First Stop Health Physician Policies

Prescriptions

First Stop Health supports responsible, conservative use of antibiotics.

Guidelines:

Medication for diabetes, hypertension, thyroid, cholesterol, behavioral health, asthma, herpes, etc.

  • These medications should be only refilled. You should not make a diagnosis and choose dosage during consultation.

  • The limit is 3 prescription refills within the calendar year. Make sure to review past consults. Only 30 days can be prescribed at a time.

  • For each prescription, the First Stop Health doctor must advise the patient to see PCP/original prescribing specialist.

  • On the 4th prescription, doctors may decline or fill one more time on a case-by-case basis.

Contraception and emergency contraception

  • One 90-day prescription within a calendar year

  • No limit for emergency contraception

  • Make sure to take adequate medical history

  • Plan B One Step can be purchased OTC by anyone of any age and does not require a prescription. Typically covered by insurance with a prescription.

 

Smoking cessation drugs including Zyban and Chantix

The Affordable Care Act of 2010 expanded coverage of FDA-approved smoking cessation medications. It is now considered a preventive service and covers 90 days and 2 quit attempts per year.

Stay up-to-date on our prescription policy here. 

With Paxlovid becoming more available, we've updated our policies in order to appropriately assess and prescribe this medication. Use this checklist when prescribing Paxlovid.

For further drug interaction information, visit this page. 

 

Note: Clinical benefit is greatest if initiated within 48 hours. In patients with severe, complicated, or progressive illness, hospitalized patients, or those at increased risk for complications, initiate treatment as soon as possible even if >48 hours have elapsed since illness onset and do not delay for laboratory confirmation. For symptomatic outpatients with mild illness not at increased risk for complications, treatment can be considered if it can be initiated ≤48 hours following illness onset. Usual duration of therapy is 5 days; a longer duration can be considered in severely ill or immunocompromised patients (CDC 2021a).

Infants ≤8 months: Oral: 3 mg/kg/dose twice daily (AAP 2021; CDC 2021a; IDSA [Uyeki 2019]).

Infants ≥9 months: Oral: 3.5 mg/kg/dose twice daily (AAP 2021; IDSA [Uyeki 2019]); some experts still recommend manufacturer labeled dosing of 3 mg/kg/dose twice daily (CDC 2021a; IDSA [Uyeki 2019]).

Children and Adolescents:

≤15 kg: Oral: 30 mg twice daily.

>15 to 23 kg: Oral: 45 mg twice daily.

>23 to 40 kg: Oral: 60 mg twice daily.

>40 kg: Oral: 75 mg twice daily.

Sick Notes

Sick notes for COVID-related consults can be issued for up to 5 days. Here are a few things to know about sick notes:

  • Sick notes are effective starting the date of the consultation. 
  • Sick notes can only be backdated for one day prior to the date of the consultation.
  • Patients referred to the ER or urgent care should not be given a sick note. (They can get a sick note from wherever they seek in-person care.) 

 

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Physician Resources & Guidelines

For best practices and updates from the CDC, click here.

Virtual Primary Care

Helpful Guides