Around here we have the local hospitals sending these type of patients
out on Seroquel. I presume they are using this because of its sedating
properties. The find the patient is more manageable and so send them
back or out to the ACF. Then I am supposed to continue it!
N
Cedric Meyerowitz wrote:
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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