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Everything posted by quickdraw_mcgraw

  1. Get someone to prescribe you and alpha and beta blocker. Like propranolol, provided you don't have any contraindications.
  2. I would tend to disagree about the duties of PA's performing minor surgeries. The only state that I could find minor surgery specifically listed as scope of practice for a PA was Arizona. But then think about it, a PA is a senior medical student who gets paid. H&P's, write orders, do little procedures. All without much knowledge or responsibility.
  3. I guess my point is that it's not a question without an answer. Most regulatory bodies in North America believe when you prescribe a substance that has the potential to cause addiction then it is your responsibility to monitor for signs of addiction. That's the price of being a doctor, responsibility.
  4. I know it doesn't seem fair. But the patient really holds all of the cards, and the college will always say "you should have recognized this before the addiction began." Doctors have been suspended or had their license revoked over this specific issue. And with post op pain meds, there are no refills from the surgeon from what i've seen. Post op surgical pain should subside within two weeks, there is no need for narcotics after that. If they come back asking for more, the policy usually is "Speak with your GP."
  5. The College of Physicians and Surgeons has ruled on this, it is now a type of case law. The scenario is that he has been making appt's to get painkillers, then one would suppose that you have been giving them to the patient. You can't suddenly stop, you caused the addiction and if the patient complained, it is you that could lose your license for creating the situation. Your responsibility is to form a therapeutic relationship and begin a program of cessation which may include referral to a pain clinic or methadone clinic. But ultimately if you think the patient is addicted, it is you job to treat it.
  6. Well, Who cares? It's about supply and demand. Before, when there was a cap, docs would stop working once they reached their cap. The result...waiting lists. Increased doctors incomes mean more patient are being cared for. Is not that what matters? Besides, CIHI just put out a report that since the cao was lifted only about 1000 docs earned over the 465 000 cap from previous. There are 20 000 docs in Ontario. You have to work pretty damn hard to earn that much money. Better to enjoy your life and cherish your career. Seeing too many patients increases the risk of an adverse event.
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