Prescribing for Co-Workers: Practices and Attitudes of Faculty and Residents

BACKGROUND: Physicians sometimes are asked by co-workers for prescriptions to deal with their medical problems. These "hallway" requests typically occur outside a formal doctor-patient relationship.There are professional guidelines on serving as physician for family members and friends, but no guidelines address writing prescriptions for co-workers. The frequency of these requests and the factors physicians consider in responding to them have not been examined. OBJECTIVES: To obtain data on the frequency of these requests and physicians' attitudes and practices in responding to them, and to explore the ethical considerations in writing prescriptions for co-workers. DESIGN: A survey was administered to all physician faculty and residents in an academic department of internal medicine. The questions included whether the respondent had ever been asked for a prescription by a co-worker and how often the respondent had received such requests and written such prescriptions in the previous three months. Respondents also were asked to rate how likely they would be to write such a prescription in 15 hypothetical scenarios. RESULTS: Of the 113 respondents who completed surveys, 68 percent reported having been asked for a prescription by a co-worker. Among those who had ever been asked, 59 percent had been asked one or more times during the previous three months and 88 percent had ever written such a prescription. Also, 88 percent of all respondents stated they were "very likely" or "likely" to write the prescription in one or more of the hypothetical scenarios. CONCLUSIONS: Most physicians in our sample had been asked for prescriptions by co-workers, and most had written such prescriptions. Many respondents indicated a willingness to write such prescriptions in a variety of scenarios, despite the absence of a formal doctor-patient relationship. Further discussion of the ethical considerations in writing prescriptions for co-workers is needed.