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Oct 1 2011

The results are in. . .Online Web survey on self treatment

 Categories:  Board News Comments:   7 comments  Print Friendly Version  |   Share this item
Survey results reveal licensee bias against prescribing controlled substances to self/family, provide insight to NCMB Task Force.

For some months now, the Forum has sought ways to engage readers and solicit direct feedback from licensees of the Board. So when the Board took up the subject of treating self and/or family, we saw it as an opportunity to take those efforts one step further. In the Summer 2011 issue of the Forum, Board President Janice E. Huff, MD, asked licensees to participate in an online survey to share their views.

Readers impressed the NCMB with their enthusiastic response to its first-ever licensee survey. More than 1,000 licensees completed the survey on treating self, family and other close associates. That makes the survey the most successful endeavor in Board history to collect feedback directly from licensees Thank you to everyone who participated!

The online survey augmented the NCMB’s efforts to solicit licensees’ views on its position statement entitled, Self-treatment and treatment of family members and others with whom significant emotional relationships exist, which is under review. The survey was live on the NCMB’s website for a period of about three weeks beginning in late July. More than 700 respondents took the time to provide optional written comments with their survey responses. Members of the Board’s Task Force on Self Treatment read and considered these comments as part of their review of the existing position statement.

In addition, more than 60 Forum readers posted comments to the online version of Dr. Huff’s President’s Message on treating self/family, setting a new record for comments to articles. These comments were also included in the Task Force’s review materials.

Position statement update
The Board’s Policy Committee reviewed a revised draft of the existing position statement on treatment of self/family at its September meeting. The Board voted to table the matter to allow the Policy Committee to consider additional changes to the position statement. The Policy Committee expects to present an updated version of the statement for consideration by the full Board at the November Board meeting.

On a related note, the Board voted in September to pursue an administrative rule that would prohibit licensees from writing prescriptions for controlled substances for themselves, immediate family members and certain others. This decision was based on feedback from licensees and other interested parties, who made clear in comments to the Board that they consider prescribing controlled substances to self and/or family to be inappropriate.

Click the link below to view the survey results.

 Comments on this article:

Why cannot we use our board recognized, good judgement to know when to treat or refer our own family or friends?  I do not charge my family, they are required to pay if seen by someone else.

By Stuart Todd MD on Oct 27, 2011 at 3:03pm

Some medications like antibiotics and voltaren gel are available on line without prescription , so if anyone can buy them, why can’t physicians ? Also writing a refill for a blood pressure medication or anti allergy medication like singular, that is prescribed already by a treating physician
should also be OK. Then there are topicals like betamethasone or clindamycin gel that would seem ok as one time RX’s when another MD cannot be easily reached. The board’s policy against prescribing any medication for a family member or self is partly at variance with the current health message of encouraging people to manage their own
health for non critical needs and thus not needlessly increase health care costs for everyone.
Maybe the Board would want to have an 800 number phsicians could use to get approval for self/ family acute and non critical medications ?

By kim masters on Oct 27, 2011 at 11:55pm

I have been practicing general surgery for 40 years. I have also done some family medicine and full time urgent care and emergency medicine. Suggesting that I shouldn’t be involved in my mother-in laws end of life battle with colon cancer, my wife ‘s uti, my son’s sprained ankle questions the basic integrity on which I have built my career. Except for the prescribing controls substances to family members, the Board should allow licensed physicians to do what we are uniquely trained to do-take care of sick folks and ask for help when we need it. To think I would have to drive to an emergency room an a Sunday to get a PA-C to treat my wife’s UTI when I treat UTI’s and much more serious maladies daily is really laughable ,isn’t it?

By james a hoffmeister,md on Oct 28, 2011 at 1:11pm

I would think that it would be clear to all of us that treating people close to us - let alone ourselves - risks suboptimal care to the patient. However, I would also hope that the usual considered judgment that the Board uses in approaching the subject would recognize that there do sometimes occur situations of delayed or interrupted treatment in which providing a temporary bridge prescription would be perhaps more ethical than denying treatment.

By Eric W. Peterson, MD on Oct 29, 2011 at 4:55am

I could not agree MORE!!

By Bill Harrison, MD on Oct 29, 2011 at 11:23pm

I agree that some commonly used and relatively safe medications, not controlled substances, should be at our discretion.  I have many extended family members with no health insurance and humble means who used to be able to count on me as a screening resource to avoid unnecessary expensive visits for poison ivy and other ailments.  My understanding of the current Board policy has forced me to turn them away—which just doesn’t feel like the right and moral thing to do.

By Cheryl McNeil, MD on Nov 03, 2011 at 7:18am

11/18/2011 PM
I agree with those physicians who value their independence in judgment based on their years of acquisition of fundamental medical knowledge to treat patients whether related by circumstances of birth or marriage or not.  I also concur it seems appropriate for physicians not to self-prescribe themselves or family members controlled substances for which their federal or state narcotic number would be required, for example.

I understand the Board is trying to ensure optimal care for the citizens of NC but one of the motivating factors in becoming a physician, for me at least, was to be able to exercise my personal (not a committee’s) best judgment in management of individual patients based on my likely greater knowledge of their various interacting medical, physiologic, personal and economic states than physicians or authorities removed from the actual patient.  There is already considerable push from federal and national agencies and payors to dictate how medicine should be practiced.  Certainly all of us should know the medical and scientific facts—but there is still a large element of art and judgment in medicine needed to produce individual optimal patient outcomes.

A related physician may be the best doctor for some family members depending on their illnesses, his/her training and skills and his/her best knowledge of the patient and his/her circumstances.

By Jeff Z Brooker, MD on Nov 18, 2011 at 11:03pm
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