Who prescribes for themselves or family

Jules A, MSN · Jul 31, 2015

I prescribe for myself for stuff like inhalers, antibiotics,etc. i have prescribed for my friends' kids if they and cannot see their provider for reasons like being on vacation... But only for minor things like poison ivy, rashes or allergies.

Be careful with the kid thing because I know a doc who was disciplined for prescribing to a friend's kid who had joint custody. The other parent did not approve and reported it to the board. No good deed goes unpunished as they say.

phillycpnp-pc, MSN, RN, NP · Jul 31, 2015

That's a good point Jules. I rarely do this for friends...but I'll think twice before doing it again...it wouldn't be worth it.

rnsrgr8t · Aug 1, 2015

I am a PNP SO i can only prescribe for kids but I would NOT do it for family or friends. Just not worth it to me. Like others have said, not worth the risk to me. I do not judge others who do it and I am grateful when my MD colleagues will write me some Augmentin for my sinus infection but if they told me no I would understand.

automotiveRN67 · Aug 1, 2015

I'm back. I wanted to sit out and see the responses.

I know a huge number of practitioners (physician, NP and PA), and find the act of prescribing for self, friends and family to be as individual as the person.

As far as I know, there is no limit on prescribing, although I have never actually read the BON Nurse Practice Act defines "what" may be prescribed, but doesn't define "to whom".

I think common sense comes into play. Would I prescribe a z-pack and tessalon perles to an adult neighbor who is a close friend? Sure. Would I write pescription for my wife who gets her Advair cheaper from a Canadian pharmacy? Sure. Would I refill losartan for myself? Sure.

Would I give antibiotics to a minor who is friends with my son? NO.

This was a good thread. I would be interested in finding out more about the actual law and limits. I will start reading about this, and post what I find.

Trauma Columnist · Aug 1, 2015

From New Hampshire. https://www.nh.gov/medicine/aboutus/self_presc.htm

From the Pharmacists letter. How should you handle an Rx written for the prescriber's personal or family use

From Indiana. http://www.in.gov/pla/files/Medical_-_January_2012_Newsletter_-official.pdf

Enough said....don't do it.

PG2018 · Aug 2, 2015

As long as there is no state regulation precluding the act of prescribing for self and family then I don't see a problem with it particularly when the prescription in question involves legend drugs for you or your wife/kids.

automotiveRN67 · Aug 2, 2015

traumaRUs.

Well, that's not so cut and dry.

None of the links you provide say it is illegal, or punishable. They say you "should not".

Of course, with controlled substances, it would be foolish to even consider it.

As far as the Indiana guideline, a prescriber cannot write a prescription to a person who the physician has "never personally examined and diagnosed". Well...that's easy. Just make sure you do this. As for the documentation, they say, "No prescription SHOULD be written for family or fellow workers without a valid physician/patient relationship and maintenance of a medical chart".

The second part is pretty vague. If someone would make a quick word-document SOAP note, and save it their desktop, this would probably qualify.

One person mentioned knowing someone who was fined for writing a prescription, but I haven't ever run across a regulation, or law that allows for this. Anyone else?

automotiveRN67 · Aug 2, 2015

So here is one article with some common-sense guidelines:

http://www.currentpsychiatry.com/home/article/should-you-prescribe-medications-for-family-and-friends/a1eba6baba36081fe00579a4482aaa41.html

And one where a psychiatrist almost kills her sister with Septra DS (very emotional).

Treating Friends and Family | Physicians Practice

So, moving on to the real risk. An article in Jail Medicine warns "You might think, I'm OK! These are my co-workers and friends! They would never sue me!â€ Well, you might think this but you would be wrong. The annals of malpractice are filled with such lawsuits.".

But the only article I could find with an actual lawsuit was this one.

Legal risks for giving free medical advice - amednews.com

But this article is really a case of medical negligence, not casual prescribing. The physician already knew the patient well, and would not have been protected for his advice if he had given the same advice during an actual visit.

Trauma Columnist · Aug 2, 2015

Here you go

Displinary Actions[TABLE=class: cavu-grid, width: 100%]

[TR=class: cavu-grid-header]

[TH=bgcolor: #F3F3F3]Case Number[/TH]

[TH=bgcolor: #F3F3F3]License Number[/TH]

[TH=bgcolor: #F3F3F3]Action[/TH]

[TH=bgcolor: #F3F3F3]Discipline Start Date[/TH]

[TH=bgcolor: #F3F3F3]Discipline End Date[/TH]

[TH=bgcolor: #F3F3F3]Reason for Action[/TH]

[/TR]

[TR=class: cavu-grid-row]

[TD][/TD]

[TD]Fine[/TD]

[TD]09/22/2009[/TD]

[TD] [/TD]

[TD]issued prescriptions to one of her family members without proper authorization from her supervising physician.[/TD]

[/TR]

[TR=class: cavu-grid-alter]

[TD=bgcolor: #F6F6F6][/TD]

[TD=bgcolor: #F6F6F6]Reprimand[/TD]

[TD=bgcolor: #F6F6F6]09/22/2009[/TD]

[TD=bgcolor: #F6F6F6] [/TD]

[TD=bgcolor: #F6F6F6]issued prescriptions to one of her family members without proper authorization from her supervising physician.[/TD]

[/TR]

[/TABLE]

I edited out the license number and case number though this is a matter of public record.

Ive been an APRN for over 9 years and you know I don't want folks looking up my licenses and finding this.

edmia, BSN, RN · Aug 2, 2015

Thanks Trauma, but this says they were disciplined for not getting permission from their supervising physician. Do you think this is the work around they used to justify disciplinary action? If the BON practice act said: don't prescribe to family and friends, I would think the rationale for action on the license would reflect that.

It's not such a clear cut subject in regulatory terms, but definitely seems to be the prevailing unwritten rule as these examples you posted show.

Another thought: what if the NP is in a rural area where they are the only provider around? Would their family have to drive miles away when ill in order to get a script/treatment?

Sent from my iPhone -- blame all errors on spellcheck

PG2018 · Aug 2, 2015

In the state given as an example, must one elicit an approval to prescribe to everyone?

I'm not against prescribing to immediate family, but I don't think I'd do it for friends. Why? Because it's like having a pool. As soon as you build it everybody in the neighborhood suddenly likes you and hints round for a swim.

I haven't ever done any of this as I haven't had a need. However, I have already made a file and envision myself checking boxes on a simple form downloaded from the Internet to suffice for the state required documentation. I don't see how there's any room to criticize prescribing legend drugs.

BeachFNP · Aug 2, 2015

This is an interesting discussion. I only rarely prescribe for family/ friends. And I mean rarely. I have done a controlled substance ONCE for a friend who was having intense anxiety issues- but- told her if she needed any more she would need to follow up with her pcp.

I occasionally prescribe for my son who has issues with repeated ear infections but I'm always discussing this with pediatrician prior to that. We have a good working relationship so he's always fine with whatever I want to do. He will be getting his second set of tubes in a week so hopefully I won't have to do this anymore here soon.

I'm not sure what the regulations in my state are, but I will be looking them up now. Every provider I know is super casual about this so I can't imagine it's very stringent regulations.