Doctors must keep 'stellar' prescription records

Medical professionals face challenges from drug-addicted patients who may resort to violence or threaten to report them to the College of Physicians if they aren’t prescribed the drugs they want, says Toronto health lawyer Elyse Sunshine.

According to The StarPhoenix, new research shows family doctors are experiencing substantial abuse from patients seeking powerful narcotic painkillers and other controlled drugs.

“It is something that we are seeing, where physicians are feeling pressured or threatened by patients who are seeking prescriptions,” says Sunshine, partner at Rosen Sunshine LLP. “The other type of threats that we see are of reports to the College. The patients will either insinuate or outright state that they’ll complain about the physician, and that could spark an investigation.”

Sunshine says the non-violent threat, “ is stressful to the health professional because once the complaint is filed, regardless of whether it has merit, the doctors know the regulator is going to have to look into it. Every professional is concerned when their regulator looks into the care they provide. Ultimately, the physician will hopefully be vindicated but it’s still difficult and could tempt them to do what he or she can to avoid it. This temptation may lead the physician to take steps which he or she will regret."

The College has the power not to investigate complaints that are frivolous, vexatious or an abuse of process, says Sunshine, but this provision of the legislation is unwieldy and rarely used, so she says doctors who write prescriptions for high-risk medications, “have to be careful that the documentation is stellar.

“Many physicians will use tools like narcotic contracts to prevent patients from double-doctoring  and to monitor the amount of narcotics a person is getting,” says Sunshine. “A patient will sometimes say they 'lost' their prescription and if this happens frequently, a physician should be suspicious. People are getting creative in how they get access to narcotics. When these tricks fail, we’re seeing more violent threats.”

Some physicians who practice in certain areas where it may be higher risk, put up signs that indicate they don’t keep narcotics on the premises and they lock up prescription notepads so they doesn’t get stolen, says Sunshine.

However, the most important thing, she adds, is for doctors to talk to their patients about what the expectations and risks are when taking medication.

“Some physicians don’t like to prescribe certain medications because they are addictive but sometimes it’s unavoidable,” says Sunshine. “Most physicians are aware of the seriousness of these medications, but the public is not. Patients don’t necessarily know how easy it can be to get addicted.”

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