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Self Prescribing Antibiotics


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I know... Don't do it! But I have to ask since I can't find the legal wording to be absolutely sure. I live in California. I'm embarrassed to discuss this, but I have a feminine issue (BV) and need a metronidazole rx. There is no chance it's caused by anything else, I know exactly what it is. I work in aesthetics, my DSA includes things like Valtrex, medrol dosepaks, and antibiotics for complications. I don't have insurance and really don't want to go to the doc, go through a female exam, just to be told I need metro. I've been unsuccessfully trying for a couple weeks to get an appointment at Planned Parenthood and really just wish I could call the dang thing in myself. Also, I'm too embarrassed to ask any friends to prescribe it for me. What would you do in my shoes?

 

:O_O:

 

Yeah I'll probably just end up waiting a few weeks till I can be seen, but this sucks!

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Common issue. The primary inhibitor here is your ( unnecessary) embarrassment. "Man up" (ahem), and approach a friend or better yet your sp and simply ask if they would mind writing you an rx for metro gel vag cream. Shouldn't be a problem. Work a deal with them that if this doesn't work you will see a PCP. I have no prob doing this sorta thing for a colleague.

 

Most BME really frown on self prescribing.

 

Good luck.

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agree with Davis. when I go to Haiti and need a doxy rx for malaria prophylaxis I always have one of my partners write it for me.

 

Agree with the above, you have to remember, your prescriptive privileges are not yours alone. They are delegated to you by your physician collaborator. Whether we like that or not (I certainly do not), from a purely technical perspective, you cannot write a prescription that your physician would not write or would not approve of (generally means limited to his/her practice). If you are audited, that could be a problem.

 

I used to write scripts for fellow PAs, physicians, or nurses, but I won't do that anymore...Not since I actually heard of one PA that got in trouble in another state for writing a prescription for his neighbors kid who was sick. The pharmacy was unclear on the dosing and called the office on the script. It made its way to a covering physician who could not find any record of the kid in their files, which was relayed to the pharmacy. It became a big mess, and I know that the PA lost their job and I know the state medical board was involved. I never heard what the outcome was, but just remember, those privileges come with limits.

 

Ask your SP. Just some friendly advice.

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I was out of town once on vacation and on a Sunday morning woke up with a raging UTI. I walked in to the Walgreens pharmacy across the street from my hotel, found the pharmacist and told her the problem. She let me write myself a 4 day supply of Cipro...enough to get me home. The pharmacist was really nice about it. I just gave her my prescribing #, she looked me up in their system, and I used one of their in house RX pads. She filled it right away while I waited. Oh, and I charted it all when I got back to the office :)

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I know tons of PAs that write rx's for their family/friends without actually "seeing" them for an office visit. How illegal is this? For example, my friend's ( a PA) daughter was sick and she lives about 3 hours away, but she sent a rx for her to her local pharmacy for a z-pack. And... sometimes her mom or dad would call her and ask for certain rx antibiotics or steroid creams. They live in the same town, so should would just electronically send the rx over to the pharmacy for her parents.

 

This seemed like a fairly regular occurrence......

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It's not illegal to write for yourself, as long as it's not controlled. Whether it's a 'good idea' or 'frowned upon' by others is another matter entirely. Charting is always the way to go.

 

Yep, and while it's not illegal to write for friends or family, you have to remember ALWAYS, that you are NOT an independent prescriber. It sucks, I don't like it at all, but, that's the way it is now. While you probably won't end up in court, you COULD end up in trouble with your medical board if it is deemed that you violated your supervisory agreement by prescribing to patients that were not approved of by your supervising physician.

 

So, not illegal, but certainly frowned on, and you could potentially be in trouble from a credentialing standpoint. You could also end up in court if the person has a drug reaction, complication, or allergic reaction.......in fact, with no charting to back you up, well, good luck.

 

Always, always, always have it charted. I still get asked by nurses, CAs, etc., I always explain that I am simply not comfortable doing that, and that perhaps they should ask one of the docs (who by the way, almost all give the same answer and recommend that they contact their doctor)....

 

In my opinion, the risk is simply too great.

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It's not illegal to write for yourself, as long as it's not controlled. Whether it's a 'good idea' or 'frowned upon' by others is another matter entirely. Charting is always the way to go.

 

Want a different view?

 

most medical board and pa board post their discipline hearing conclusions on line. Search some of them - scared the living heck out of me for what people get in official license trouble for. Sorry i don't write for family or friends....

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Want a different view?

 

most medical board and pa board post their discipline hearing conclusions on line. Search some of them - scared the living heck out of me for what people get in official license trouble for. Sorry i don't write for family or friends....

 

I wasn't talking about writing for family or friends, I was speaking to the OP about their original question of writing for themself for a yeast infection. And as I stated, there may be consequences of various types, I'm sure, but the fact remains (at least to the best of my knowledge) that it isn't illegal.

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Want a different view?

 

most medical board and pa board post their discipline hearing conclusions on line. Search some of them - scared the living heck out of me for what people get in official license trouble for. Sorry i don't write for family or friends....

 

and odd, that's not what you said in this thread ... want a different view?

 

http://www.physicianassistantforum.com/forums/showthread.php/19302-Can-PA-s-write-prescriptions-for-themselves

 

write for myself and family for the simple little things - but not pain control or controlled meds

guess you had a change of mind and that is of course allowed in life. there are some good links in that thread, here are a couple others (remembering that we are not independent prescribers...)

 

http://www.nh.gov/medicine/aboutus/self_presc.htm

 

http://www.nabp.net/news/kansas-news-mid-level-practitioner-prescribing/

 

The Physician Assistant Licensure Act and the Advanced Registered Nurse Practitioner Act do not specifically preclude mid-level practitioners from writing prescriptions for themselves or their family members. The American Medical Association’s Code of Ethics allows for the activities in emergencies or for minor issues, but it is considered inappropriate to prescribe controlled substances to family members.

 

as others have said, there may be state specific guidelines which i am unaware of.

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tO ADD TO THE MIX:

This is the north carolina BME position:

 

Not illegal, but frowned upon.

 

And (in a different position statement), they INSIST on records.

 

davis

 

 

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home : professional resources : position statements : self-treatment and treatment of family members

Self-treatment and treatment of family members

Created: May 1, 1991Modified: Amended May 1996, May 2000, March 2002, September 2005, March 2012

It is the Board’s position that it is not appropriate for licensees to write prescriptions for controlled substances or to perform procedures on themselves or their family members. In addition, licensees should not treat their own chronic conditions or those of their immediate family members or others with whom the licensee has a significant emotional relationship. In such situations, professional objectivity may be compromised, and the licensee’s personal feelings may unduly influence his or her professional judgment, thereby interfering with care.

 

There are, however, certain limited situations in which it may be appropriate for licensees to treat themselves, their family members, or others with whom the licensee has a significant emotional relationship.

 

1.Emergency Conditions. In an emergency situation, when no other qualified licensee is available, it is acceptable for licensees to treat themselves or their family members until another licensee becomes available.

2.Urgent Situations. There may be instances when licensees or family members do not have their prescribed medications or easy physician access. It may be appropriate for licensees to provide short term prescriptions.

3.Acute Minor Illnesses Within Clinical Competence. While licensees should not serve as primary or regular care providers for themselves or their family members, there are certain situations in which care may be acceptable. Examples would be treatment of antibiotic-induced fungal infections or prescribing ear drops for a family member with external otitis. It is the expectation of the Board that licensees will not treat recurrent acute problems.

4.Over the Counter Medication. This position statement is not intended to prevent licensees from suggesting over the counter medications or other non-prescriptive modalities for themselves or family members, as a lay person might.

Licensees who act in accord with this position statement will be held to the same standard of care applicable to licensees providing treatment for patients who are unrelated to them. Thus, licensees should not treat problems beyond their expertise or training.

 

The Board expects licensees to maintain an appropriate medical record documenting any care that is given. It is also prudent for the licensee to provide a copy of the medical record to the patient’s primary care provider.

Licensees who inappropriately treat themselves, their family members or others with whom they have a significant emotional relationship should be aware that they may be subject to disciplinary action by the Board.

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and odd, that's not what you said in this thread ... want a different view?

 

http://www.physicianassistantforum.com/forums/showthread.php/19302-Can-PA-s-write-prescriptions-for-themselves

 

.

 

 

That link was from 03-05-2009, 06:36 PM Come on - read the dates on things.........

YES I had a change in heart - once reading over what people were getting in trouble for - no more... my license is my life, my career, my income, my whole life - stupid to risk it for a script....

 

 

 

 

 

I wasn't talking about writing for family or friends, I was speaking to the OP about their original question of writing for themself for a yeast infection. And as I stated, there may be consequences of various types, I'm sure, but the fact remains (at least to the best of my knowledge) that it isn't illegal.

 

safe to assume if I am not writing for family or friends I am not writing for myself - I call my PCP and ask them....

 

 

 

 

 

 

There are many things that are not illegal that can get you fired or your priveleges/license revoked.

 

EXACTLY - why risk it?

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Thank you for all your opinions and information, it's helpful to see what others would do. I did finally make it in to Planned Parenthood to get the medication.

 

Legal & licensing issues aside, it is my opinion that self prescribing is morally okay in a case like this. I clearly see the reasons against prescribing for self/family in most other scenarios. Unfortunately, I didn't feel comfortable writing for myself and instead chose to take a few hours to go to the free clinic, endure a rather painful exam, get unnecessary testing for STDs I didn't have, and also explain to the NP who treated me why I had no insurance. It was a big waste of money because I took her time away from other patients and used government money for unnecessary STD & pregnancy testing, only to get the prescription I already knew I needed. Oh and there were some lovely protestors outside the clinic with signs telling me not to have an abortion...

 

BTW- I don't have health insurance because I am not employed full time yet and I can't afford to buy my own coverage.

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