Does legislation reduce harm to doctors who prescribe for themselves?

Objective: To consider the issue of legislation restricting self prescribing by doctors. Method: Searches of the medical literature in Medline, Australian Medical Index and CINAHL using the terms 'medical', 'legislation' and 'physician impairment' from 1966-2003 supplemented by checking citations of review papers. Results: We found 144 articles, although no trials of legislation. The remaining research was inadequate to answer the question of whether restricting self prescribing reduces doctor impairment. However, descriptive studies suggest that impairment attributed to self prescribing is most often from self administration, which is not altered by legislation to restrict self prescribing. Discussion: There are important theoretical adverse consequences of legislation that restrict self prescribing. Apparently self evident legislation may be counter productive. The need for doctors to have an independent general practitioner is reinforced.