Policy of the
Graduate Medical Education Committee Section: Resident
Support/Conditions for Appointment Subject:
Patient Care Activities under the “Residency Program Exemption” to the Number: 2.600 Date
Developed: 4/97 ACGME Requirement: Institutional IID4
Last Review/Revision: 10/06,
1/2010
Replaces: previous policy, Use of Hospitals’ DEA
Numbers, dated 5/03
Purpose
To
define the policy and procedures for patient care by resident physicians
(includes fellows) under the “resident program exemption” of the Arkansas
Medical Practices Act (Sub-Chapter 2, 17-95-203, #7) - to include use of
hospital assigned and personal DEA numbers.
(Also, see related GMEC Policy 3.300, Moonlighting and Malpractice Insurance
Coverage While Moonlighting)
Definition
In
the context of residency (and fellowship) programs, the term “patient” refers to persons with whom a resident has
established a physician-patient relationship as documented in the medical
record. This may include peers, nursing
or hospital medical staff, or friends who are established patients at UH, ACH,
CAVHS, SVI or BHMC-LR and whom the resident sees in the clinic or appropriate
medical setting within the scope of his/her duties within the residency
program.
Policy
1. Residents may provide patient care under the “resident
program exemption” of the Arkansas Medical Practices Act only for patients as
defined above. This exemption is
intended to be applicable only for supervised patient care under the auspices
of the residency program. This
restriction includes, but is not limited to, prescribing of controlled
substances and other medications.
2. Residents may use a hospital’s specific DEA
number only to prescribe controlled substances to patients (as described above)
followed within that hospital’s system.
3. Residents may, in the context of their
practice in the residency program, prescribe controlled substances and other
medications only to patients as defined above.
Residents shall not prescribe excessive amounts of controlled substances
to any patient, including the writing of an excessive number of prescriptions
for an addicting or potentially harmful drug (Arkansas State Medical Board,
Regulation 2).
4. Residents shall not prescribe controlled substances for their own
use or for use by members of their family (Arkansas State Medical Board,
Regulation 2).
5. Residents may prescribe controlled substances
only when the resident has a physician-patient relationship with that
patient. This physician-patient
relationship shall be clearly documented in the patient’s medical record. The
reason (i.e., diagnosis and plan of treatment) for each prescription of a
controlled substance shall be documented in the medical record.
6. Residents who hold an
Each
resident in residency programs sponsored by the UAMS College of Medicine is
assigned unique identification codes composed of several numbered digits. The identification codes are described below
and, where indicated, a specific code must be attached as a suffix when using a
hospital’s DEA number.
St. Vincent’s
Prescription
Writing
In
accordance with the Arkansas Department of Health Rules and Regulations
Pertaining to Controlled Substances, when writing a prescription for a
controlled drug, the resident must issue the prescription for legitimate
medical purposes. The prescription must
bear the:
1.
Full name and address of the patient;
2.
Drug name, strength, dosage form, quantity prescribed, and directions
for use;
3.
Resident’s last name printed as well as the signature of the resident;
4. Hospital DEA number and the resident’s
specific identification code or the resident’s DEA number; and
5. Date.
Moonlighting
Activities
If
a resident practices outside the UAMS system, the resident must obtain his/her
own private DEA number. Obtaining a
private DEA number is considered a professional responsibility and will not be
paid for by UH, ACH, or the individual clinical departments.
Misuse of DEA
Numbers
Misuse
of hospital-assigned or personal DEA numbers includes, but is not limited to:
1. Using a hospital’s specific DEA number to
prescribe controlled substances to patients not followed within that hospital’s
system;
2. Prescribing excessive amounts of controlled
substances to any patient, including the writing of an excessive number of
prescriptions for an addicting or potentially harmful drug to a patient;
3.
Prescribing controlled substances by a resident for his/her
use or for the use of his/her immediate family;
4.
Prescribing controlled substances by a resident for peers,
nursing or hospital medical staff, or friends without clear documentation of a
physician-patient relationship in the medical record; or
5.
Any violations of the provisions of this policy.
Misuse of any DEA
number will be reported directly to the Dean and could result in disciplinary
action up to and including dismissal from the residency/fellowship
program. Individuals found misusing
hospital assigned or personal DEA numbers must undergo a “for cause” drug
screen, and if indicated, a diagnostic and/or therapeutic intervention and
subsequent indicated drug screens during the remaining time within the
residency/fellowship program.
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