Avoid Prescribing Pitfalls

Signing a prescription means you have a patient-physician relationship and all that goes with it. In a 2008 TMA risk management program, Michele Shackelford, JD, of Shackelford Consulting counseled her audience to do the following to avoid being taken in by a drug-seeking patient:

  • Establish a high boundary for prescribing for family or friends, then follow it.
  • Have a medical record of some sort on every patient for whom you prescribe.
  • A patient going straight to heavy-duty drugs sends up a red flag. Make sure the patient's complaint and your diagnosis after a proper examination justify the prescription as the most appropriate treatment.
  • Set up a system by which your staff can make you aware of any strange patient behavior or untimely requests for refills. Confront the patient, keeping good notes in your medical record.
  • If your practice population suddenly changes, you may have been identified as an easy mark for heavy drug prescriptions. Immediately institute strict office practice protocols and procedures as set out in Texas Medical Board rules for pain management.
  • If you feel intimidated by a patient demanding drugs, call the Texas Medical Board for assistance.
  • Do a reality check if you begin to believe that you can't let the patient down by refusing to prescribe what the patient says - he or she must have to survive. There are always other options.

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Last Updated On

March 22, 2018