Accutane isn't the only acne medication dermatologists recommend--- in fact, it's the "last resort." They only use it if you've tried about everything else they can throw at you and none of it's worked, because it can have pretty serious side effects (my cousin used it for her acne, and it damaged her liver).
Dermatologists do have many milder medication that are much more effective than things like Proactive that don't require a prescription. I'm using Stievamycin for my minor acne, and it's been really effective. And a good thing about the one I'm using is, it not only works on acne that I have right now, but fades scarring & minimizes pores & evens out skin tone. The price is also cheaper than Proactive, so it was a no brainer for me.