Are MDs allowed to prescribe medication for themselves?

November 23, 2005 9:38 AM

Are MDs allowed to prescribe medication for themselves? If so, are there any limits on what they can and can't procure for personal use?
posted by cior to health (16 comments total)

It's unethical to prescribe medicine to yourself or relatives. MDs take this rather seriously, I don't know about the legal complications but your license to practice can get revoked.
posted by geoff. at 9:49 AM on November 23, 2005

Samples. Who needs drug stores.
posted by m@ at 9:53 AM on November 23, 2005

Aside from the ethics, is there an actual law/rule/statement from the AMA or other entity that prohibits this? Would a pharmacist fill the prescription?
posted by cior at 11:11 AM on November 23, 2005

From Nye's perspective, self-prescribing is not only ill-advised, it is technically illegal: "You are violating the Medical Practice Act if you treat yourself because it's illegal to prescribe medication without a medical examination, and most medical boards would interpret that to mean an objective medical examination, which you can't do on yourself."

The American Medical Association clearly considers self-prescribing unethical. Policy E-8.19 states: "Physicians should generally not treat themselves or members of their immediate family," and makes an exception only for certain emergency situations.

Psychiatric Times
posted by chrismear at 11:53 AM on November 23, 2005

However, the reality is that many physicians do self-prescribe. This abstract is a summary (I've skimmed through the full text), but from the abstract:

"Twenty-five percent of all medications and 42% of self-prescribed medications were obtained from a sample cabinet; 7% of all medications and 11% of self-prescribed medications were obtained directly from a pharmaceutical company representative."

JAMA Abstract here

I would *guess* that most of these cases would be somethink like getting the prescription strength heartburn medication from the sample cabinet, or antibiotics for an infection.

The idea behind the physician not treating themselves and their immediate family members is that, despite good intentions, they tend to lack critical judgement needed for a proper medical evaluation. They "know" their symptoms or their family member's symptoms and don't perform a proper, objective medical evaluation.

Then there is the other concern about physicians themselves abusing medications, but to truly abuse medication in this way would require much more than a prescription pad -- that would require much more deceptive practices.
posted by jerryg99 at 12:11 PM on November 23, 2005

I, personally, love this movie.
posted by phaedon at 12:33 PM on November 23, 2005

I've prescribed myself medicines several times, including, once, controlled substances (the Xanax which I use on airplanes.) Pharmacist was happy to fill it.

Frankly, I was a little surprised - I was expecting him to balk, and when he didn't, I was expecting to get a nasty letter from the DEA. It didn't happen.
posted by ikkyu2 at 12:33 PM on November 23, 2005

I would sure hope that it's not allowed. A former family doctor of mine self-prescribed medication and became very, very ill. She misdiagnosed and then took the wrong medication. In fact, she's unable to practice because she's so ill.
posted by Mike C. at 12:48 PM on November 23, 2005

If you ever wind up in front of a medical review board, any history of self precribing is going to look very bad. That said, I would be embarrassed to waste my docs time asking for a refill on a cortisone cream for eczema. But I always go through the motions for Klonopin before flying.

MikeC - what else can you tell us about this? Sounds intriguing.
posted by docpops at 12:59 PM on November 23, 2005

My husband is an MD and will write for himself or for me, but only very selectively. Cream for eczema, yes. Prophylactic for malaria, yes. Ambien for sleeping on a plane, no.

I think this varies from state to state- in California, it appears to be a non-issue, but I understand that Virginia law prohibits pharmacists from filling self-prescriptions or prescriptions for a family member.
posted by ambrosia at 2:04 PM on November 23, 2005

NPR had this interesting little bit last month about the practical troubles with self-prescribing. (I think it was self-prescribing, but it may have been the doctor picking up a prescription he wrote for someone else. Same difference, practically.)
posted by smackfu at 2:38 PM on November 23, 2005

Wow, thank you for all the helpful information. Yeah, I like Dead Ringers too. Classic AskMeFi experience, question answered and bolstered with anecdotes.
posted by cior at 2:49 PM on November 23, 2005

Just the other day, a friend of mine who's an MD mentioned that he prescribed himself something. But most doctors are probably a lot more cautious than he is. He's not your run of the mill MD.
posted by Clay201 at 6:09 PM on November 23, 2005

docpops: To add to the intrigue, the doctor almost died. I don't know what diagnosis/medication was involved, but I think I know who to ask. I'm very curious, myself.
posted by Mike C. at 9:28 PM on November 23, 2005

Heh. My sister's an MD, and she hates shots. Before she had surgery, she realized she would get an IV and gave my dad a prescription to go out and buy her some lidocaine (a topical anasthetic). He rushed back, and she put it on just in time for the nurse to come in and put the IV in ... the wrong arm.
posted by electro at 9:58 PM on November 23, 2005

This is an evolving topic. As a resident, I was told that it was fine to prescribe non-controlled substances for self or family. Controlled substances have always been out for the obvious reason.

About a year ago, the State Licensing board in my state (Georgia) stated that it was unprofessional to administer any substance to a family member. It didn't even specify prescription drugs, supplements, whatever. I can't even give my child a tylenol.

Frankly, I consider it another case of bureaucracy out of control. There will always be people, doctors included, doing stupid things, but this is worse. The fences just keep going up, and the end is no where in sight.

In the long-run, that kind of thinking fosters contempt for the authorities because they take the most conservative position possible, rather than a reasonable one. Why? It may be in the puritanical nature of those who find themselves on such panels, but it's also CYA.
posted by INFOHAZARD at 10:50 AM on November 27, 2005