Re: Covfefe-19 - Part 4- Stay the **** Home
Can a doctor write a(ny) script for themselves? Should they?
It gets complicated and there is a lot of misunderstandings out there. Ethics and the law will vary (and there is some state to state variance). Essentially, I can legally write a script for (nearly) anything. I can also write for family and friends. The prescription pad is a huge power but with great power...never mind. Now there are checks, for instance, the pharmacist should not fill what they feel are inappropriate scripts. Insurance will also not cover things that are wildly inappropriate. There are also medical-legal implications if you do not document correctly (you have to physically see a patient to write a script with few exceptions). What are you going to do, keep a word document with your plan for your wife? (I actually know of some doctors who do this...)
However, many of our boards (both state and specialty) will have further ethical guidelines and they can strip you of your license or board certification. I support strict punishment for these transgressions but I am probably in the minority.
Another thing that is often misinterpreted is "FDA approval." Once a medication is FDA approved, a physician can use it "off label" for many things (does not mean insurance will cover it). For example, in my field, the diseases we see are very rare. Most of our medications are shown effective in small studies, thus the medications are not FDA approved for the indication (it is not financially beneficial for the company to seek approval another indication) however we get insurance to cover the medications because they are shown effective in the literature and there are no alternatives. Some very common med are used much more off-label than their "FDA approved" indication.
Sorry...kind of long winded with a lot of caveats.
Basically:
1. We can already prescribe hydroxychloroquine off label right now if we wanted.
2. There is no evidence supporting this use at this time, thus I would not prescribe it as one does not know the risk profile. Real trials are underway. Those who prescribe it now are reckless in my and more importantly several infectious disease experts I trust opinion.
3. You can prescribe to yourself and family but it is ethically dubious. I do not see friends or family on principle (I will get people in to see colleagues).
