***Damn, hit send by accident
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I found it ironic that my legalistic-only fixated superiors watch as I’m pilloried for ethical shortcomings in your vision, Astro.
You’d figure, wouldn’t you? There are many things doctors don’t learn until after they begin practice, however. My short list of Med School shortcomings includes:
- Legality of self-prescription (you already knew that)
- How to bill (a myriad of rules exist)
- How to be a small business owner
- How to be prepared for a malpractice suit (it’s said they happen to everyone eventually. Not me yet, though)
I hope it’s clear to you from this thread that a simple answer is elusive.
I’d suggest that you bounce this question off some pharmacists in your state. Pharmacist almost always know more about the legalities of prescribing, because well…that’s what line of business they are in. I note above you wrote “She felt that it might look bad to an auditor should she ever be investigated.” What kind of auditor? As in a state or federal one that would have you prosecuted for breaking the law? Or one that would question medical ethics?
And, as a practical matter, who enforcing prescribing laws will even be looking at scripts for 800 mg ibuprofen tablets? They’ll be plowing through the pharmacists controlled substance scripts on file.
I’m thinking legal, not ethical. They typical ethics board review would not address an issue as broad as a physician’s global prescribing practice.
In that case, most definitely the people you would want to talk with is pharmacists. If this is illegal in your state, then a pharmacist could be held legally liable as well as you. I’d be shocked to learn that in the case of non-controlled substances, there actually would be a law against self-prescribing. Basically, this would mean that pharmacists would be questioning a physician’s global prescribing practice. NOT the sort of thing pharmacist want to get involved in. As you are discussing specifically non-controlled substances, I just can’t imagine a prosecution of a doctor for writing themselves a script for 800 mg ibuprofen tablets. To be blunt, the very notion sounds downright silly.
ChoosyBeggar
Most State Bar organizations have an Ethics Hotline availible for Attorney’s. If an attorney is concerned about or is unsure of the ethical ramafications af a particular activity he or she can obtain guidance by calling the HotLine. They will not offer specific answers or legal opinions but they will point out Cases and AG Opinions that have dealt with the same or similar issues.
I would think Medical Liscencing Board in your jurisdiction would offer a similar service. If all else fails you may consider seeking advice from an attorney.
My own uninformed opinion (not a legal opinion) is that as long as the perscriptions you write for yourself are not for substances that are addictive or ones that alter consciousness (ie get you “High”) or alleviate pain the consequences, if any, will probably not be severe. Be aware that there may be a statute that prohibits self RX, regardless of the substance involved and that there may be Rules promulgated by your liscencing board, the violation of which may jeapordize your ability to practice medicine.
Good Luck, if you get a definitive answer I hope you will let us know.
PS Hardly a day goes by that I don’t kick myself for not going to med school.
Why would there ever be a need for you to write a script for the Ibuprofen yourself?
As a doc in a hospital you have numerous colleagues who could all write it for you, no?
Or can you see the problem with that approach too?
I’m glad this thread is typed out on the internet. I have a feeling with as many MDs in here, I wouldn’t be able to read it if it was written out. 
Frankly, I find it even more inadvisable to just “ask a colleague” to write a prescription for me. I refuse to do it for others, unless I’m their physician. A collegial relationship is not a doctor-patient relationship.
Legalistically, one may get one’s ass in a sling much more by prescribing for another without doing adequate history, exam, recordkeeping, etc. than by self-prescribing non-controlled meds. I’ve seen many cases go before our state Medical Board where physicians are reprimanded for this sort of behavior, even with non-narcotics.
Besides, it’s just not good practice.
First, the usual disalimer: IANAL. Why I suggested he contact pharmacists is because if there is a law against such, there is a good chance pharmacists would know it. If a pharmacist could point this doctor to the specific law against all self-prescribing, then that would be a definitive answer. The medical licensing authorities would be another possible source. In particular, they would know about their own rules which might jeapordize his ability to practice medicine. As a pharmacist isn’t allowed to prescribe drugs, he may not know those rules of medical review boards.
Yep. If another doctor prescribes, then they become legally liable. Under the worst case scenario where the doctor they prescribed to had a serious adverse reaction and died, they could even be sued for malpractice. If a doctor self-prescribes and dies, well…no jury will blame anyone other than that doctor.
Kinda what I meant, IMHO it’s just as bad to prescribe for someone you have a collegial relationship with, as to prescribe for yourself, with whom you have a personal relationship.
I called the Medical Board of California and they directed me to the following:
Section 2239 clearly states that self-prescription of controlled substances is forbidden. Less clear (to me)is whether drugs specified in 4022 (all prescription drugs) are categorically forbidden as well (damn legal jargon :mad: ). I read it as self-prescription of these meds constitutes unprofessional conduct only:
IANAL, though. Is my interpretation accurate?
Cheesybeggar: [insert legal disclaimer here] I have not researched the issue, nor do I have any particular expertise in the area of medical practice. Nor will I attempt an in depth analysis of the statutes you cite (unless you want to discuss fee arrangements, I am in Northern California, I would be more inclined to recommend people more competant than myself in this area)However, even assuming your interpretation is correct (I am not sure it is), and such behavior constitutes “unprofessional conduct” I suggest you consider the heading you quoted “The heading to this section stated that these are actions that will result in forfeiture of licensing”.
My understanding (not a legal opinion)(not based on detailed analysis or research)(most likely wrong) is that MD’s can’t self prescribe controlled substances, and if their self prescription of a non controlled substance impairs their ability to practice medicine or causes injury to themself or others they may loose their license to practice medicine. Furthermore, if they commit a felony or more than one misdemeanor involving the use or consumption of any controlled substance, or any drug requiring a RX (wheter self prescribed or not) or alcohol, and are convicted, the conviction will be sufficient proof of unprofessional conduct, and they could loose their license to practice medicine.
Damn, this always happens! I tried to answer your question, but my response seems more confusing than the original statutory language you asked about. Normally, I write things then let them sit for week, then edit, the end result is usually much better. Especially after the ninth or tenth edit. Poor as this is I hope it helps a little, if only to provide an example of erroneous interpretation.
My take on it is: “You can’t self-prescribe controlled substances, and if you do, we can take away your license. You can self-prescribe non-controlled substances, but if anything bad happens because you do, we can take away your license.”
I’m not sure about the part that absolutely forbids self-prescribing any controlled substance. However, I do know that any doctor who does self-prescribe any controlled substance basically is painting a bullseye on themselves for the DEA to aim at. Thus, California law on this really isn’t that relevant, in that only a fool of a doctor would want to risk the DEA coming after them. IOW, it is a Very Bad Idea for doctors to self-prescribe controlled substances even if state law allows it.
choosy,
I understand your question. If you want my advice - don’t ask doctors for legal advice. They are great for medicine but they don’t know shit about how to think legally (just my experience).
My opinion (I’m legally qualified although not a practising lawyer at present):
Yes your interpretation is correct. It’s unprofessional conduct to prescribe medicines to yourself that are prescription-only. You can be struck off for unprofessional conduct.
Is it illegal? No because there is no actual law against it. Just internal codes of conduct.
This is similar to legal codes of conduct. You can be barred from practising law for certain behaviour even though it’s not actually illegal.
So the answer is: you won’t be sent to prison but you might lose your job.
If you lose your job, however, it’s not all doom and gloom because you can go to other places (like Africa) where they are crying out for western trained doctors and aren’t too fussy about professional ethics.
Do you have any further questions?
oh sorry, forgot to mention that the above is just my opinion and could be wrong. I have no experience in this area (medical law).
Also I think I’m gonna get cut off from this board in a few hours so if you do have any further questions, I probably won’t be able to answer them.
oh well
Damn, just noticed I misspelled your name CHOOSYBEGGAR. I assure you it was an honest mistake. I hope you did not take offense because none was intended. If you like I will write it correctly a few hundred times as pennence. 
I am sorry.
Jojo: Why are you going to get cut off?