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It’s official: The new NCMB position statement on treating self/family

 Comments on this article:

I am not sure when another provider would not be available. We have a large number of Emergency Rooms and Urgent Care type of facilities capable of handeling emergent and urgent care. I suppose in the less popultaed regions of our state a rual areas a 50 mile rule could apply. However as I been hounded by the spouse who notes an ear infection of your child when you just completed a busy day doesnt consistute an urgent situation, as I too would hate to take my child to an ER as a clinician knowing this is not an emergency, but Im not arguging that point to my spouse.

When I was active duty in the United States Armed Forces we were provided a list of medications approved to prescribe to family or self and limits on refills. The list did not list any controlled medicatuions, but an occassional ATB, or one refill of antihypertensive untill follow up could be established.

Lastly at least some clinical acceptable guidlines as I am not sure what fungal other than oral should be considered urgent, but maybe insteadd a pharyngitis with a proper ATB

please excuse any typo’s Craig

By Craig S. Purcell on May 21, 2012 at 6:02pm

lets use some common sense again can i use an antibiotic for mild cellulitis, infected cat bite or other skin infection, sinusitus(aware of newest controversies) UTI? etc etc   surely if I treat these in office or other I can handle self-treatment>..

By Barbara Wolfhope MD on May 21, 2012 at 10:43pm

How about treatment by a Physicians Assistant that works under your license. Can they treat the physicians family members or is this considered inappropriate also.

By Charles Bess MD on May 22, 2012 at 8:16pm

I find it ridiculous that we are even talking about whether physicians can treat themselves or their family members.  you can make the same argument for any profession.
Why my scope of practice or access to some medicine be restricted because a few doctors abuse or may abuse controlled substance. It’s like, because a few patients abuse narcotics , every patient should be denied of its use.

By Muhammad Zaidi on May 23, 2012 at 11:01pm

So, as a pathologist, I can only prescribe formalin or B-Plus for myself? Or as a radiologist, I can only prescribe barium for myself?  Or as a psychiatrist, I can only prescribe Haldol for myself?  The updated policy is still far too restrictive. Perhaps medical school and internship should no longer be required for certain specialties since the NCMB does not consider such physicans capable of functioning as a physician.

By J L on May 28, 2012 at 3:56pm

We seem to live in an age in this
country where ever-increasing
regulation and restriction is
fashionable. How about a few new
positions that enhance our liberty
for a change. The Board should only
get involved if there emerges a
problem with a physician (pharmacy
complains,etc, patterns of abuse)

By andrew gurien on Jun 01, 2012 at 4:38pm

Seems like we are restricting the cliniclal liberty of everyone because of the misdeeds of a few. Doctors, nearly all, know right from wrong and good medicine from bad. Marshaling the one off bad outcomes as a reason to put a boot on the neck of well intended clinicins seems counterintuitive.

By Marc K. on Jun 01, 2012 at 4:40pm

I applaud the common sense approach of this new position statement. It certainly wrong to have a family member spend $1000 in healthcare cost in an ED to receive treatment for a toothache, sinus infection, UTI, etc because your father, uncle or brother who is an MD could be sanctioned by the board for prescribing an antibiotic and OTC analgesic. PCP’s may often not be able see you that day and refuse to take new patients after 3 pm. Clearly the need for controlled drugs should be under the discretion and advice of your PCP.

By David Garces MD on Jun 01, 2012 at 4:57pm

I can understand a prohibition on controlled and/or addictive substances, but it seems illogical and a bit paternalistic to prohibit a physician from writing himself or a family member antibiotics for the occasional infection or a refill of noncontrolled medicines used on a routine basis. Do we want to take that much individual judgement from physicians?

By Zachary Kitchen on Jun 01, 2012 at 6:33pm

The guidelines are not clear.  Most unclear is what IS and what ISN’T going to qualify in the eyes of the NCMB as an “acute minor illness.”  Two examples are given, but even for those you say care “may” be acceptable. We need to have clear YES or NO (not “may”) on a range of situations and/or meds.  And, what about procedures (e.g. a few sutures or steri-strips?  getting a fish hook out of a hand?)

By Johnson on Jun 01, 2012 at 11:26pm

The guideline is still onerous.  There is a difference between being foolish and being illegal.  It may be foolish in the Board’s eyes for a physician to treat a family member, but this should not be illegal.  As a radiation oncologist, I would prefer not to treat my own family members for cancer, but I know oncologists who have, and successfully, I might add.  Treating a serious illness like cancer is quite different from managing minor acute or chronic problems (like acne, migraine, fever blisters, seasonal allergies, etc.) 
It is an undue burden for me to take time away from my cancer patients, who actually are sick, for me to run to the doctor when I need a steroid cream for poison ivy.  This issue is so ridiculous I can’t believe the Board doesn’t have enough to worry about.  The Board should focus on protecting patients from physicians who are truely dangerous, child molestors, and “pill mill” operators, not trying to protect doctors from themselves.

By Laura Allen on Jun 04, 2012 at 11:51am