For immediate release: Wednesday, 23 May 2012
Doctors should refrain from prescribing drugs for themselves, family or friends unless in emergency situations.
UK-wide medical defence organisation MDDUS is urging doctors to instead seek an objective opinion of a fellow GP.
Many doctors may hold the view that the ability to self-prescribe is harmless and is a convenient aspect of the job and that, by prescribing something seemingly innocuous such as antibiotics for a simple infection, they are saving time and resources.
Any restriction may even be regarded as interference with doctors’ professional autonomy and decision making.
However, MDDUS has handled a number of cases where doctors have been subject to fitness to practise proceedings for either self-prescribing or for prescribing to a family member or friend.
Therefore, doctors who are considering self-prescribing are advised to follow the guidance provided by the GMC in this area. “Self-prescribing is not technically illegal,” says MDDUS medical adviser Dr Barry Parker, “but the GMC makes it clear that it should be discouraged, stating that doctors should, wherever possible, avoid treating themselves or anyone with whom they have a close personal relationship, and should be registered with a GP outside their family.
“Doctors recognise that self-prescribing drugs of dependence such as opiates or powerful painkillers is entirely unacceptable, but the reality is that they should also avoid diagnosing and treating themselves or loved-ones with other medications. If not, they may be called upon to justify why it was necessary to prescribe in these circumstances.’’
Recent GMC fitness to practise proceedings have been raised against doctors for prescribing themselves or friends and family with drugs such as benzodiazepines and opiates as well as with antibiotics and non-benzodiazepine hypnotics.
The GMC makes particular reference to controlled drugs, highlighting the dangers of loss of objectivity leading to potential drug misuse and misconduct. GMC guidance states that these drugs should not be self-prescribed or prescribed to someone close to the doctor, save for immediately necessary treatment where no other doctor is available and the drug is required without delay to save life, avoid serious deterioration or alleviate otherwise uncontrollable pain.
“The reasons for the advice in relation to controlled drugs are readily apparent, but we have also dealt with cases where doctors have been referred to the GMC for prescribing antibiotics to themselves or family,” says Dr Parker.
“There may be genuine emergencies or difficulties in remote locations where doctors may have to self-prescribe, but in most situations another doctor will be available, even if less convenient, and assistance should be sought in the same way as any other patient.
“This also affords the doctor and his family the benefit of an objective opinion as, even when self-prescribing for a minor condition, it is not always easy to look objectively at the situation and make a balanced decision.
“Doctors are entitled to the same NHS care as everyone else; if they need a prescription, they can see another doctor for an independent assessment and advice.’’
There are other factors that may come into play. “If treating a family member or friend, a doctor may be unfamiliar with their full medical history or current medication,” adds Dr Parker. “There is therefore the potential for drug interactions, and the treatment prescribed may not be properly recorded in their medical records for future reference.
“As always, it is important to make comprehensive clinical notes in relation to treatment prescribed. This may be more difficult in cases of self-prescribing or prescribing for family or friends and may lead to additional problems in terms of clinical care, as well as scrutiny by the GMC should the matter be referred for investigation.”
For further information contact Richard Hendry on 0845 270 2034 or 07976 272266, or email firstname.lastname@example.org.
Note to editors
MDDUS (The Medical and Dental Defence Union of Scotland) is a medical and dental defence organisation providing access to professional indemnity and expert medico- and dento-legal advice for doctors, dentists and other healthcare professionals throughout the UK. For further information on MDDUS go to www.mddus.com.