Examine patients before remotely prescribing Botox


For immediate release: Friday, 24 April 2015

Doctors who prescribe Botox and other injectable cosmetics remotely are reminded they must first examine the patient in person or put their registration at risk.

Earlier this year, a leading cosmetic doctor was suspended for 12 months after acting “dishonestly” and encouraging nurses to obtain Botox illegally. A BBC investigation in 2012 exposed the doctor’s misconduct and as a result the GMC tightened up its guidance on the prescribing of injectable cosmetics.

However, UK-wide medical and dental defence organisation MDDUS still regularly receives calls from members regarding remote prescribing, particularly the prescribing and administering of Botox.

“Before prescribing Botox or other injectable cosmetics, doctors must have a face-to-face consultation with the patient to establish their medical history and reasons for wanting the treatment,” says MDDUS medical adviser Dr Naeem Nazem.

“Doctors must not use telephone, Skype or any other form of video-link to assess a patient in order to prescribe Botox, Dysport, Vistabel or other injectable cosmetic medicines. Instead, they must undertake a physical consultation with the patient, even if the medicine is to be administered by another healthcare professional such as a cosmetic nurse.

“Only after a face-to-face consultation can the prescribing doctor, or another suitably qualified healthcare professional, administer Botox. They should ensure they recognise and work within the limits of their own competence and deliver care based on the best interests of the patient.

“We strongly advise all those prescribing Botox ensure they have up-to-date training in its administration, complications, interactions and adverse reactions.

“Doctors can prescribe remotely for some medicines, provided they are able to make an appropriate clinical assessment of the patient’s needs.”

The GMC’s Good Practice in Prescribing and Managing Medicines and Devices provides further guidance for doctors prescribing remotely. This includes extra responsibilities to consider if the patient has not been referred by their own GP and the doctor has not had a face-to-face consultation or access to their medical records.

“Patients should be made aware of the limitations of a remote consultation,” says Dr Nazem. “When prescribing any drug it is important to make a clear, contemporaneous record of the consultation, including an adequate assessment of the patient and their consent to treatment.

“Doctors should also consider the geographical location of their patient when prescribing remotely, for example, to an online pharmacy. Regulatory requirements for medicines differ between countries and MDDUS members are reminded that indemnity does not extend to work outside of the UK.”


For further information contact Richard Hendry on 0845 270 2034 or 07976 272266, or email rihendry@mddus.com.

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.


This page was correct at the time of publication. Any guidance is intended as general guidance for members only. If you are a member and need specific advice relating to your own circumstances, please contact one of our advisers.

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