Nigel

I phone the consultant in charge asking informing him that nowhere on
discharge summary does it make diagnses of Schizophrenia.  If he / she tells
me patient has it, I ask for an appended summary to be faxed - which
happens. If patient does not have Schizophrenia I ask Consultant to write a
hospital script and nursing home picks it up from hospital Pharmacy.  If he
declines I ask him what must I do.  They quickly help sort it out.

I find this solves the problem.  I actually once told a RMO that the famly
paid $100.00 for script privately and they are now coming to see him to get
the money back.  I had a phonecall from Consultant to please explain - which
I did.  Since then compliance from that Consultant much better.

The big problem is the waste of time getting hold of thec guilty consultant
/ RMO

Cedric



-----Original Message-----
From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]
On Behalf Of Dr Nigel Farrier
Sent: Thursday, 15 February 2007 10:28 AM
To: General Practice Computing Group Talk
Subject: Re: [GPCG_TALK] In quest of OS Medical Records for AU


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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