Physician Prescribing Practices Program (P4)

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• Are physicians allowed to write prescriptions for themselves or for family members?

  No, unless another physician is not readily available for emergency services.
  Note: You cannot bill for this service.
  For further information go to: CMA Code of Ethics - Section 20
  

• Can prescriptions have an electronic signature?

  
  All prescriptions, including computer generated versions, require a doctor’s “hand” signature.
  Note: in the case of a computer generated prescription with a scanned signature, the signature must be initialed by the doctor who is generating it.
  

• Can prescriptions be faxed to the pharmacy?

  
  Yes. Please refer to the College’s faxing guidelines for more information.
  

• What about electronic prescribing?

  Unacceptable

  • E-mail prescriptions. An unsecured e-mail transmission does not provide authentication of the e-mail sender (to confirm he or she is an authorized prescriber) nor protect the information sent in the e-mail. Pharmacists cannot accept e-mail prescriptions.
  • Prescriptions produced by computer but not signed by a physician, or with an electronic signature that is not hand-initialled by the physician.

  Acceptable

  • Prescriptions produced by computer, then hand-signed by a physician or with an electronic signature that is hand-initialled by the physician, given to a patient to take to a pharmacy.
  • Prescriptions produced by computer then hand-signed by a physician or with an electronic signature that is hand-initialled by the physician, faxed to a pharmacy of the patient’s choice.
  • Hand-written and signed prescriptions faxed to the pharmacy of a patient’s choice, following College guidelines.
  • For best practices in communicating prescriptions, refer to Guiding Principles for Ensuring Safe and Efficient Communication of Medication Prescriptions

• What is "double doctoring"?

  
  When a patient visits multiple doctors to get prescriptions, often for narcotic drugs or other controlled substances, within a 30-day period.
  Note: A physician may use his or her discretion in authorizing a requested prescription, if the individual discloses appropriate reasons for the requests.
  For more information, refer to the Controlled Drugs and Substances Act, (1996, c. 19 C-38.8)
  

• If a prescription is forged or stolen, can the police be notified and/or the prescription handed over to the police?

  
  Yes. According to the Office of the Information Privacy Commissioner, the pharmacist is not providing a “health service”, and a forged or stolen prescription does not contain “health information”.
  Physicians must also consider the ethical aspects of releasing information about a patient.
  

• If a prescription is fraudulently altered, can the police be notified and/or the prescription handed over to the police?

  
  Yes. According to the Office of the Information Privacy Commissioner, the fraudulent alteration of a prescription in any material respect means that this form is no longer ‘health information’ and can be disclosed to the police.
  Physicians also must consider the ethical aspects of releasing information about a patient.
  

• How do I apply for an exemption to prescribe methadone?

  Complete the application form for methadone exemption on the Health Canada website.
  
  Note: Health Canada requires the support of the College to process the application - all completed applications should be forwarded to the College Methadone Program office first.
  
  The College may request additional information prior to supporting an application for exemption.
  
  For more information, call 1-800-320-8624 ext. 4944 or e-mail methadoneinfo@cpsa.ab.ca.
  

• Can I prescribe medical marijuana to a patient?

  Yes, by submitting an application to Health Canada on behalf of the patient.

  Information on How to Apply and Helping Patients Apply is available on the Health Canada website or by calling toll free 1-866-337-7705.

  Note: The College of Physicians & Surgeons of Alberta recommends that physicians do not prescribe marijuana to patients. This recommendation is based on the lack of scientific evidence regarding medical marihuana’s risks and benefits and the lack of clarity surrounding civil litigation risks.
  
  If you decide to prescribe marijuana, you need to ensure your complete compliance with the complex regulations outlined by Health Canada.