Much of the focus in medicine of late has been on the opioid epidemic. Many medical practices have retrained physicians and other providers on prescribing opioids. However, there is another perennial issue related to drug prescribing that seems to be gaining enforcement traction but has received little attention. Recently, I have had three physician clients investigated for prescriptions written to themselves, employees, friends/acquaintances, or family members. Not all prescriptions were narcotics, but in each case, there was no medical record to support a patient visit related to the prescription and no patient exam, physical or otherwise.
None of my clients knew they had done anything questionable but now face the possibility of a license or Drug Enforcement Administration (DEA) suspension, which can have a significant impact on their careers. Almost all states have one or more state laws requiring a prescriber or dispenser to ensure that prescriptions are based on patient examination. Some states have rules dictating when a physical exam is needed, and some states have special standards for controlled substances. Where there are exceptions to physical exams, such as cases in which telemedicine might be permissible, almost all states still have requirements for a physician-patient relationship and a documented patient evaluation.
Here are four recommendations physicians should follow before writing prescriptions for family and friends:
- All individuals require an appropriate exam, whether physical or visual, in compliance with state law. The physician should document the patient’s condition or issue, then retain the record in a HIPAA-compliant manner.
- Physicians should not operate beyond their area of experience and expertise. They should not prescribe something to friends and family that they would not prescribe to their patients.
- Narcotic prescriptions should be picked up by a patient directly from a pharmacy or handed directly to the patient at the time of the medical visit.
- Physicians should follow both state and federal legal protocols required for prescribing, record keeping, and patient treatment under all circumstances. Although a common practice, physicians need to be aware that self-prescribing and prescribing for family, friends, and employees puts them at risk. Being aware of state laws and DEA and licensure requirements can protect their license—and save their careers. Ericka L. Adler has practiced in the area of regulatory and transactional healthcare law for more than 20 years. Visit medicaleconomics.com to read the full article.
