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North Carolina News: Item 2180 - Filling Prescriptions Written for Family Members
Reprinted from the April 2009 North Carolina Board of Pharmacy Newsletter.
(Editor’s note: Board staff thanks Nancy Hemphill, special projects coordinator, North Carolina Medical Board, for authoring this item.)
The North Carolina Medical Board is frequently asked whether a physician or physician assistant may self-prescribe or write prescriptions for family members or others with whom he or she has a close relationship. In addition, the Medical Board is often asked whether a pharmacy is obliged to, or prohibited from, filling such a prescription.
There is no statute or rule governing this situation, but the Medical Board has a formal position statement called “Self-Treatment and Treatment of Family Members and Others with Whom Significant Emotional Relationships Exist.” (All of the Medical Board’s position statements may be found at www.ncmedboard.org.) In general, the Medical Board’s position is that such care is inappropriate. The Medical Board believes that when physicians prescribe for themselves, or for those with whom they have significant emotional relationships, a variety of factors can compromise the delivery of good quality medical care. The physician’s objectivity may be impaired, the patient’s autonomy may be reduced and these may give rise to misunderstandings about the physician’s prescribing behavior. That said, there are a couple of important exceptions. The position allows self prescribing or family prescribing for “minor illnesses and [for] emergencies,” though the specific situations that would qualify are not defined. When providing care to oneself or to loved ones, the prescriber is advised to comply with all the requirements of good medical practice, including appropriate record keeping.
The Medical Board recognizes that this is not a bright line and it understands pharmacies – and pharmacists – have the right to decide whether to fill a particular prescription. Pharmacies may adopt a blanket policy against filling prescriptions they suspect are in conflict with the Medical Board’s position, or they may decide to dispense on a case-by-case basis, taking into account the type of pharmaceutical, whether or not it is a controlled substance, the dosage, the type of condition for which it is prescribed, and the circumstances under which it was prescribed.
