Prescribing Far Off Label

[jennybean0305]

What are your thoughts on this? I worked as an RN with a doctor who billed himself as a holistic wellness doctor, and he had some very unusual practices. He would treat thyroid levels according his own scale and using the patient's report as a guide. He injected ozone into blood and then re-infused it into people with chronic illnesses. He treated people for candida, as a fungus that is undetectable on any scan or bloodwork, but still can make you sick. (treated with a liver flush and diet restrictions).

Anyway, he never ran into any problems. I know it is common and accepted to prescribe some medications off label, to the point that they will be listed that way in drug references.

I was recently called by a company whose Medical Director was put on probation for treating sub-therapeutic thyroid and testosterone. One of her patients had a heart attack, and the widow is suing her. Then 5 more families joined the suit while a whole host of patients are supporting her, and saying that she changed their lives for the better.

My question is: would you avoid that practice? It seems like a silly question, but there are not a lot of employment opportunities in the area. If I had an equal option, I would take the other.

[traumaRUs, MSN, APRN]

As a licensed provider, (not holistic) I would be cautious about Rx'ing off label meds. What the heck is "Ozone"? The only thing I can think of is the ozone layer of the atmosphere??

[Oldmahubbard]

In psych, we do prescribe off label at times, ie there are no FDA approved treatments for borderline personality disorder.

But this is way out there, and if there is ever a complaint, you will have zero legs to stand on.

There is no such thing as a liver flush. Run.

[Corey Narry, MSN, RN, NP]

Well, there is Off Label and there is "voodoo". We have used FDA approved medications for "Off Label" use but with reliable published evidence that it works for the particular indication. Chemicals (ozone?) that are not FDA approved can be scary. I would never be involved in such a practice for the mere fact that you could kill someone with that "#s4!*", I mean stuff.

[cayenne06, MSN, CNM]

My question is: would you avoid that practice? It seems like a silly question, but there are not a lot of employment opportunities in the area. If I had an equal option, I would take the other.

[/size]

YES. Avoid at all costs. What this person is doing is unethical and unacceptable.

[jennybean0305]

Thanks everyone. This is what my gut was telling me. Nice to hear confirmation. Any yeah - I don't know what ozone or liver flushes are! I just heard him prescribing it.

[kbrn2002, ADN, RN]

This doesn't sound like holistic medic, it sounds like a modern version of a snake oil salesman. Prescribing FDA approved meds off label or out of recommended dose ranges is one thing but injecting ozone into blood and then infusing that blood? Please tell me this doctor wasn't infusing that blood into anybody other than the person it originally came from at least.

[Neats, BSN]

Growing up in Canada around tribal natives I have a tendency to think holistically when it comes to my health and my family. Deviating away from prescribed medication-using them for other purposes can be hazardous, but I can see the value if it has been proven to be useful. Sort of like pot for nausea/vomiting and glaucoma.

Working in an office where that how you described would scare me.

[OllieW, DNP, PhD, NP]

I remember a lecture from that lady who does reviews (cannot remember her name). Anyway, she addressed off label applications of medications that had research to support the use. She suggested either referencing the off labeled study or including the EBR in your charting. the research is there to protect both the provider and the patient. I cannot imagine any reputable source supporting Ozone therapy...