Thanks to “Dr. Google,” many patients come to their doctor armed with information about their condition and potential treatment plans, including specific medications they want prescribed. As the medical provider, you may disagree about the effectiveness or necessity of the suggested medication for that particular patient and refuse to issue the desired prescription. But what happens if a patient suffers ill effects after your refusal and files a complaint with the state licensing board? Could your medical license be at risk?

The Standard of Care Benchmark

Medical professionals have no general ethical or legal obligation to prescribe a particular medication simply because the patient believes it's the right course of action. Despite the prevalent "customer is king" axiom, a patient is not a customer or client, and a healthcare provider has no duty to follow their lead at all costs.

Rather, a healthcare professional must meet a threshold “standard of care” in treating and prescribing medication to their patients. A medical review board will find a doctor to have met an appropriate standard if the doctor acted as a reasonably prudent, similarly-qualified healthcare provider would have under the same or similar circumstances.

Determining the appropriate standard of care can be challenging, however. Every patient and medical situation is different; even experts can have competing views. Although the process may vary across states, medical boards typically determine the appropriate standard of care by culling the experience and knowledge of board members and other medical experts, assessing state clinical guidelines, and reviewing relevant, credible scientific evidence.

If the board determines that you failed to meet the requisite standard of care by failing to prescribe a certain medication in a particular case, it has the authority to discipline you in a range of ways, including censure, fines, probation, or license suspension or revocation–any of which can seriously hamper your medical career.

Ethical Duties When Prescribing Medication

With respect to prescribing medicine, healthcare providers have an ethical duty to evaluate the patient, specify the therapeutic objective, be well-informed about current medications on the market, and prescribe the most appropriate medication in their clinical judgment. The physician should also discuss the treatment plan with the patient, provide essential details and instructions, and carefully monitor the treatment.

A physician is not required to prescribe a specific medication for a patient, even if the patient wants it and even if state clinical guidelines recommend their use. You may decide that certain medicines are inappropriate for a particular patient for any number of reasons, from concerns about an adverse interaction with other medication to a reasoned judgment that an alternate treatment plan would be more effective.

But no matter how sound you believe your reasoning to be, a patient may still file a complaint against you. The medical board will have an obligation to take the complaint seriously, investigate the allegations, and determine whether you acted with the requisite standard of care. If the board finds that your decision was not reasonable or appropriate, your reputation and license could be in jeopardy.

If you have determined that a particular prescription isn't the right course of treatment for a patient, protect yourself as much as possible by thoroughly documenting your rationale, especially if you are deviating from state guidelines or standard practices. These documents may prove helpful if the patient files a board complaint against you. Also, take the time to discuss your reasoning to your patients and explain why an alternate solution or treatment is preferable. Listen and respond to their concerns with respect and empathy. None of this may ward off a complaint, but may help to show that you acted reasonably.

Protecting Your Rights if a Patient Files a Complaint

If a patient has filed a state licensing board complaint against you for refusing to prescribe specific medications, take the complaint very seriously, even if you believe it has no merit.

Your professional license is fundamental to your ability to practice. A misunderstanding or mischaracterization of the situation could lead to a professional reprimand, license suspension, or revocation. You should be ready to defend your position and license vigorously.

If the state licensing board is investigating you, hire an experienced license defense attorney-advisor without delay. Your attorney can help you collect crucial evidence and prepare a strong defense. Their knowledge and experience can help you avoid common pitfalls and reach the best possible outcome.

The Lento Law Firm Professional License Defense Team stands ready to help you fight complaints regarding your refusal to prescribe certain medication. We work to protect your integrity and ability to practice medicine. Call the Lento Law Firm today at (888) 535-3686 for a prompt consultation.