I said No.
The tech took the two prescriptions from a customer. She filled them both then plopped them on me to check. The first thing I noticed was the patient and the Dr. shared the same unusual last name. I deduced (correctly) that the Dr. was prescribing for his/her spouse. Rx #1 was no issue. I am fairly liberal and while I am not a huge fan of self/family-prescribing, I realize its not illegal so I don’t fret. Rx #2 was another story. Sitting before me was great big bottle of 100+ Maximum Strength Schedule II opiate. I didn’t much like the look of that.
I checked the computer–Dr had only one rx at our store, recently filled. Dr’s spouse only had a few rx’s, also recent fills but no narcs. The blank was clear that this Dr was a specialist and the med was obviously out of the scope-of-practice, for the written prescription even had the condition being treated. The Doctor was also retired.
So, lets add it up. Retired Dr Specialist writing large quantities of C-II’s for the spouse outside of the scope of practice.
I decided I was not going to sign off on it.
I dunno, if it was for a dozen T-3’s, maybe I’d look twice but decide to go ahead, but this was way outside my comfort zone. The couple had taken off so I decided to fact-find and called some of my contemporaries. Not one of them would want their initials on the back of the hardcopy. I even called my other pharmacist at home and he didn’t like the look of it either and he knew of the physician.
An hour passed and they were both a no show so I called and left a message at their house to please contact the pharmacy. About 20 minutes later the Dr. called back. I gave my gentle and very well rehearsed schpiel as to why I didn’t feel right about filling the drug. Dr. didn’t take it very well. He/she announced that for the 14 years he/she had been self prescribing narcotics for his/her own orthopedic condition and no pharmacist had ever given him/her any trouble. Dr also added that he/she had sharing his/her prescription for years because Spouse didnt have insurance (what?!?!). Dr proclaimed that he/she would just wait until tomorrow when my partner would be on shift “because HE knows me”. I (again gently) informed Dr that he/she is free to do anything Dr’s wants but nobody at this store will be filling that prescription.
The Dr announced he/she was offended at my actions and would just take his/her business back to the competitor he/she had been going to. (fine with me).
As far as I am concerned this Dr was just digging a deeper hole, admitting self prescribing narcotics, billing them to his/her own insurance, then distributing them to the spouse. This constitutes not only insurance fraud but is a violation of federal law. All of this was confirming my decision to hand the prescription back unfilled.
I called the Board of Medical Examiners the next day just to get their stance. They agreed with my actions and said that every member knows that the practice, while not specifically illegal, is strongly discouraged. He also added that the rest of this Dr’s revelation (self prescribing and distribution to the spouse) was a violation that could result in action by the board.
I decided to take the high road and not play tattle tale. I told him that if the Dr gave me any additional trouble then I would call back and give him more specific information but for now, lets just make this call a fact-finding inquiry.
In the state of my original liscensure, this practice is illegal. Too bad its not here. It would have made for a much more pleasant evening for Pharmacy Chick.
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