3. Don't dispense or prescribe controlled substances for friends or family
Other than in a true medical emergency that occurs in an isolated setting where there is no other qualified physician available, practitioners should not prescribe or dispense controlled substances or scheduled narcotics for themselves, their immediate family, their friends, or their neighbors. And if they must, perform a real examination and document it in writing, with a diagnosis requiring prescription medication. Note the amount, strength, frequency and date of the script, and keep the record of the exam and treatment.
4. Don't prescribe pharmaceuticals outside of an established medical relationship
New state-wide PDMP programs require prescription entry into a database before the end of the next business day – there is no "Friends & Family" exception.
5. Avoid "courtesy" writing of prescriptions
For the renewal of non-conflicting medication prescriptions written by another treating physician, which the patient requests as a "courtesy," the practitioner should never prescribe without independently assessing the condition or illness for which the drug is being prescribed, or obtaining the medical records from the original prescribing physician documenting the condition. Beware of simply relying on a patients "naked" request, not supported by an examination and a diagnosis.
6. Don't write a prescription without examining a new patient first—and be in the same room with them
Medical protocols are changing, and "telemedicine" envisions doctors completing examinations and treatment of new patients even when the physician is halfway across town or halfway across the globe. But we are not there yet. Do not provide scripts for controlled substances for the husband or child of a patient you never met, the mistress of your medical practice partner, or anyone else who could have easily come in person for an office examination but didn't. It may be one thing to "call in" a script to the pharmacy for an existing patient who calls for a refill, or who e-mails about a reaction to a prescribed medication and wants a substitute – but it's entirely another for someone just passing through town and who never "presents" to your practice for a proper examination and diagnosis.
Efrem M. Grail is a former prosecutor, www.graillaw.com, defends medical professionals and health care provider entities in federal and state criminal and administrative enforcement matters in Pittsburgh and the rest of the country.