Feature Prescribing

Physician, don’t heal thyself: the perils of self prescribing

BMJ 2014; 349 doi: https://doi.org/10.1136/bmj.g7401 (Published 08 December 2014) Cite this as: BMJ 2014;349:g7401
  1. Tom Moberly, editor, BMJ Careers
  1. tmoberly{at}bmj.com

It’s legal and commonplace but regulators are increasingly taking a dim view of self prescribing among doctors, reports Tom Moberly

Many doctors prescribe drugs to treat themselves. Self prescribing is legal in many countries, and doctors may feel well placed to prescribe the relevant drug to treat their condition or that of a relative. It may also be more convenient for doctors to prescribe a drug for themselves to avoid wasting time and money arranging a consultation with another doctor.

But the potential problems of self prescribing have been recognised for many years. Doctors attempting to treat themselves risk misdiagnosing their condition because their emotional involvement may affect their ability to provide an accurate diagnosis and the desire to manage symptoms swiftly may mean investigations are missed. Doctors who treat themselves often fail to keep adequate records of self prescribing in their medical notes, which may affect future care as other clinicians are left unaware of the treatment.

Despite these problems, self prescribing is commonplace. A study published in 2009 found that three quarters of Canadian clinicians took care of their own medical needs when they could.1 A survey in 2005 found that more than half of physicians in Norway in their fourth and ninth years after graduating from medical school had self prescribed at least once during the previous year.2 And a study in 1998 suggested that around half of US resident physicians had self prescribed.3

Official guidance

The concerns of self prescribing are reflected in guidance from medical authorities around the world, advising doctors against such practice. In some countries, such as Canada, guidance cautions against self prescribing except for minor conditions or in emergency situations when another qualified professional is not available. Guidance from other countries, such as the Netherlands, the Czech Republic, and Latvia, include …

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