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Ethical dilemma: A self-prescribing GP

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Check the GP guide lines and make sure the prescription written follows this. Check the prescriptions legall and clinical particulars and if they are correct than the prescription can be dispensed
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Ethical dilemma: A self-prescribing GP
Answer
24/09/11 15:47as a reply to Deepak Gupta.
Good Medical Practice 2006 highlights self prescribing and discourages it as OBJECTIVITY must always be the focus of prescribing. Although some doctors have been referred to the GMC for self prescribing of medicines, I on the hole would have no problem in dispensing this Rx. As a professional commonsense must prevail, if it is a one off and not for a drug of dependence, abuse, high retail value on the NHS, opiate, controlled drug etc etc then I would reasonably stand up in court and justify why I had chosen to dispense the Rx.
Ethical dilemma: A self-prescribing GP
Answer
24/09/11 21:53as a reply to Deepak Gupta.
I recently had to deal with an NHS prescription for a large quantity of sildenafil tablets that had no SLS endorsement. Following several ethically challenging conversations, I established that the prescription had been written by a consultant for himself, and given to his registrar to sign. Compared to that, I find this dilemma relatively straight forward...
Ethical dilemma: A self-prescribing GP
Answer
25/09/11 00:06as a reply to Deepak Gupta.
Hi JemPharm,

That sounds quite a difficult situation to handle! What did you do?

Chris
CPD Editor, Chemist+Druggist
Ethical dilemma: A self-prescribing GP
Answer
26/09/11 14:44as a reply to Deepak Gupta.
I had a similar issue only a few weeks ago. A consultant hand-wrote an FP10 for Cialis for himself on a hospital out-patients pad, and brought it into the pharmacy himself. Again, this did not have the appropriate endorsement of 'SLS' on it, and so I kept it to one side until he returned from shopping. When he came back, I invited him into the consultation room to question him as to why? He stated he was doing a locum and lives over 100 miles away, and for convenience, had prescribed for himself. He also stated he has had cancer, and that he does not normally write his own prescriptions, hence, was unaware of the precise endorsement needed for it to be prescribed on FP10. As he seemed away of the implications, I dispensed this, then contacted the Medicines Management team of the PCT. They have taken it from here, but I understand that they are looking at it being a case of fraud.
Ethical dilemma: A self-prescribing GP
Answer
29/09/11 20:27as a reply to Deepak Gupta.
This situation is not an easy one to deal with. The first time I was asked by a self-prescribing doctor, I had to consult both the GMC and the NPA Information department(The RPSGB were not helpful). On this matter, they both told me that while it is not illegal to do this, doctors are strongly advised not to do this for ethical and objectivity reasons. This also applies for prescribing to anybody close to them like family members.These are clearly stated on the Prescribing Guidelines on the GMC Website. The NPA also said that it is good professional practice not to fulfil these requests and for these reasons, I flatly refuse to have anything to do with them. The only way I could practically assist the doctor (if possible) is if the requested item has been prescribed for him/her by another doctor (GP/colleague) who is not related. The supply can then be made under the 'Emergency supply at the request of a doctor' rules, and it is the responsiblility of that doctor to provide a prescription from another within three days. It is unfortunate that sometimes these doctors can get angry ,occasionally abusive, and will try to undermime your professional decision. So don't be intimidated and stand by your decision to refuse.
It is also a personal observation that a lot of these doctors have been trained abroad and are not aware of the the GMC guidelines, so make them aware. I have done this way and it does work, but I refuse in general.
Ethical dilemma: A self-prescribing GP
Answer
29/09/11 21:02as a reply to Deepak Gupta.
I have a real issue with taking an inflexible view here. There is an issue if Dr tries to prescribe for himself on FP10, or course. However, if on private scipt that Dr is paying for, it them becomes a judgement of clinical appropriateness the same as any request to purchase a medicine. There are many things that were POM that are now P or even GSL, so - for example - should we have reported a Dr for writing themselves a script for amorolfine 5 years ago, while now it can be bought OTC? Or how about if the private script was for 0.5% hydrocortisone cream... It's about time that we had the courage to use our professional judgement. Besides, if Dr have written a signed order that would be just as valid legally and we would be in no position to question their "self-prescribing"...
RE: Ethical dilemma: A self-prescribing GP
Answer
30/09/11 12:37as a reply to Chris Howland-Harris.
pragmatic..... and sensible approach
Ethical dilemma: A self-prescribing GP
Answer
03/10/11 15:05as a reply to Deepak Gupta.
The GMC guidelines clearly discourages GP self prescribing.It recommends that the GP should ask his or her own GP for a prescription.However in this circumstance providing the private prescription is legally written it could be dispensed.As the Pharmacist has a good working relationship with the GP he might want to point out the guidelines and perhaps keep a note for future.

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