by Richard D. Weber, J.D.
MDA Legal Counsel
Published in the March 1996 issue of the Journal
Question: I would appreciate knowing whether there are any restrictions on prescribing for myself, both for dental and non-dental reasons.
Answer: There are no restrictions if the prescription is within the scope of practice of dentistry. Prescribing drugs for non-dental reasons would be illegal.
Question: My wife's prescription for a hormone replacement has run out and it's the weekend. In that her physician is not available over the weekend, and it would be inconvenient for her to obtain a refill by going to one of those all-night clinics, can't I just write a prescription for the refill? Since she has already been diagnosed and is on a treatment plan with her physician, I do not believe there should be a problem.
Answer: Since this appears to fall outside the scope of practice of dentistry, the refill prescription would be illegal.
Question: My son is hyperactive and at one time his pediatrician indicated that Ritalin might be in order. Rather than take him back to the pediatrician, I would like to write out a prescription and have it filled. I will then tell the pediatrician at my son's next appointment.
Answer: Since treatment of the hyperactive condition would be outside the scope of practice of dentistry, writing a prescription for Ritalin would be illegal.
Question: I have a long-term patient in my practice who is also a good friend. He called requesting a prescription to Entex LA, a decongestant. Since his physician could not see him that day and he really needed it, I wrote the prescription. Is there a problem with this, and if so what are the repercussions?
Answer: Prescribing a decongestant would appear to be outside the scope of practice of dentistry, and therefore illegal. It would be a violation of the Public Health Code and sanctions could be assessed, including licensure revocation.
A common inquiry among dentists is whether they can prescribe drugs for themselves, their family and their friends. The simple answer to these inquiries is yes, so long as the prescription serves a legitimate, professionally recognized purpose within the scope of their practice. As long as the appropriate standard of care is observed, prescribing drugs to relieve pain in the teeth, gums, jaws or dependent tissues for a family member or friend is within the bounds of the law.
Problems arise, however, when the prescription is for a non-dental purpose that is outside the scope of dentistry. The preceding questions include examples of prescriptions that fall within the scope of medical practice and therefore would constitute the practice of medicine. This is true even if the practitioner has a license to distribute controlled substances. A controlled substances license only permits a practitioner to prescribe the relevant medicine within the scope of his/her practice. (It should be noted that the chief difference between the state license and a DEA license for narcotics is the applicable jurisdiction; the federal license applies throughout the country, whereas the Michigan license only applies in-state.)
The important legal consideration relative to prescriptions to family and friends is not to whom one is prescribing, but whether the medication being prescribed is within the scope of the practitioner's practice. If it is, the practitioner can prescribe medication to any individual regardless of the relationship. If not, the practitioner cannot prescribe it to anyone.
There are obviously other considerations that should be assessed in prescribing for one's self or family members. For example, professional objectivity could be compromised, and there could be concerns regarding patient autonomy and informed consent. Therefore, the better practice may be to prescribe for one's self or family members only in emergency settings or in isolated instances.