Can I get in trouble writing prescriptions for myself?

The opinions of my colleagues come down near-uniformly on the side of self-prescribing being a bad idea. Yet nobody quite knows why. Most cite a vague belief that in the event of an audit of a doctor’s prescribing practices, self-prescribing counts as a Bad Thing.

Googling pulls up examples of docs cited for self-prescribing controlled substances. That makes lots of sense. But what if the medications in question are topical steroids, COX-2 inhibitors, or birth control pills?

It’s to do with “crossing the line”. Once you prescribe yourself something harmless, there’s only a certain degree of difference between that and prescribing Codeine.

Self-prescribing is a bad idea. It’s also illegal (in Ireland).

Too simplistic. I don’t buy it.

Damn, Doc! Weren’t you taught about this at school? Or at least during your residency? I’m very surprised to learn that a person could go through all the training and social interaction required to become a doctor and then have to check with his colleagues and people on a message board to see what they think. No disrespect intended, just surprised is all.

Don’t you think it’s a good idea to have a neutral (in the sense of “not on that particular drug”) party watching to make sure you’ve got the right dosage?

Really? Here doctors get an official “buy-whatever-you-want”-passport (certain restrictions apply for narcotics.) Your health insurance might refuse to pay for this, but that’s the only problem. I can’t remember a single instance when my father got a prescription by someone else.

Doctors make the worst patients, right?
Either hypochondiracs, or stoics, no middle ground.

It’s a REALLY bad idea to prescribe for yourself, especially if you don’t do all the examinations, tests on yourself that you would do for a patient.

In self-diagnosis the differential diagnosis goes out the wndow, so does the multi-disciplinary team and the 2nd opinion.

And don’t even talk about the legal ramifications for the hospital or clinic where you work if you screw up your own meds.

If I was eg an Orthopaedic surgeon, I sure as hell wouldn’t want to prescribe cardiac drugs for myself.

Q: What’s the definition of a double blind trial?
A: 2 Orthopaedic surgeons trying to interpret an ECG!

In a pinch, I will renew a non-scheduled prescription of a chronic med prescribed for me by one of my docs. That’s generally if it runs out and the doc is not available to renew it in a timely fashion.

But I won’t initiate new therapy on myself. I have learned the hard way that I am not a good judge of my own medical needs.

Keep in mind that it will differ from Country to Country, and in the US from State to State. In Kansas, for example, it is legal for physician to prescribe for themselves and family members. And every doctor I personally know does so.

There’s fairly little risk in self-prescription. Even if a physician wants meds due to additiction, there are myriad ways that they can get it without writing a prescription and leaving a paper trail.

You might be surprised how many veterinarians write scripts for topical steroids, COX-2 inhibitors, or birth control pills for their “dogs”.

Good idea/bad idea I think depends on you.

I would hesitate a schedule II drug, mostly out of fear of the DEA. They are right up there with the IRS, IMHO. :wink:

Thanks for the input. Thanks especially to those with factual input. The editorial replies stirred my curiousity but did not quite answer the question.

Starving Artist, so that your concerns are allayed, I’m not shopping around for opinions, but for facts. Also, I overslept the day, “legalities of self-prescription,” came up during Med school :).

I posted here because I’m unable to find a satisfactory, definitive answer on my own. The SDMB is often a useful place for that sort of thing.

My colleagues generally avoid self-prescription (for innocent medications!). They say this is to avoid slippery slope interpretations should the DEA or Cal Med Board question their practices. That sounded like BS to me. I sense I’m right.

About what?

When you prescribe therapy for yourself you lose a very important thing, objectivity. True, a topical probably won’t send you into a downward spiral of narcotic drug abuse, but there’s a reason that doctor’s have doctors, shrinks have shrinks etc. I’m sure you’ll go out and do whatever the hell you feel like (since you’re right), but you did feel compelled to ask.
Are you more worried about the potential legal problems involved, if so, where do you practice? If you’re more worried about the ethics, I think you should go with your doctor’s opinion, unless of course that’s you.

According to the AMA Code of Ethics, a physician should generally avoid treating oneself or one’s family because objectivity and (in the case of family) the complexities of the outside relationships may intrude in the doctor-patient relationship.

But it is ok for short-term or minor problems.

The sort of self-prescribing I plan to do is much less than medical management. It’s on an occasional basis when scheduling quirks prevent a visit with my MD. I have no complex health problems which makes my job even easier.

Many of the posters in this thread offered advice on whether self-prescribing (or self-care) is a good idea. The consensus on this question is a resounding no. I appreciate your input and concern.

However, I intended to restrict the focus of this thread to legalities of self-prescribing. When I said, “…I’m right,” it was in regard to legalities (ie, self-prescribing non-scheduled drugs does not jeopardize licensure or prescribing privilege).

Do they offer any evidence for the above assertions? More broadly (and playing Devil’s advocate), while we can theorize higher incidences of negative medical outcomes in these cases, are there data?

Here is a professional article directed at Physicans Physician – Treat Thyself? that addresses some of these self prescribing issues. In the article a well regarded California doctor, Gary Nye, M.D., offers the opinion that -

You can do as you wish, (and you’ve made it crystal clear that you will) but it sounds like there is going to be relatively little sympathy from your colleagues, should a self assured young dermatology resident find himself before a medical ethics review board.


Physician – Treat Thyself?

I checked this with a very knowledgeable pharmacist I know in the US. He was unaware of any federal law against this, and he should know about that. He was uncertain about state laws, but he doubted it. Basically, his argument was who seriously would thinks its OK for a doctor to prescribe all sorts of drugs to patients, yet would think it odd if he prescribed himself some 800 mg ibuprofen tablets?

HOWEVER, he commented that such self-prescribing for controlled substances was NOT advisable. His comment was that even if technically legal, this would be inviting the wrath of the DEA to revoke the doctors controlled substances license. IOW, he might not be charged with a crime, but the DEA doesn’t have to wait for a conviction to act against a controlled substances license.

So, you can prescribe people medication, but you don’t know if you can prescribe meds to yourself. Forgive me if I’m a bit baffled by your request, but it seems to me like something that is either acceptable, or blatantly against the law. Shouldn’t your Prof have advised you of such things? Isn’t there some local code you can refer to, or state law?

I’ll admit that I’m wondering why this is in question. Of all people, shouldn’t med students be the first ones told about such a law? If I wanted to know if doctors could prescribe their own meds, I’d ask a doctor, but since you are one, I’m at a loss.

So, how would the general public have a better idea of the legality of an MD prescribing their own meds than another MD would? I’m pretty sure you’re not home-schooled.

Astro, thanks for joining the discussion and for your contribution. I asked about the legalities of self-prescribing because I couldn’t find factual information on my own. Your post is the first addressing that the practice is possibly illegal. My spidey-sense tells me that you’d think I’d carry on regardless. Sometimes I don’t get this place :confused:

Maybe you (and others in this thread) believe that my mind is set on this issue. Far from it.

I am a young resident. My record is unblemished, it’s new. I won’t be jeopardizing it. That’s why the issue of legality is central to the question of self-prescribing.

Not to say it’s the only issue or even the main issue. Whether the ethical issues are thorny or not is both situational and dependent on individual values.

To come down squarely on one side or the other solely on ethical grounds, IMHO, dilutes the complexity of the issues.

I sense that I’ve misrepresented my colleagues’ (actually, my superiors’) views on self-prescribing, as well. My curiousity regarding self-prescribing arose when, in my presence, Derm MD-A asked Derm MD-B to write them for blood pressure medication C. I asked MD-A why she didn’t write the script herself. She felt that it might look bad to an auditor should she ever be investigated. Legalities were on her mind, not ethics

Astro, of course you didn’t know that. I