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Analysis: Self prescribing can have serious consequences

Despite the recent increases the GMC has seen in cases, the overall number of doctors who face investigations for self prescribing remains very small. Nevertheless, accusations of self prescribing can have serious consequences for doctors.

The GMC’s latest advice on prescribing advises that ‘Wherever possible you must avoid prescribing for yourself or anyone with whom you have a close personal relationship’ (Good practice in prescribing and managing medicines and devices, 2013, paragraph 17). The GMC says controlled drugs present particular dangers and you should avoid prescribing them to yourself or someone close to you.

In the MDU’s experience, the most common drugs involved in self prescribing are benzodiazepines, antibiotics and opiates. Along with GMC investigations, doctors can also face disciplinary action or even fraud investigations.

There may be rare situations where a GP considers there is little or no choice but to self-prescribe, but the GMC expects doctors to comply with the standards of good practice set out in their guidance and any GP who does chose to self-prescribe must be prepared to explain and justify their decision as a failure to do so can lead to their fitness to practise being called into question.

Treating friends and family should also be avoided if possible. One exception is in an emergency situation where there is no one else available, in which case a GP has an ethical obligation to provide immediate medical care to anyone who requires it.

In other situations, such as in remote rural communities or on small islands, a GP may be faced with the dilemma that his or her friends and relatives do not have easy access to alternative medical care.

If so, patients should be made aware of the potential pitfalls that such arrangements might create, including difficulties with confidentiality and remaining objective.

Any GP who self-prescribes or prescribes for family or friends must be able to justify their actions and must record their relationship and the emergency circumstances involved. Your medical defence organisation can advise you if you are in doubt.

Dr Claire Macaulay is a medico-legal adviser with the Medical Defence Union