Physician, heal thyself: a cross-sectional survey of doctors' personal prescribing habits

Self-prescribing and prescribing to personal contacts is explicitly discouraged by General Medical Council guidelines.

This study examines how widespread the practice of self-prescribing and prescribing to personal contacts is.

A 16-item questionnaire was distributed via an online forum comprising 4445 young medical doctors (representing 20% of all Irish registered doctors), which asked respondents about previous prescribing to themselves, their families, friends and colleagues, including the class of medication prescribed. Demographic details were collected including medical grade and specialty.

A total of 729 responses were obtained, the majority of which were from young non-consultant hospital doctors from a range of specialties. Two-thirds of respondents had self-prescribed, over 70% had prescribed to family, and nearly 60% had prescribed to a friend or colleague. Older doctors were more likely to self-prescribe (χ²=17.51, p<0.001). Interns being less likely to self-prescribe was not unexpected (χ²=69.55, p<0.001), while general practitioners (GPs) and paediatricians were more likely to self-prescribe (χ²=13.33, p<0.001; χ²=11.35, p<0.001). GPs, paediatricians and hospital medicine specialties were more likely to prescribe to family (χ²=5.19, p<0.05; χ²=8.38, p<0.05; χ²=6.17, p<0.05) and surgeons were more likely to prescribe to friends (χ²=15.87, p<0.001). Some 3% to 7% who had self-prescribed had prescribed an opiate, benzodiazepine or psychotropic medication. Male doctors, anaesthetists and surgeons were more likely to self-prescribe opioids (χ²=7.82, p<0.01; χ²=7.31, p<0.01; χ²=4.91, p<0.05), while those in hospital medicine were more likely to self-prescribe psychotropic medications (χ²=5.47, p<0.05).

Prescribing outside the traditional doctor-patient relationship is widespread despite clear professional guidance advising against it.