Question: We’ve had concerns raised about a member of our medical staff writing scripts for themselves and family members.  There was also a question raised about another member who performed a test on a family member without going through the formal mechanisms for patient registration.  What can we do to educate our medical staff about the risks involved with these kinds of practices?

Answer: Medical staff members need to be reminded of the significant concerns that arise when a physician treats himself or herself, a family member, or someone with whom the physician has a close relationship (such as a domestic partner, fiancé, etc.) Such activities also present serious risks for the hospital, including the legal risk of malpractice liability and the risk of citation for violation of regulatory and accreditation requirements for proper documentation of care provided to patients, all of whom should be registered in the usual manner.

The American Medical Association has spoken specifically to this issue, in its Code of Ethics (see Standard E-8.19), as have various state medical boards.  We recommend reviewing the guidance provided by these bodies and adopting policy language in the Medical Staff Rules and Regulations that reinforces that the standards of acceptable medical practice do not allow physicians to treat themselves or members of their own families.  Of course, there is an exception to every good rule, so the provision should recognize specific exceptions, like where the patient’s disease is rare or exceptional and the physician is considered an expert in the field or in an emergency where no other medical staff member is readily available to care for the family member.