NC Medical Board Seeks Feedback on Self-Treatment Position Statement

Janice Huff, MD, President of the North Carolina Medical Board has created a task force to review the Board’s Position Statement, “Self-treatment and Treatment of Family Members and Others with Whom Significant Emotional Relationships Exist” and has appointed Ralph Loomis, MD, chair. Also serving on the Task Force are Paul Camnitz, MD, and Judge Jack Lewis, a Public Member of the NCMB. 

The existing position statement was adopted in May 1991. It was last updated in September 2005. The position cautions against self treatment and the treatment of loved ones, except for minor, acute illnesses or in emergency situations.

The Task Force met on Tuesday, June 28 to discuss the position statement and suggest changes to its contents, as many have found it to be vague. The NCMS was represented at this meeting. The North Carolina Medical Board is now seeking feedback from our members regarding this statement with hopes of bringing additional clarity to the policy.

Email nancy.hemphill@ncmedboard.org if you would like to submit written comments to the Medical Board.

Read the existing position statement.

 
 

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9 Comments

  • Vaishali Mody, MD

    I agree that there is nothing wrong in treating or caring for our family members or friends in the same sound medical fashion that one would care for a patient seen in the office. I would not prescribe medications or controlled substance when not needed. However, I do feel that prescribing controlled substance is one area where restriction would benefit a provider so the provider is not taken advantage of.

  • How ridiculous is it that I could loose my license or be sanctioned for prescribing an antibiotic for my son with chronic sinus problems. Do you really want me get in line for the ER at night or for the pediatricians office on a weekend? If my cousin or a next door neighbor or a close friend has a hernia, or appendicitis, I shouldn’t do their surgery even though I’m the one they know best, trust most and prefer?
    If the board has no greater issues, then our profession must be doing really well with virtually no cares in the world.

  • Mahendra Patel MD

    I agree with Drs Sethi, Newman, and Inglefield.

  • Ralph Ramos, MD

    “If it ain’t broke, don’t fix it.”
    Why is the present position statement broken? I haven’t read or heard of any misuse of the privilege of being able to treat minor emergencies. Even if the position statement is changed, the people who ignore the position statement now will continue to ignore the statement. This seems like a lot of time/effort being wasted on a minor problem.

  • pramod sethi

    I agree with dr Newman.There are numerous occasions when self treatment of oneself or family members for minor nonemergent problems is unavoidable and should be the responsibility and prerogative of MD to decide if they need to call another MD to call in antibiotic or other noncontrolled prescription. I also agree that we should not allow narcotics and controlled substances to be prescribed to self or family.
    By the way is anybody aware of similar “moral position statement“ in other countries ?

  • Shannon Jimenez

    I believe the position statement is fair the way it is minus one exception. There should specifically be wording in there prohibiting prescribing of schedule III or higher controlled substances for immediate family members and of course self.

  • David Newman, M.D.

    The Boards position should apply to any prescribing of controlled substances by a physician for themselves or family members. The abuse potential far outweighs any benefit. I do not believe that this should be the standard for non-controlled drugs.

    Two scenarios come to mind. The first involves a physician that has elevated cholesterol. In most developed countries statins are available OTC but they are regulated in the US. If the physician has been prescribed a statin by his physician and subsequently has ordered his own lab work why should the physician not be allowed to renew a prescription for the medicine by self prescribing? Why should the physician be forced to see a physician’s assistant, who is less well trained than himself, to obtain a refill? Besides the costs incurred and the time wasted it is obvious that there is no risk to the public or the physician himself to allow this self prescribing.

    The next scenario involves the permissability of a physician covering call for a practice to prescribe for patients that are not his own. It is common for antibiotics, anti-emetics, etc. to be phoned in by a covering physician without ever having examined a patient while it would be against Board policy to allow a physician to do the same for his spouse when at least he has seen the patient.

    There are numerous times when physicians are left with the choice of self prescribing for minor conditions or spending time and money on an emergency room visit or doctors visit. If the physician chooses to not seek help then he is responsible for his own health and the results of his/her actions. This should not be an issue of public policy but of personal responsibility. Please change the Board policy to reflect this reality.

  • It should remain vague if that is the term you prefer. Often I have experienced in my own family situations where the need and opportunity to provide care is logical,safe, caring and very cost effective. Restriction to a more “clear” definition will create hardships for medical families who are already under care. A good example is chronic medications. I can report and have witnessed that a visit was demanded for a family member to renew a prescription for a medication that was being monitored properly for side effects, only to have the PA for the physician refill the medication without a single question or review of the medications. This is an example of time wasted unnecessarily. Any restriction will be used to interrupt care by insurance companies authorizations and create an opportunity for “disciplinary” action against the physician. Doesn’t the board have other better things to do? What I consider a minor illness(for example an asthma attack) maybe is not so minor to a cardiothoracic surgeon. Surgery is not something I would consider minor, but I know of surgeons operating on family members with excellent results and care. Not sure where this sort of issue even comes up to discussion when health care reform, liability issues, impaired physicians should be the focus of the board and the society. Task force? How much did this all cost? If we can’t responsibly take care of loved ones, who will? We can and do it safely and effectively; we will call our esteemed colleagues for help and guidance and if needed turn over care to them quickly if we reach the limits of our expertise or are too “emotionally involved”. Certainly the insurance companies don’t care for our loved ones like we do, and we should continue to make sure they get the best care. Restrictions are unnecessary in general the board should ferret out the rare cases.

  • Michael H. Weinstein, MD, PhD

    I do not be believe that self treatment or the treatment of others with whom a physician has a significant emotional relationship should be permitted except for minor illness or emergency situations. Criteria for this exclusion are, of course, subjective in some circumstances. However, I do not believe that it is in the best interest of patients to be treated by family members or others to whom the physician has a close relationship, since such relationships are likely to alter the objectifvity and judgement of the physician.