While it is permitted for Texas physicians to both treat and prescribe medicines to their family members, as well as to friends or employees, the Texas Medical Board is likely to look askance in particular situations. One such situation—perhaps the most publicly scrutinized at the moment—is the prescription of controlled substances.
The Texas Medical Board has established rules governing the prescription of controlled substances to family members and others close to a physician in Chapter 190 of the Texas Medical Board Rules. These substances may be prescribed only in certain circumstances, according to these rules. For one thing, there must be an “immediate need” for the prescription. According to rule 190.8(M)(ii), this “immediate need” may not be considered to last longer than 72 hours. Moreover, the substances may not be prescribed without having taken an “adequate history,” without having “performed a proper physical examination,” or doing so without “creating and maintaining adequate records.”
The Texas Medical Board has seen fit to impose penalties in many cases where physicians have written prescriptions for family members. Many of these instances were punished because the Board considered it clear that the physician had prescribed when the baseline of evidence for a clear “immediate need” had not been met.
Other penalties have been levied due to a tendency for physicians to fail to create the proper records after having prescribed for their family members, employees, or loved ones—likely due to a sense of the informal relationship they have with these individuals which causes an accidental mental slip in the way they think of their records-keeping.
That said, sometimes physicians are accused of violating these rules even where they have held to them meticulously. In this case, they may offer as a defense before the Board that in fact there was a documented immediate need for prescription of a controlled substance, and may put forth the proper records of the actions they have taken.
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