Resources & Information

 Comments on this article:

the encouragement of professional courtesy would be a great aid to establish thoughtful consideration of the appropriateness of self care or care of the immediate family

By John D. Wilkinson M.D. on Jul 22, 2011 at 7:06pm

I agree with the statement but want to posit a caveat.  If the condition treated is a chronic one requiring periodic follow-up monitoring, such as TSH tests, and renewal of prescription for T4, why should I (an endocrinologist) not be able to render this care for my wife?

By Richard A Dickey, MD on Jul 22, 2011 at 10:36pm

I feel physicians are capable of managing common medical problems. They should have freedom to prescribe simple medications for anyone eg antibiotics, antihypertensives etc. Narcotic meds and uncommon toxic therapies should be excluded however.

Also I feel this will save cost substantially to everyone concerned.

By victor williams, MD on Jul 22, 2011 at 10:50pm

other situations of self or family treatment that should be consdered Ok with documentation, of course: refills of medications that are not controlled substances, like blood pressure medicationsm that have recently been prescribed by otherphysicians treatming the patients; medication for topical skin treatments for acute bites and allergies, medications that are about to be released into the public domain as nonprescription items like orlistat and zyrtec.
Another way to look at this issue is that we are trying to reduct the cost of medcine, and encourage people to treat themselves for monor illnesses. Now we appear to be telling physicians that they are not competent even to do that.
Also we should consider allowing physicians to self prescribe for medications that are freely avaiable to the public in MEXICO LIKE SOME ANTIBIOTICS. May be also to refill veterinary medications for ones pet for acute diarrhea or allergy

By kim masters on Jul 23, 2011 at 7:45am

No doubt these policies are well intended, but they are extremely vague and based on fears of what could happen, rather than on data about actual events.  I have heard this debate for over 45 years, but I have never heard of any actual harm from a physician treating self or family.  We should be admonished to be circumspect and most careful, but it is difficult for me to envision a circumstance calling for disciplinary action by the Board.  I would not prescribe a controlled substance for family, but sometimes other prescriptions are appropriate.  Give us credit for having good judgment, and try not to be overly judgmental or controlling.

By Phillip J. Walker, M.D. on Jul 23, 2011 at 2:49pm

I replied to the original editorial. 
I agree the Board Should Have a Policy.
I am a pathologist whose internist, a cardiologist, doesn’t believe in statins.  He is a part-time herbalist and spiritualist but we like him and have periodic office visits and I see him nearly every day in the cafeteria. Because of my strong family history of coronary artery disease (associated with smoking in my ancestors)and my abnormal Lp(a) I have been taking statins on my own with my doctor’s knowledge as has my wife who has a metabolic syndrome although she is thin.  We also go to the gym and use treadmills 5 days per week.  I also read Goodman & Gilman in my spare time and take an ACE inhibitor at possibly homeopathic dose levels to protect my kidney function. 
I have no DEA license and never wrote a script for a controlled drug. 
I believe no one should do so for themselves as well.  I run a forensic toxicology lab and would consider suggesting urinary drug screens on a random basis for everyone. 
These uses, and the example you quoted in your illustration should be documented in case things don’t work out so the trail of evidence can be picked up. 
Its not too much to ask that notes be kept for whatever self-prescribing is done and finally, there should be a real doctor involved in the process who reviews the activities periodically.

By Robert Spencer Howell on Jul 25, 2011 at 10:05am

Most physicians see value in addressing minor family or self health issues as beneficial, not an injurious or risky practice. As often as we recommend Benadryl for sleep or probiotics for colon health, we may also recommend an antibiotic for a UTI or drops for a conjunctivits. Most physicians are caring, careful, and also expedient practitioners, and to expect that all family members and MDs go to ERs or wait until their regular doctor is available to address something that one can address simply and expediently is unreasonable. Truly, I would not perform my child’s appendectomy, or write controlled substances, but the cautious recommendations to self and family would be as prudent as that made to our own patients. Making policy that is “enforceable” will lead to very unnecessary restriction of practice, which is not a major safety issue in our healthcare system. Do accountants do their own taxes, and construction workers remodel their own homes? Our practice is our trade, but also our conscientious calling.

By Rosa E. Cuenca, MD, FACS on Jul 26, 2011 at 6:26pm