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Thread: Ethics question

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    Ethics question

    What do you think about a dentist writing a prescription for a Z-pack for a friend with upper respiratory symptoms?
    Last edited by mikey; 01-25-2011 at 02:51 AM.

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    Why didn't the friend just get a script from their regular doctor?

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    I thought technically, if the doctor/dentist in question hasn't been seeng the person as a patient (i.e., having an established file on them), it's a no-go. Which is why we can't just ask the hospitalist or ER doc for an antibiotic script without officially being seen.
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    Quote Originally Posted by agalisgv View Post
    Why didn't the friend just get a script from their regular doctor?
    convenient and free

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    Quote Originally Posted by Kasey View Post
    I thought technically, if the doctor/dentist in question hasn't been seeng the person as a patient (i.e., having an established file on them), it's a no-go.
    that's my understanding too

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    Z-packs suck and do not work for me.

    I went to the doctor the other day and unfortunately had to see someone I do not always see, she tried to give me one and I told her they do not make me feel any better and usually I feel no different after taking them. She got frustrated with me. Whatevs.

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    I see absolutely no problem with it. It's a Z Pack for crying out loud, not a month supply of narcotics. Is it supposed to be done that way, no, but come on. I don't think anyone will be getting hurt. I am sure the dentist asked the proper questions to make sure they aren't taking other medications that may interfere, allergies, etc.
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    Quote Originally Posted by BigB08822 View Post
    Is it supposed to be done that way, no,
    Then it is unethical--which is not the same thing as illegal or immoral

    I would call it unethical because the friend isn't a patient. I have had doctors give me scripts without seeing me--often for Z-packs--but only those doctors who have been treating me a long time and know me well as a patient.
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    Dentists give antibiotics for abcesses so it's not like they are completely untrained to do so. The problem is that the patient may have something other than an upper respiratory problem & may need to see a doctor.

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    Well then there is no point in this thread as we all know it is unethical (by definition) but the OP asked our opinion and I gave mine.
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    Quote Originally Posted by BigB08822 View Post
    Well then there is no point in this thread as we all know it is unethical (by definition)
    I don't know if that's actually true, though. For example, I know a doctor who writes scrips for his daughter. I had always thought that was unethical, but he insists that it isn't.
    "The secret to creativity is knowing how to hide your sources."-- Albert Einstein.

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    What a coincidence. I have been sicky lately and I was just thinking about how I could get my doctor to prescribe a z-pack ($15 copay that I can use my flex spending on) without first paying the $40 out-of-pocket cost for an office visit.

    I promise I didn't ask my dentist for it, though

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    mikey - I happen to believe that it is unethical. If he had been seeing the friend as a client then it be appropriate.

    But if the friend called the dentist friend and said - hey I have a sinus problem, Z-pak has worked in the past and my regular doctor is out of town or unavailable, then that is not appropriate.

    Not only unethical, but dangerous. If you don't have all the information/assessment of the client and you do prescribe the wrong thing..And as a dentist, he should not be treating anything other than tooth abcesses, etc.

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    What is a Z-pack?

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    A commonly-prescribed 5-day regimen of Azithromycin, marketed in the US as Zithromax.

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    I know a doctor who wrote a prescription for birth control for someone he was not seeing as a patient.

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    Quote Originally Posted by Prancer View Post
    I don't know if that's actually true, though. For example, I know a doctor who writes scrips for his daughter. I had always thought that was unethical, but he insists that it isn't.
    It's a slippery slope issue. If the daughter is her father's patient, writing her scrips would not be unethical unless treating family members/friends was against the code of medical ethics - and I don't think it is?

    But prescribing even the most simple of medications without examining a patient is unethical, period. Ultimately, it involves the temptation to abuse power.

    We can't even get antibiotics from our vet without having our pets examined, even if we are sure that antibiotics are what is needed. For example, our cat had a lingering cold and we would have preferred to try out a course of antibiotics before we paid for any tests. But the vet was concerned that she might have a blockage of some sort in her nose and wanted to rule that out first. Perhaps we could have argued with him, but in the end we just paid the bill and had the test done.

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    Did the dentist's office in the original post actually do a dental exam/cleaning/treatment/check up on the patient? If so, then I can see it being justified because of the infection risk involved. There have been reported cases where a person's heart is attacked by infections contracted during dental work.

    My brother, who has major health issues as the result of a heart attack and transplant, has to take antibiotics before dental appointments. Even if it's just a cleaning/checkup, he takes a round of antibiotics to prevent the germs from getting into his bloodstream and causing further damage to his immune system or his organs.

    If it was just a wink-wink arrangement and the buddy never even went to the dentist's office, then it is unethical imo. The fact that the buddy would brag about it means that the dentist has put himself at risk of being caught because the buddy has a big mouth.

    I was just talking to a doctor friend about this and she said that fewer and fewer doctors are writing prescriptions for their family members because the prescriptions are being tracked more closely now and patterns are being recognized, such as "didn't have an appointment, but a prescription was phone in." It's to cut down on prescription fraud and drug abuse.

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    Quote Originally Posted by FigureSpins View Post
    Did the dentist's office in the original post actually do a dental exam/cleaning/treatment/check up on the patient? If so, then I can see it being justified because of the infection risk involved. There have been reported cases where a person's heart is attacked by infections contracted during dental work.

    My brother, who has major health issues as the result of a heart attack and transplant, has to take antibiotics before dental appointments. Even if it's just a cleaning/checkup, he takes a round of antibiotics to prevent the germs from getting into his bloodstream and causing further damage to his immune system or his organs.
    I agree FigureSpins, dentists in my area frequently prescribe prophylactic or post-procedure antibiotics for anyone in a risk category, anyone with heart valve issues, or anyone who is immuno-compromised in any way. The presence of an URI may suggest to the dentist that the antibiotics are in order, not because of the URI, but because a patient already fighting off a viral infection may be more susceptible to a bacterial one.
    AceOn6, the golf loving skating fan

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    Quote Originally Posted by Japanfan View Post
    It's a slippery slope issue. If the daughter is her father's patient, writing her scrips would not be unethical unless treating family members/friends was against the code of medical ethics - and I don't think it is?
    I always had the idea that it was unethical for doctors to treat immediate family, but I don't know if that's true.
    "The secret to creativity is knowing how to hide your sources."-- Albert Einstein.

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