Ask any physician and they will have a story about that one cousin who always is asking them to diagnose their symptoms at the family holiday gathering; or their sibling who calls them to prescribe an antibiotic to treat what they’re sure is another strep throat.
As professionals, physicians often consider it a privilege to be able to assist their family and friends with medical concerns, and said family and friends consider it a major convenience to have a physician in the family. Physicians even may feel obligated to treat family and friends who cannot obtain a timely appointment with their own physicians or will incur significant out of pocket expenses for medical treatment.
While the impetus to help those closest to them is understandable and admirable, doing so (or self-treating) actually may violate certain laws and be contrary to generally recognized professional standards. Moreover, there are ethical and liability considerations with this practice. In order to avoid these concerns, physicians should consider the following when treating family and friends or self-treating.
Federal Drug Enforcement Agency
The Drug Enforcement Agency (DEA) is the federal agency charged with enforcing laws regulating controlled substances. The DEA does not specifically prohibit self-prescribing or prescribing for family and friends. Prescriptions for controlled substances, however, must be issued for a legitimate purpose, be medically necessary, made in the usual course of the provider’s practice, and not otherwise violate any state laws. This is understood to mean that physicians only should prescribe controlled substances after conducting a proper medical history and assessment, and properly document such treatment.
State Laws
Several states have laws that address treating family and friends and self-treatment, which generally relate to the prescription of controlled substances. Prior to engaging in any self-treatment or treatment of family friends, physicians should consult relevant state regulations and medical and licensing board opinions.
Examples of states with such laws or restrictions, include:
- State of Ohio: Ohio prohibits controlled substances from being prescribed to certain family members and self-prescribing. In the case of family members, there is an exception for emergency situations, in which case the treatment must be document in a patient medical record. [1]
- State of Illinois: Illinois law prohibits a physician from self-prescribing or self-dispensing any controlled substances. A physician may prescribe a controlled substance to an immediate family member only if “there is a bona fide practitioner-patient relationship and appropriate records are maintained for all treatment of the family member.”[2]
- State of California: While California has no law prohibiting the treatment of family and friends, the Medical Board of California discourages the practice. Physicians must follow the same practices for all persons to whom medication is prescribed, including: conducting an appropriate examination, establishing medical necessity for the prescription and creating and maintaining a medical record evidencing that these standards were met.[3] Physicians also are prohibited from self-prescribing controlled substances.[4]
Ethical Obligations
Treating and prescribing for family and friends, as well as self-treatment, not only is impacted by federal and state laws and regulations, but is the subject of ethical considerations for physicians. The American Medical Association (AMA) has published an opinion with extensive guidance on the subject.
The AMA disfavors self-treatment and/or the treatment of family and friends, stating “[p]hysicians generally should not treat themselves or members of their immediate families. Professional objectivity may be compromised when an immediate family member or the physician is the patient; the physician’s personal feelings may unduly influence his or her professional medical judgment, thereby interfering with the care being delivered.” [5]
The AMA further notes that physicians who treat friends or family often are inclined to provide medical advice beyond their scope of practice or not complete a full and proper evaluation. Friends and family may be reluctant to go against the physician’s medical advice or seek other treatment for fear of straining the family or friend relationship. The AMA recommends that physicians do not treat family or friends (or self-treat) except in “emergency settings or isolated settings where there is no other qualified physician available . . . until another physician becomes available.”[6]
Additionally, the Federation of State Medical Boards (FSMB) has issued a position statement recommending that physicians do not treat immediate family or close personal contacts, or treat themselves. The FSMB recognizes exceptions to these recommendations in the following circumstances: urgent or emergent situations, instances where necessary care cannot be accessed through another health professional, and isolated areas where one’s family member or close personal relation is the only available health care provider. These exceptions should be limited to no more than 30 days, and the physician should conduct a comprehensive history and examination, create and maintain a medical record, and notify the patient’s primary care provider (if applicable) as soon as possible for continuity of care.[7]
While this guidance is not considered “law,” compliance often is considered to be a reasonable standard by which physicians are judged. Acting in a contrary manner could reflect negatively on a physician in a disciplinary action, employment review, or professional malpractice action, for example.
Employment or Contractual Requirements
Physicians who work for medical practices or hospital systems have to comply with certain policies and procedures implemented by their employers. It often is the case that practices and institutions have policies in place that prohibit physicians from self-treatment (particularly self-prescribing) and treating family and friends without meeting certain requirements. Physicians should be familiar with the policies of their employers and not act in a contrary matter. Failing to do so could subject a physician to discipline or employment termination. Also, depending on relevant state law, the employer may be obligated to disclose ethical or treatment concerns to the state medical board or governing body.
Liability Concerns
Physicians should be sure to confirm that their professional liability insurance policy does not exclude coverage for services provided to family and friends. Although one may think that a family member or friend would not institute a professional liability action, they are not excluded from filing such actions by law, and malpractice can and does occur.
Physicians may be at additional risk of malpractice actions should they not provide appropriate examination or assessment of their friend or family member’s condition. This often occurs when physicians do not feel comfortable conducting an adequate examination in more “sensitive” physical areas of their friends and family members or asking necessary questions that are deemed ‘personal‘ in nature.
Considerations When Treating Family and Friends or Self-Treatment
Should a physician believe it is appropriate to treat family or friends, or self-treat, they should do so with the following considerations:
- Confirm the treatment is not contrary to relevant laws or regulations.
- Confirm the treatment does not violate any employment or medical staff policies.
- Treat the family member or friend the same as any other patient: conduct a medically-appropriate examination, only treat or prescribe as medically necessary, treat the patient only within the scope of the physician’s practice, and create and retain a medical record.
- Refrain from prescribing controlled substances to family and friends unless it is an emergency and there is no ability to send the person to an emergency room or urgent care facility.
- Refrain from self-prescribing controlled substances and only self-prescribe non-controlled substances in limited instances and in accordance with state laws.
- Maintain HIPAA and other relevant confidentiality laws.
- Be mindful of licensing requirements. If a family member or friend lives in a state where the physician does not hold a license treating them could violate state licensing laws.
- Make certain that their professional liability insurance policy does not exclude coverage for services provided to family and friends.
Although treating family and friends or engaging in self-treatment is not always illegal per se, it does raise ethical and practical considerations. Physicians should understand these concerns and be mindful of the potential implications. While helping other people often is a physician’s natural instinct, doing so in these circumstances may well do more harm than good.
Reference
[1] See Ohio. Admin. Code § 4731-11- 08 (2023). “Family Member” includes a “spouse, parent, child, sibling or other individual in relation to whom a physician’s personal or emotional involvement may render that physician unable to exercise detached professional judgment in reaching diagnostic or therapeutic decisions.”
[2] See 77 Ill. Admin. Code § 3100.380(d).
[3] See California Medical Board, General Office Practices/Protocols, Online Online. Last accessed on March 13, 2025
[4] See Cal. Bus. And Prof. Code Art. 12 § 2239.
[5] American Medical Association Code of Medical Ethics’ Opinion 8.19 – Self-Treatment or Treatment of Immediate Family Members.
[6] Id.
[7] Federation of State Medical Boards, Position Statement: Treatment of Self, Family Members and Close Relatives. Online. Last accessed on March 13, 2025).
Featured Image courtesy:© 2016 – 2023 Fotolia / Adobe. Used with permission.
Author: Christina M. Kuta, J.D., LL.M., M.S.W. 1
1 Roetzel & Andress LPA
Corresponding Authors: Christina M. Kuta, J.D., LL.M., M.S.W.
Key terms: Employment , Contractual Requirements, Physicians, diagnosis, family, medical ethics, AMA, State Law, medical practices, hospital systems, professional liability.
Published In: Onco’Zine – The International Oncology Network
How to cite:
Christina M. Kuta, J.D., LL.M., M.S.W. Treating Family, Friends or Yourself? A Good Deed May Not Go Unpunished. Onco’Zine. March 21, 2025. DOI: 10.14229/onco.2025.03.21.003
Last Editorial Review: March 19, 2025
Article History:
- Original manuscript received February 7, 2025
- Review results received March 14, 2025
- Manuscript accepted for publication: March 18 , 2025
- Article published online: March 21, 2025
Article: © 2025 The Authors. Used with permission.
