, no good answer for you if there is some bad outcome or unintended consequence. I always imagine the worst case scenario and this one could end up with a visit to the medical board to explain you lack of visit and documentation. Not worth the risk.

[GetMeOuttaThisMess]

And in Tx it's illegal unless you could demonstrate they are an established patient or will seeing them (scheduled appt. for example).


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[Marinejiujitsu]

Your good friend is asking to be your patient.  Always be cautious with that for reasons discussed many times here.   As long as you maintain records, and your SP is aware then you're okay.  I'll write some rx's for some friends/family some of the time (acute care type things) but always write a SOAP note and file it in my home office.  SP is aware that I (rarely) do that and is okay.

I have written for Zofran before for patients who are traveling.  It's a good med to have.  I wouldn't do it for this case though.  Sorry...don't want to have a hangover?  Don't drink so much.  Big difference between that and avoiding food in Mexico to avoid diarrhea.

NEVER, EVER, EVER rx yourself. 

I had a pharmacist tell me it's ok to call in non controlled substances for yourself. Feels weird to me though.

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[MCHAD]

1 hour ago, Marinejiujitsu said:

I had a pharmacist tell me it's ok to call in non controlled substances for yourself. Feels weird to me though.

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Completely depends on the state, and even if legal by state statutes it could still be looked on as "unethical" by a medical board.

[JBH11]

Thanks for the input. I've seen other providers write themselves zofran before going away traveling but it's not something i am comfortable with, especially as a new grad. 

[CAAdmission]

Skip the Zofran and give your friend the CAGE questionnaire.

[myironlung]

i never do it, not worth any liability or risking my license. PA school was the hardest thing in my life and have waaay too many expenses now to risk losing my profession.

[Reality Check 2]

Advice to not drink like an idiot is much more appropriate in this situation.

True friends will listen.

[Boatswain2PA]

I've had a lot of fun getting drunk.

 

Never had any fun BEING drunk.

 

Now I spend all night getting there, but make sure I never arrive.

[Reality Check 2]

I have genetics for issues with drinking, so I chose to not go there.

Grew up in a violent household with a psycho drunk bio dad who required a restraining order and frequent calls to police for beating on my mum. Finally got rid of the turd and he hasn't known my whereabouts in over 20 yrs. Drinking to get drunk has no appeal to me. 

I have driven for friends and taken one buddy to the ER in college after he tried to drink a girlfriend away. Several liters of fluid and a crapload of phenergan later - no zofran then - I dragged him home with me and took pictures of him sleeping in my childhood girlie twin bed -peach abnd green flowers - and my mum gave him loads of crap over it - going so far as to crack open a beer under his sleeping nose..... The nurse in the ER called me back asking if I was his wife - the dead look shut her up fast. Just told her I wasn't mean enough to leave him at 3 am.

Thanks to celiac I can't drink half the stuff anyway.

Give me good gf cookie and I am a happy girl.

So, again, I side with being a true friend and calling BS on stupid behavior. Give him a cookie.

[Boatswain2PA]

You may have missed my point....

Never had any fun BEING drunk.  Most people go "wait a minute, Yes I have.....oh.....you're right!!!"  as they realize all the fun they have had was before they were drunk.

[JMPAC]

8 hours ago, MCHAD said:

Completely depends on the state, and even if legal by state statutes it could still be looked on as "unethical" by a medical board.

I've called in zofran for myself before a boat vacation (I'm not a drinker but bad motion sickness) and I refilled a month of my own levothyroxine when I was a little late getting in to see my doc (been on the same dose for years). They're meds I've had before and I know I'm not going to sue myself. I wouldn't do the levothyroxine for long because I know I need updated blood work, but I don't see anything wrong with cutting out the middle man occasionally for something like zofran before a long road trip. 

As for the original question, I would've said no to that friend, too. 

[MCHAD]

5 hours ago, JMPAC said:

I've called in zofran for myself before a boat vacation (I'm not a drinker but bad motion sickness) and I refilled a month of my own levothyroxine when I was a little late getting in to see my doc (been on the same dose for years). They're meds I've had before and I know I'm not going to sue myself. I wouldn't do the levothyroxine for long because I know I need updated blood work, but I don't see anything wrong with cutting out the middle man occasionally for something like zofran before a long road trip. 

As for the original question, I would've said no to that friend, too. 

You may not see something wrong with it but some state medical boards do.

[JMPAC]

44 minutes ago, MCHAD said:

You may not see something wrong with it but some state medical boards do.

What would they find wrong? I'm just curious what could happen. I did it after I asked one of my docs about it and a couple of them told me they've called things in for themselves over the years like zofran or abx for UTI, etc. She said she didn't mind calling me in a script but said I could just do it for myself. I've only done those two times and they're certainly not drugs with abuse potential, so I'm not sure why a medical board would even give it a thought. 

[camoman1234]

9 minutes ago, JMPAC said:

What would they find wrong? I'm just curious what could happen. I did it after I asked one of my docs about it and a couple of them told me they've called things in for themselves over the years like zofran or abx for UTI, etc. She said she didn't mind calling me in a script but said I could just do it for myself. I've only done those two times and they're certainly not drugs with abuse potential, so I'm not sure why a medical board would even give it a thought. 

Not a good idea, if the doc jumped off a bridge would you?

[JMPAC]

4 minutes ago, camoman1234 said:

Not a good idea, if the doc jumped off a bridge would you?

Okay, wow. Genuinely asking for info on what I thought was a professional message board. Can it not be a respectful conversation? Does internet anonymity cause rudeness on every damn platform? 

[sas5814]

26 minutes ago, JMPAC said:

What would they find wrong? I'm just curious what could happen. I did it after I asked one of my docs about it and a couple of them told me they've called things in for themselves over the years like zofran or abx for UTI, etc. She said she didn't mind calling me in a script but said I could just do it for myself. I've only done those two times and they're certainly not drugs with abuse potential, so I'm not sure why a medical board would even give it a thought. 

What they could find wrong is no documentation in a chart even if you wrote it electronicaly, no documented justification for the med, no physical exam to justify the med. It isn't like I haven't done it over the years but things have changed and continue to change and I have had to change with it. You have to look at it from the perspective of sitting in front of a panel down at the board getting grilled. Nothing matters but what is documented and meeting the standard of care. Just this morning I had to see a colleague for a problem I could easily have managed myself because the potential fallout from self prescribing is just too high. I would imagine, if it became an issue the board was looking at, the best you could do is a letter of censure and the worst is some mandatory training on medical ethics and spending the rest of you career explaining it every time you credential or apply for a job. It just isn't worth the risk for me.

As an aside pharmacies have started refusing to fill prescriptions if they realize you are self prescribing or prescribing for a first degree family member. That could be the path to a board report that, otherwise, is unlikely.

[JMPAC]

5 minutes ago, sas5814 said:

What they could find wrong is no documentation in a chart even if you wrote it electronicaly, no documented justification for the med, no physical exam to justify the med. It isn't like I haven't done it over the years but things have changed and continue to change and I have had to change with it. You have to look at it from the perspective of sitting in front of a panel down at the board getting grilled. Nothing matters but what is documented and meeting the standard of care. Just this morning I had to see a colleague for a problem I could easily have managed myself because the potential fallout from self prescribing is just too high. I would imagine, if it became an issue the board was looking at, the best you could do is a letter of censure and the worst is some mandatory training on medical ethics and spending the rest of you career explaining it every time you credential or apply for a job. It just isn't worth the risk for me.

As an aside pharmacies have started refusing to fill prescriptions if they realize you are self prescribing or prescribing for a first degree family member. That could be the path to a board report that, otherwise, is unlikely.

Thanks, I really appreciate your insight. It's just something that seems to be a pretty common practice with the providers I work with, so I really didn't think too much of it. I'll definitely think twice before doing it again.

[MCHAD]

45 minutes ago, JMPAC said:

What would they find wrong? I'm just curious what could happen. I did it after I asked one of my docs about it and a couple of them told me they've called things in for themselves over the years like zofran or abx for UTI, etc. She said she didn't mind calling me in a script but said I could just do it for myself. I've only done those two times and they're certainly not drugs with abuse potential, so I'm not sure why a medical board would even give it a thought. 

Self prescribing is illegal in many states even for non controlled...and in others while it isn't illegal on the books it is considered unethical, in Utah for example.

[camoman1234]

24 minutes ago, JMPAC said:

Okay, wow. Genuinely asking for info on what I thought was a professional message board. Can it not be a respectful conversation? Does internet anonymity cause rudeness on every damn platform? 

"I did it after I asked one of my docs about it and a couple of them told me they've called things in for themselves over the years like zofran or abx for UTI, etc. She said she didn't mind calling me in a script but said I could just do it for myself. "

This comment is what I was referring too. Please re-read it and you will get my point, don't play follow the leader if it is something not right. Just because someone else did it does not make it right. I am not trying to be an a$$, just being honest. 

[twodogsandaPA]

I'm not a practitioner but I work in California with a doctor who's license was suspended and he had to perform community service because he was found guilty of Rxing himself. He's now back to working but that mark is still on his record when you look him up on sites that check licenses.


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[Marinejiujitsu]

I'm not a practitioner but I work in California with a doctor who's license was suspended and he had to perform community service because he was found guilty of Rxing himself. He's now back to working but that mark is still on his record when you look him up on sites that check licenses.


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Controlled substance?

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[twodogsandaPA]

Controlled substance?

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I didn't ask for details.


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