In my anesthesia group, the second call doc is known as the "Rover," which sort of means that they are the out of OR everyman. Aside from administering anesthesia in the endoscopy suite (11 cases yesterday, thank you very much) we are also the doc that gets called for all new pain consults and central line placement requests, as well as anything else that people may need. The pain consults are mostly what you'd expect--post-surgical pain management, acute on chronic pain, oral conversions of IV narcotics, what have you. But now, twice, I've gotten called from services that want me to write narcotic prescriptions for patients being discharged from the hospital. Let me be clear: they are not asking for advice on what oral pain meds to discharge the patients on, or recommendations about conversions or tapering or dosing. They just want me to show up and write a prescription for the patient to take home with them.
NURSE: Dr. XYZ said to call you guys to come write the morphine prescription. She's supposed to be discharged right after.
MICHELLE: Wait, but I've never even met this patient before. I've never even heard of her. And I'm never going to see her again. I don't think it's really appropriate for me to be writing a morphine prescription for this person. Who's the primary doctor in charge of her care?
NURSE: Dr. XYZ.
MICHELLE: So why doesn't Dr. XYZ write the prescription?
NURSE: He says he can't.
MICHELLE: He "can't"? He's...not a doctor? He doesn't have a DEA number?
NURSE: He just told me to call you and for you to do it.
MICHELLE: Look, I want to help you, but I'm not going to do that. I can't just come and write narcotics for a patient that I've never taken care of, know nothing about, and am never going to see again. That's just completely inappropriate. Someone who is responsible for that patient needs to take it on themselves to write that prescription. Either the primary doctor on service or her primary doctor outside of the hospital. Someone who is going to follow up with her. Someone who is going to see her again, ever.
NURSE: But Dr. XYZ wanted you to do it.
MICHELLE: I'm not trying to pass the buck here, or give you a hard time, I know you're just following orders. But...look, if he wants advice on what narcotic to send her out on, or wants me to help him calculate the appropriate dose, that's fine. But I'm not going to come and just write a prescription for someone I never met. Frankly, I'm an anesthesiologist in the OR. I don't even carry a prescription pad.
NURSE: (Pause) So...you're not going to do it?
Any doctor with a DEA number can write a prescription for narcotics for patients that need it. Whether or not they want to take responsibility for writing those prescriptions is a whole other thing. Which begs the question...if they as the primary physician don't feel comfortable taking the responsibility, why would I?
Here's one for the comments section: What's the most inappropriate thing you ever got called for in the hospital?