My random thoughts on Money

[ghost dog]

I teach IMGs, who typically work some pretty brutal jobs before ( or rather if) they gain entry into the Canadian medical system. Some jobs I have heard these foreign (fully qualified) physicians doing: waiter, cashier, security guard, taxi driver - the list goes on.

 

 

I think they were incredibly lucky that they were able to find their ways to support themselves.

Have you ever earned below minimum wage in Canada because noone is hiring and you can't move because you don't have any money but debt, just living?

With the current state of economy... even if you want to, you can't and that' the saddest part. You don't know what the did and where they have been and can't just assumed that they are all lazy and 'didn't try hard'. that's what I meant to say.

 

This particular patient had worked a previous job in some other industry, and was fully able to go back to this position; he just didn't want to do so.

 

He had finished a truck driving training course about 3 months ago, and thus far been unable to find work in that field.

 

The limitat'n to particip'n / welfare form asks if a patient is physically unable to work, not if they " feel like "working.

 

Nuff said.

[ghost dog]

As a family doc, as long as you do your job honestly and with integrity you will NEVER have to worry about complaints like that....

 

These kinds of losers just make themselves look even more stupid by filing complaints -- which, as you said will never materialize anyway.

 

If you give in to their demands because you are afraid of a "complaint" then you need to take a good look in the mirror, because you are just becoming an accessory to what I consider fraud.

 

I couldn't agree more.

 

On the flip side of this, I recently read about an MD who was filling out special diet forms for people on the Ontario disability support program (ODSP) in a fradulent manner (I can't remember his name at the moment). I have no idea why he would do this, but apparently the CPSO is going to discipline him for it; I think this is a new one for the books.

[moo]

I couldn't agree more.

 

On the flip side of this, I recently read about an MD who was filling out special diet forms for people on the Ontario disability support program (ODSP) in a fradulent manner (I can't remember his name at the moment). I have no idea why he would do this, but apparently the CPSO is going to discipline him for it; I think this is a new one for the books.

 

Exactly. On the flipside, the GOVERNMENT can file a complaint against you if you are just filling out forms nilly willy.

 

You can't worry about getting complaints; otherwise you will never do your job properly. I've been threatened with complaints because I don't refill a drug addicts' oxycontins or I cut them off because they broke the contract I make every chronic pain patient sign. Doesn't bother me because I know the college will tell them to f- off.

[ghost dog]

Exactly. On the flipside, the GOVERNMENT can file a complaint against you if you are just filling out forms nilly willy.

 

You can't worry about getting complaints; otherwise you will never do your job properly. I've been threatened with complaints because I don't refill a drug addicts' oxycontins or I cut them off because they broke the contract I make every chronic pain patient sign. Doesn't bother me because I know the college will tell them to f- off.

 

Absolutely. However, make sure you either i) give the person a 30 day supply of meds in order to find another physician or ii) a tapering opioid regimen.

 

In the rare event they do complain to the college and go through withdrawal , this won't look good.

[japlanet]

Absolutely. However, make sure you either i) give the person a 30 day supply of meds in order to find another physician or ii) a tapering opioid regimen.

 

In the rare event they do complain to the college and go through withdrawal , this won't look good.

 

You could certainly instruct a patient on how to taper their medications, or give them a few week's supply (though it may be that they should still have several weeks left on their old supply which is gone) - but none of those things will prevent someone from going into withdrawal if they don't follow your instructions and/or use the meds up too fast. I guess what I'm saying is that it is important to document the instructions you gave and the fact that you explained the risk of withdrawal etc.

[ghost dog]

You could certainly instruct a patient on how to taper their medications, or give them a few week's supply (though it may be that they should still have several weeks left on their old supply which is gone) - but none of those things will prevent someone from going into withdrawal if they don't follow your instructions and/or use the meds up too fast. I guess what I'm saying is that it is important to document the instructions you gave and the fact that you explained the risk of withdrawal etc.

 

Documentation is everything in regards to a potential college complaint.

 

If you didn't document it, it didn't happen.

 

In respect to aberrant opioid behavior / opioid dependence, the patient will have zero meds left in the scenario in question. This will always be the case.

[titles]

The worse is when you fill this out, the patient goes to some advocacy office and the advocacy office fills in what they think you should fill in and they want you to sign it. I'm like, WTF, I'm not going to say this just because your advocate thinks this is what you have.

 

Ridiculous.

 

I feel for doctors who get these forms, I REALLY DO. You're in such a bind - your patient is relying on you to fill out a form so that they get money. As someone who CARES about their patient's interests, but also cares about your own integrity, I think you get placed in a dilemma.

 

Doctors are advocates, says so in the ODSP case law. Your opinions, while always welcomed, are inherently biased. So Ministry of Community and Social Services might not believe you anyway....back up your opinions with records.