DrugBuyers.Com: New OP in R&D phase consider CII's

an MRI isn't a physical exam.It's a diagnostic test. A physician would need to perform a hands on physcical exam to determine how the findings on the MRI are actually manifesting themselves clinically for the patient. Many people have bulging and even herniated discs and are completely asymptomatic.... A physician prescribing ANY medication for a patient is responsible for HIS OWN assessment of that patient...not reliance on another physician's notes pertaining to an assessment. As someone who has worked in the profession for close to 10 years I can tell you a physician is a FOOL and an irresponsible practitioner if he DOESN'T assess the patient before intervening in that patient's care. The Board of Medical Examiners/Nurse Examiners/Pharmaceutical Examiners doesn't excuse your errors if you made them because another professional didn't document something accurately, or missed something pertninent to a patient's care when they assessed the patient.
And you add yet a thrid layer for the possibility of misinterpretation or omission because most physician's progress notes and H & P are dicatated and transcribed by a transcriptionist. A missing word like "not" changes EVERYTHING...I spend a great deal of time reviewing medical records and can tell you the number of transcription errors is astounding!
If the physician's notes make no mention of the cranial nerves, do you assume they were within normal limits or did the physician assess them? Did he assess for jugular venous distention and not mention it because it wasn't present or did he not asses for it? Were the patient's deep tendon reflexes tested & normal? You see...the average physician may or may not assess for all the things you need to assess before you prescribe narcotics used to treat severe pain. Is the liver enlarged? Do you assume it was not because there is no mention of it or was it assessed? Did he assess for orthostatic hypotension? You have no way of knowing because there isn't a "standard" way of doing it...and the physician who did the physical exam your relying on, wasn't aware that he was perfoming an exam that would be utilized to prescribe a CII narcotic...or it might have been far more in depth.
I'd be willing to bet the "Physician" doing the R&D on this hasn't practiced long...and has probably never had the pleasure of participating in a malpractice lawsuit, or board investigation....because if they had, they wouldn't even consider this.
With schedule II drugs the stakes are much higher...and the only way for a physician to meet his responsibility to assess a patient for important area's such as mental health, depression, other substance abuse just CANNOT be done without a face to face, hands on assessment. An alcoholic could easily hide his condition in a phone consult...but would absolutely be detected by a trained practitioner, who performs a responisble and thorough physical exam prior to writing for schedule II drugs. The risks associated with prescribing strong narcotics that will alleviate pain that could & would mask pain that requires further evaluation is far more likely when the practitioner does not perform a head to toe physical exam of the patient.
I hope your friend has LOTS of malpractice insurance because he will need it.

Edited by IMSUSCOT1 (11/05/03 11:05 PM)