I ran into a doctor during some shadowing the other day who is a type 1 diabetic and he says that he writes his own insulin prescriptions to reduce hassle.
Is this ethical? I'm assuming in most cases people would raise an eyebrow?
He doesn't do this, but as a hypothetical could he use the insulin samples often given to those deal with patients who need it?
Everyone draws the line in a different spot.
I think any physician would agree that you should not write yourself or any close family members a prescription for a controlled substance in almost any circumstance. My personal line is you shouldn't write one *ever* - if you're somewhere where a pharmacy is open, there's almost certainly an urgent care or an ER available - but some will argue "maybe" for something like a 2 day course of opiates for a broken bone until they can get in and seen by an orthopedist.
Once you get past controlled substances, it gets a lot more blurry. I'm perfectly capable of assessing Centor's criteria on pharyngitis. I'm a board certified internist (and have even heard Robert Centor himself speak before, not that that matters). If my wife has an absence of cough, tonsillar exudates so clear I can see them across the room, a fever, and adenopathy? I feel comfortable writing her an augmentin scrip. Done it before, would do it again. If a relative runs out of their prescription triamcinolone or something and they want a new scrip? I can probably deal with that. I'm willing to prescribe myself something in this situation as well.
What I won't do is prescribe any medication that requires monitoring. I'm an Endocrinologist but won't prescribe my wife Levothyroxine. Why? Because then she wouldn't go get her TSH drawn with her PCP.
In addition, I agree with the above poster that I won't prescribe any psychiatric medications. I think you can get into questions about how objectively you are in assessing the patient's mood, and I don't want to do that.
Technically speaking, you need to document something for any scrip. But that something can be a slip of paper you just write a short note on - it's not like you're billing for it. I can't say I always bother when it's myself or my wife though. What's she going to do, sue me?
Oh, and if I was diabetic, I'd prescribe myself insulin any day of the week. I would hope that's one medicine I know how to manage by this point, and self-monitoring is fine.
