Physician Prescribing Practices (PPP)

Direct authorization by valid signature is required to verify the authenticity of prescriptions.

Handwritten prescriptions given directly to the patient must be signed manually. EMR-generated prescriptions that are printed and given directly to the patient must be counter-signed with a “wet” signature.

EMR-generated signatures are only acceptable to pharmacists when the prescription is transmitted directly from the EMR to the pharmacy of the patient’s choice, as in the case of a fax. In a closed electronic system where transmission is by secure messaging, the password protocol is considered the prescriber’s direct authorization. The physician must log in and transmit the prescription themselves (i.e. may not delegate) in this case.

Physicians may provide a new prescription for a patient without seeing that patient in-person in accordance with current recommendations for virtual care. For more information, refer to the CPSA guidance document for virtual care.

If clinically appropriate, a physician may refill a prescription over the phone or fax without seeing a patient in person. Certain drugs cannot be verbally authorized or refilled as per regulations to the Controlled Drugs & Substances Act.

Please refer to our Opioid Agonist Treatment page for detailed information.

Yes. Physicians may decide whether or authorizing the use of medical cannabis is appropriate for their patients. The physician must register with CPSA to authorize cannabis for medical purposes. For more information, please refer to Cannabis for Medical Purposes.

No. Specific details about the prescribing practices of individual physicians is not public information.

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.” 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.

Yes. However, there must be no conflict of interest. This means patients cannot feel coerced to purchase from that pharmacy,. A physician’s ownership in a pharmacy must not impact his/her prescribing practices.

For further guidance, please refer to the Prescribing: Administration, Conflict of Interest, Code of Ethics & Professionalism and Relationships with Industry Standards of Practice.

No, except when another prescriber is not available for emergency services. Note: You cannot bill for this service.

For further information, refer to the CMA Code of Ethics and Professionalism, Section 20.