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Prescribing Medications for Family Members

Posted Date: June 17th, 2014 | Categories: Licensure & Disciplinary


Is It Illegal to Prescribe Medication to Family Members?

Many physicians have been in the situation where a friend, neighbor or family member seeks their advice outside of the office for a rash, sore throat, or other common symptom.  It is human nature to try to help and offer your expertise in these situations and write a prescription for an antibiotic or other medication.  Most physicians are aware that pain medications and other  controlled substances should not be prescribed in these situations. However, I have found that many physicians are unaware of the State Medical Board of Ohio’s rules regarding common non-controlled medications. The State Medical Board of Ohio takes all of its rules seriously and in the past month I have attended two investigatory interviews with physicians who had to answer for “casual” prescribing.

What should you do if a family member asks you to examine, treat or prescribe to him or her?

What are the ethical standards, rules and law, and guiding principles you should consider?
Nearly every physician has or will be confronted with these questions at some point.
The following are some bright lines with respect to the issue of prescribing to family members:

1. Physicians may treat and prescribe controlled substances to family members only in emergency  situations. See AMA Code of Medical Ethics Opinion 8.19, the February 2012 Practice Guidance Statement, Prescribing to Self and Family, State Medical Board of Ohio, and Rule 4731-11-08, Ohio Administrative Code.

2. “Family members” include a spouse, parent, child, sibling or other individual where the physician’s personal or emotional involvement may render the physician unable to exercise detached professional judgment, such as a boyfriend or girlfriend. See Rule 4731-11-08, Ohio Administrative Code.

3. Physicians should not generally serve as a primary or regular care provider for immediate family members. See AMA Code of Medical Ethics Opinion 8.19.

A physician should always consider whether he or she can ensure that his or her personal feelings will not unduly influence his or her professional judgment and that the personal feelings will not interfere with the care being delivered. Please note that Medical Board regulations prohibit a physician from self-treatment with controlled substances due to the fact that a physician cannot exercise detached professional judgment when treating him or
herself. See Rule 4731-11-08, Ohio Administrative Code.

A physician is always responsible to provide care that conforms to the minimal standard of care, regardless of the identity of the patient. See Section 4731.22(B)(6),Ohio Revised Code. A physician is responsible for completing and maintaining accurate medical records reflecting the physician’s examination, evaluation and treatment of all the physician’s patients. See Rule 4731-11-02, Ohio Administrative Code. E-Blast from the State Medical Board of Ohio October 2012 – Prescribing For a Family Member Page 2

While there are not specific rules or statutes prohibiting a physician from treating family with prescription drugs that are not controlled substances, physicians are also required to meet the applicable ethical standards of their profession. See Section 4731.22(B)(18), Ohio Revised Code.

The AMA Code of Ethics Opinion 8.19 recommends a physician only treat family members in emergency or isolated settings when another physician is unavailable. Why is this so important? In cases involving the treatment of family members, physicians often times do not complete a full physical examination or history, do not inquire about sensitive information that may be pertinent to the diagnosis or treatment plan, and do not maintain
patient records.

If the physician or patient feels uncomfortable, or if the physician does not feel that he or she could be objective, then the physician should not treat the family member. Consider the emotional and psychological impact that could occur if the treatment was inadequate, if the wrong diagnosis was made or if complications arose from the treatment.

NOTE: The rules, statutes, and minimal standards of care referenced apply to all physicians and physician assistants practicing in Ohio. The AMA Code of Ethics applies to medical doctors. The AMA Code of Ethics does not apply to osteopathic physicians, podiatric physicians, or physician assistants. Osteopathic physicians and podiatric physicians must meet the ethical requirements of the American Osteopathic Association or the American Podiatric Medical Association, respectively.

If you would like additional information on this topic or any other State Medical Board of Ohio rules please contact Eric Jones, J.D., M.B.A at (614) 545-9998.

Click HERE for a link to the State Medical Board of Ohio’s Rules.

Resources:
1. The AMA Code of Medical Ethics Opinion on Physicians Treating Family Members,
http://virtualmentor.ama-assn.org/2012/05/coet1-1205.html May 2012
2. Medical Board Practice Guidance Statement, Prescribing for Self and Family Members, February 2012
http://med.ohio.gov/pdf/Prescribing%20for%20Self%20and%20Family%20Members.pdf
3. The Overlapping Roles of the Rural Doctor, http://virtualmentor.ama-assn.org/2011/05/ccas1-
1105.html May 2011
4. Requests for Care from Family Members, http://virtualmentor.ama-assn.org/2012/05/ecas1-1205.html
May 2012
5. Rule 4731-11-08, Ohio Administrative Code, http://codes.ohio.gov/oac/4731-11-08
6. Rule 4731-11-02, Ohio Administrative Code, http://codes.ohio.gov/oac/4731-11-02
7. Sections 4731.22(B)(6) and 4731.22(B)(18), Ohio Revised Code, http://codes.ohio.gov/orc/4731.22



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