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Monday, February 15, 2010

Pharmacist prescribing prompts legal concerns

Do you need to adjust your practice to limit liability risk?


Physicians used to be the only people prescribing drugs to patients. Those days are long gone.

Over the last four years or so, in almost every province, limited prescribing and renewal authorities have been granted to other health workers, including pharmacists, nurse practitioners and even naturopaths.

The latest province to follow the trend is Ontario. Despite the Ontario Medical Association’s objections, work is now underway to permit pharmacists to extend, adapt and adjust prescriptions. New draft regulations will govern prescribing by nurses and naturopaths as well. British Columbia, P.E.I. and New Brunswick already have similar legislation, while Alberta pharmacists can become certified to initiate certain prescriptions. Nearly every other province is working on some variation of these ideas.

The decision to extend prescribing authority to non-doctors is a logical response to the growing queues of orphan patients, and to doctors’ clamouring about suffocating workloads. But the trend towards expanding prescribing authority introduces new liability issues for physicians.

Click here to read the rest of this article on the Parkhurst Exchange website.

Photo: Shutterstock

4 comments:

  1. Random thoughts on prescription issuance by regulated healthcare professionals.

    RE: the legal perspective

    A prescription is a contract.

    Whomever " initiates" the contract is the contractor.

    Insurance companies must clearly delineate the liability issues for anyone who has a "care contract" without following appropriate procedures that are assumed as inherent in such a contract.

    In the event that the prescription is not linked to a valid " initiator" to make this type of contract there should be clear guidelines as to what the impact is for the " prescriber " who is a " regulated" health professional.

    Regulated professional bodies have " administration manuals for the examination of administrators.
    They are different than the guidelines given to practitioners.
    Your organization should have someone who functions in the administrator role to ensure policies and procedures are in place ...and followed.

    RE: the scale and scope perspective

    It is foolish to have any "system of contracts" that is not legal and binding on both parties.

    "Double doctoring" is not acceptable by the payor.....and should not be tolerated by the courts.

    If a patient has a prescription relationship that constitutes following a "regime" (as opposed to emergency refill or acute episode control)the penalties for litigation issues should be different.

    Prescribing rights of subordinate staff should be viewed as " standing orders" following specific protocols for disease states. They should have expiration dates.

    Some realtime tech connect ( similar to WEED charting) should inform any prescriber in an interdpendent team of all current prescription Hx of the patient and relevant information of disease process and treatment success where all team members serving the client are part of the info loop .

    Interdisciplinary teams should not overlook the genuine possiblility that in the future the client will have multi-disciplinary team relationships that are broader than medical determinant of health.
    This broad-based service arena is seen as dramatically more cost-effective than the exclusivity of past interpretations of " health".
    In many respects this self-directed construct forms the strength of the " self-care" movement and the " flip" is where the healthcare professional becomes the servant ( not the patient as servant to the healthcare professional).

    A word to the wise.... better a servant...than a slave. 8-)

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