She would have to at least examine you and know your history and what meds your on. Macrolides decrease cyp450 thus could increase concentration of other drugs your on. It also could be a way of letting you use your immune system, taking a bacteriostatic cuz u seem sick might not be be the best choice considering many things are viral. But ya you can write scripts for family as long as things get documented and they are observing you. Macro can also cause liver dysfunction. But gotta love the 3 pills of 500mg. Even non compliant pts finish their meds.
I'm not giving advice. This is my field. I do actual work. I deal wi exactly the same type of 'pressure' for my time. It is the same in this situation, in fact, I do more work (time-wise) than what I'm asking for. Anyway, thanks for clarifying the rest.
no but I stayed at a holiday inn express last night. and I am an official internet expert. bbs certification and all. now that I think about it, there is a level of liability if you croak while taking said PRESCRIBED drug. So it's not the same as you fixing her computer.. her liability is much greater. while it's not about whose liability is greater ,it becomes more a judgment call.. perhaps unfair of you to expect that since maybe you can die from these meds.
Wrong choice of word on my part, didn't mean to denigrate what you do just didn't really know the nature of the IT support. Regardless, I understand that it is your field but it is not the same situation. No one is denying that, in a utilitarian sense, you are doing MUCH more for her than she is for you. The difference is, the consequences off a goof on your part (unlikely) would have no impact on anyone's health (unless this is some crazy IT support I've never heard of). If something goes wrong with her prescription, and again I recognize fully that the chances are near zero, it is a whole different ballgame and things can turn ugly fast. Reciprocity is important, and I would likewise be frustrated with your situation but I strongly believe these are not the same situation based on the possible outcomes. For what it's worth, most physician's I know would prescribe the medication if they felt it was indicated.
I completely got what you were saying about the error on her part and other good points in this thread and hadn't considered them before. This is a good discussion. I didn't intend for my response to come off as short.
Physicians and NPs write for friends and familly ALL THE TIME. It is NOT illegal to do so. However, some practitioners do not LIKE to write for family members because they think that practitioners in general tends to treat family members differently. In this case, if it's just a Z-Pak, it's really not that big of a deal. I see plenty of these scripts written for family members every day as a pharmacist. I'm actually going to medical school next year and I won't have a problem writing this script in the future for a family member.
Do you even need an antibiotic is the better question. Is it legal, yes - but it's unethical. She is not doing you justice by not giving you a proper evaluation and instead just treating you blindly. I wouldn't write my friends prescriptions without seeing them first.
Good post. I understand that you are a medical student or resident. Many of my friends are/were in medical school or residency as well. This was often their stance before they started practicing. However, what would you do if a family member needed a Z-pak or some albuterol nebs on a Sunday, and an ER visit would cost $3000? I think most physicians would give an ABX if the patient has had that medication before, and was unable to be seen. Also, what about your father? If he has had azithromycin before, has an infection around the same time every year that he goes to the doctor for, gets prescribed azithromycin every year, you wouldn't write him a script for that?
This is different. For family members I would have an understanding of their health and their symptoms, and I would feel comfortable prescribing urgent care level medications after giving them a 5 minute look over. Refills are generally alright as well. As for antibiotics, unless there is an obvious bacterial cause to their symptoms, I am not treating them until I get a culture back. The literature is pretty clear on the harm of overprescribing antibiotics and their limited usefulness in many commonly prescribed situations (e.g. sinusitis).
I bolded the relevant part. Maybe it's been said already, but new(er) RNPs and docs alike are nervous about such things because it's illegal and they can (potentially) get in a LOT of trouble with their respective boards, insurance companies, etc. They are required to actually assess you via a visit to their office and/or at a hospital, and have a paper trail. This is especially true in Texas and similar states where an RNP practices under an MD, meaning there is a second party involved who could get in trouble as well. Take it easy on her....it's not personal. Hope this helps. Edit: I don't know whether it's legal/illegal in the technical sense of the word, but she can definitely get in trouble with her licensing board. How likely that is is another thing, but like I said, newer practitioners are more nervous about such things.
1. Most NP's and PA's write prescriptions under a physicians authority. Some can do it without it, but typically that requires them to have their own malpractice etc, which gets pricey and puts them in a bind. 2. The issue with writing prescription is that many lawyers and judges now hold doctors liable for anything that happens from the patient taking the medication. As a result, for legal reasons, any doctor, np, or pa should add anyone they give medications as an official patient with medical record, documenting history, physical and other medications. For direct family, this does not become much of an issue for other relatives things can always go bad. While this issue is somewhat minimized with the medical-legal system in Texas, many healthcare providers are not up-to-date with how to deal with this system, have heard the horror stories, etc. 3. Can become a slippery slope. As some have mentioned here, continually prescribing medications for all your close friends and family can become burden and put you in a bind if you are ever audited, or something happens. Because of this, some docs, pa's, & np's will take the position of just not writing any prescriptions unless you are their patient. 4. Different field. Just because they are medical professional does not mean they are extremely comfortable with the area your problem would be. While you would think oh any doctor can treat a sore throat and ear infection, you would be surprised how many doctors are not up-to-date with the newer medications recommended or treatment strategies used. This also becomes a bigger issue if something were to come up and it gets brought up in the legal system. 5. Antibiotics are generally over-prescribed. Most illnesses are viral and will not respond to Abx. There are few cases where a bacterial infection can be suspected(i.e. the overnight strep test, other biopses of bad infections, or patients with documented chronic infections due to underlying issues, such badly draining sinuses, etc.), but otherwise an antibiotic should not be given to a patient until they have been sick for nearly 5-7 days. The reason is that time span is the normal progression of a true full blown viral infection. Even in a number of the typical bacterial infections, more and more evidence is showing that many antibiotics do not really affect symptoms or length of the bacterial infection. Furthermore, many cases that do require antibiotics really need a much longer course (10-14 days) or a more fine tuned drug than a simple Z-pak. Because of all this, some health professionals are hesitant to prescribe any medications over-the-phone or without seeing the patient.
