Horst

Risperdal has been approved for these cases.  And is on PBS.  If Risperdal
doesn't work, I then tell family Zyprexa not on PBS unless patient has
Schizophrenia or Bipolar disorder and it costs over a $100.00 per month.
I'll supply samples (that is one reason I see Reps.  They then don't mind if
I phone asking for samples of Zyprexa) and get urgent review buy
Psycogeriatricians or Geriatrician.    

Now, if all these Dr's who prescribed incorrectly on the PBS rectify matters
and don't, then with the saving maybe Zyprexa may also be approved in
Dementia. 

I know it's a catch 22, but patients won't come to your defence when the
shit hits the fan.

Cedric

-----Original Message-----
From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]
On Behalf Of Horst Herb
Sent: Thursday, 15 February 2007 8:44 AM
To: General Practice Computing Group Talk
Subject: Re: [GPCG_TALK] In quest of OS Medical Records for AU


On Wednesday 14 February 2007 10:05, Cedric Meyerowitz wrote:
> If Dr's can't be educated on PBS prescribing, how are we going to have 
> success with school children.  Remember the Dr sees the PBS rules 
> every day on his desktop, yet ....

Most doctors comply with most PBS rules most of the time. Most of the PBS 
rules make sense too, and compliance comes natural.

Some, however, don't. If you have a psychotic nursing home resident who 
requires the highest level of care and if said nursing home resident calms 
down with 2.5 mg of Olanzapine, starts participating in social events,
starts 
being visited again by relatives because he doesn't spit and scream any more

at anybody coming in through the door, and saves a bundle of taxpayers money

by being downgraded in level of care need - then anybody with a few brain 
cells would think that this medication is both working to the patient's 
benefit, to the patient's social environment's benefit, and to the
taxpayer's 
benefit. Yet PBS rules don't allow prescribing this medication subsidized, 
and the patient can't afford it privately. Just oversedating him with 
Benzodiazepines or exposing him to rather serious (and mostly guaranteed) 
adverse effects as with long term treatment with "typical" antipsychotics as

many still do is not an ethically acceptable alternative.

The only human solution is then for the doctor to find out that his 
psychiatric knowledge is that poor that he misdiagnoses said patient with 
schizophrenia instead of dementia  with psychosis, or paranoia with 
aggression and delusion.

I see rules and laws as guidance. Most make sense and are obeyed by default
- 
usually even by people who don't even know about them, just because it is 
common sense. But some must be broken if and when humanity and common sense 
require it, and when this breaking stands the test of "no undue benefit to 
self" (that is, the rule or law breaker does not benefit more than others 
from doing so)

> If Dr's can't be educated on basic Computer rules, how are we going to 
> be succesful educating kids (what I mean about basic PC skills: Do at 
> least one back up a day, make sure virus definitions are updated at 
> least daily, etc).

Doctors never have been educated on basic computer rules. Schools dumb 
children deliberately down on computers nowadays

Horst
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