Penn Study Finds 52% Of Resident Physicians Self-Prescribe Medications

October 13, 1998

Philadelphia, PA -- A new study from researchers at the University of Pennsylvania Medical Center shows that the common practice of self-prescription by physicians begins at the outset of one's medical career. Indeed, the practice of self-prescription is evidenced during residency training -- the in-hospital, specialty-training period that occurs after graduation from medical school. According to the study, more than half, or 52%, of the residents surveyed reported that they prescribed medications for themselves. In addition, 42% of self-prescribed medications were obtained from a hospital's "sample closet," with another 11% being obtained directly from pharmaceutical company representatives. The study appears in tomorrow's Journal of the American Medical Association.

"We know from previous studies that self-prescription is common among practicing physicians. Now we know the practice starts early," says David A. Asch, MD, MBA, senior author of the study and also Executive Director of Penn's Leonard Davis Institute of Health Economics. To examine residents' behaviors, Asch and his colleagues surveyed 316 residents enrolled in four different internal-medicine residency programs in the United States (specifically, Johns Hopkins University, Stanford University, Tulane University, and the University of Pennsylvania).

Although self-prescription appears the norm among both residents and practicing physicians, there are some troubling aspects associated with such activity. Foremost among those is that professional objectivity is lost when physicians self-prescribe. "A physician who treats himself has a fool for a patient," cautions Jason D. Christie, MD, lead author of the study and a pulmonary fellow at Penn. "This may not be a problem when self-treating for minor or self- limited conditions. But a loss of objectivity means also that one can lose sight of when the line has been crossed." According to the study, the classes of drugs most frequently self-prescribed were antibiotics, allergy medications, and contraceptives. Only two percent of residents indicated personal use and/or self-prescription of psychotropic drugs (used typically to treat depression, anxiety, and sleep disturbances).

The source of the self-prescribed drugs represents still another area of concern, adds Christie. "If pharmaceutical companies are offering these drugs to ingratiate themselves with physicians who will then be more likely to prescribe their drugs to patients, then we have created a conflict-of-interest that potentially puts physicians ahead of their patients. We should view this the same way we view all gifts from drug companies to physicians," he concludes.

Finally, Asch and his colleagues urge a concerted educational campaign be undertaken by the medical profession (and especially residency program directors) to counsel new physicians about the problems inherent in self-prescribing medications. "If organized medicine's view of self- prescription is that it is a bad thing because it represents a loss of objectivity, and yet studies reveal that the practice is rampant, then we either need to change our policy view or do something to reduce the practice.

"One of the characteristics of a profession is that it looks within itself to identify ways for self-improvement," continues Asch. "We either need to decide that self-prescription isn't so bad, or we need to put self-prescription on the professional agenda. This is particularly true for resident physicians. Perhaps the best opportunity for encouraging life-long physician behavior begins with physicians-in-training. To that end, residency program directors should put the issue of self-prescription out into the open, so that it can be discussed explicitly, rather than merely winked at."

Editor's Note: David A. Asch, MD, MBA, can be reached directly at (215) 898-5611.
-end-


University of Pennsylvania School of Medicine

Related Drugs Articles from Brightsurf:

The danger of Z-drugs for dementia patients
Strong sleeping pills known as 'Z-drugs' are linked with an increased risk of falls, fractures and stroke among people with dementia, according to new research.

Wallflowers could lead to new drugs
Plant-derived chemicals called cardenolides - like digitoxin - have long been used to treat heart disease, and have shown potential as cancer therapies.

Bristol pioneers use of VR for designing new drugs
Researchers at the University of Bristol are pioneering the use of virtual reality (VR) as a tool to design the next generation of drug treatments.

Towards better anti-cancer drugs
The Bayreuth biochemist Dr. Claus-D. Kuhn and his research team have deciphered how the important human oncogene CDK8 is activated in cells of healthy individuals.

Separating drugs with MagLev
The composition of suspicious powders that may contain illicit drugs can be analyzed using a quick and simple method called magneto-Archimedes levitation (MagLev), according to a new study published in the journal Angewandte Chemie.

People are more likely to try drugs for the first time during the summer
American teenagers and adults are more likely to try illegal or recreational drugs for the first time in the summer, a new study shows.

Drugs used to enhance sexual experiences, especially in UK
Combining drugs with sex is common regardless of gender or sexual orientation, reveals new research by UCL and the Global Drug Survey into global trends of substance-linked sex.

Promising new drugs for old pathogen Mtb
UConn researchers are targeting a metabolic pathway, the dihydrofolate reductase pathway, crucial for amino acid synthesis to treat TB infections.

Can psychedelic drugs heal?
Many people think of psychedelics as relics from the hippie generation or something taken by ravers and music festival-goers, but they may one day be used to treat disorders ranging from social anxiety to depression, according to research presented at the annual convention of the American Psychological Association.

New uses for existing antiviral drugs
Broad-spectrum antiviral drugs work against a range of viral diseases, but developing them can be costly and time consuming.

Read More: Drugs News and Drugs Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.