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Aboff BM, Collier VU, Farber NJ, Ehrenthal DB. Residents' Prescription Writing for Nonpatients. JAMA. 2002;288(3):381–385. doi:10.1001/jama.288.3.381
Author Affiliations: Department of Medicine, Christiana Care Health System, Wilmington, Del.
On Call Section Editors: Joseph K. Lim, MD,
and Stephen J. Lurie, MD, PhD; Editors: Ethan M. Basch, MD, R. Sonia Batra,
MD, MPH, Natalie Holt, MD, Alison J. Huang, MPhil, MD, Nina Kim, MD, Vincent
Lo Re, MD, Dena E. Rifkin, MD, and Mrugeshkumar K. Shah, MD, MPH.
Context Writing prescriptions is one of the most tangible new responsibilities
that residents acquire after graduating from medical school. During their
regular duties, house officers' prescription writing is carefully monitored.
Little is known, however, about residents' patterns of prescription writing
outside of supervision or about residents' knowledge of the ethical and legal
guidelines that regulate prescription writing.
Objective To study what factors influence residents' decision to write prescriptions
Design, Setting, and Participants Survey distributed in December 1997 to 92 internal medicine and family
practice residents at a US community-based teaching hospital. Eighty percent
Main Outcome Measures Self-reported prescribing activities for nonpatients and for individuals
in 12 hypothetical vignettes.
Results Eighty-five percent of respondents reported having written prescriptions
for nonpatients. Based on their responses to the vignettes, under certain
circumstances, up to 95% of residents would write a prescription for an individual
who is not their patient (eg, a sibling). Thirteen percent of residents believed
that some ethical guidelines on prescription-writing activity existed. Only
4% of residents reported being aware of federal or state laws addressing the
appropriateness of physician prescription writing for nonpatients. None of
the residents were able to describe the circumstances that make prescription
writing for nonpatients illegal or unethical based on legal statutes or ethical
Conclusions In a sample of community-based internal medicine and family practice
residents, unsupervised prescription writing by residents for individuals
who are not their patients is a common occurrence. Since residency training
is a time when practice habits are established, it is important that all residents
learn about the ethical, legal, and liability implications of writing prescriptions
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