Scope of Practice

[killingbill]

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I had a patient come in with a script for 10 Fentanyl patches from a cardiologist. This patient is on long term pain therapy. Is this prescription fillable? I remember learning that MD's must write within their scope of practice...?

 

[killingbill]

Oh and I forgot I have seen an Oxycontin prescription written by a psychiatrist. Can psychiatrists write for pain meds?

 

[MountainPharmD]

I had a patient come in with a script for 10 Fentanyl patches from a cardiologist. This patient is on long term pain therapy. Is this prescription fillable? I remember learning that MD's must write within their scope of practice...?

Please tell me you are not a Pharmacist. Please tell me you are a brand new technician who is just curious and doesn't know how dumb this question is...

 

[MountainPharmD]

Oh and I forgot I have seen an Oxycontin prescription written by a psychiatrist. Can psychiatrists write for pain meds?

You should really stop while you are ahead and just move on....

 

[killingbill]

Please tell me you are not a Pharmacist. Please tell me you are a brand new technician who is just curious and doesn't know how dumb this question is...

i'm assuming to deflect the fact that you don't know the answer or anything about prescribing laws that you turn it into a joke...

 

[killingbill]

Please tell me you are not a Pharmacist. Please tell me you are a brand new technician who is just curious and doesn't know how dumb this question is...

LOL you went to school in kansas... no wonder your only used to hicks prescribing for their livestock

 

[Praziquantel86]

i'm assuming to deflect the fact that you don't know the answer or anything about prescribing laws that you turn it into a joke...

How is pain management outside of the scope of a cardiologists practice?

I find it ironic that you're insulting a pharmacist for supposedly not knowing about prescribing laws when you asked the initial question. Pot, meet kettle.

 

[confettiflyer]

i'd have a smart ass remark too, but everyone beat me to it.

so i'll be helpful for once in my life: MD's have unlimited scope of practice. you can be a cardiologist and write for amoxicillin in peds if you really wanted to. heck, you can get someone started on a chemo regimen or write scripts for insulin in pt's with T2DM.

you have to worry about scope with other practitioners like dentists, optomotrists, etc... a dentist prescribing a statin won't fly.

you're welcome young, uneducated technician/clerk man-woman-child who has horrible grammar usage.

 

[confettiflyer]

lol this is horrible

 

[killingbill]

http://www.deadiversion.usdoj.gov/21cfr/cfr/1306/1306_04.htm

a CARDIO-logist deals with the heart in normal practice... not pain... you idiots

 

[GreyFox2002]

http://www.deadiversion.usdoj.gov/21cfr/cfr/1306/1306_04.htm

a CARDIO-logist deals with the heart in normal practice... not pain... you idiots

Correction, a CARDIO-logist deals with diseases of the entire cardiovascular system, not just the heart.

Think hard. What are pain syndromes associated with the cardiovascular system that a patient may be present with, requiring intervention with opiate analgesia?

 

[rxforlife2004]

http://www.deadiversion.usdoj.gov/21cfr/cfr/1306/1306_04.htm

a CARDIO-logist deals with the heart in normal practice... not pain... you idiots

lol...omg...please...an MD can write for anything...literally anything....! but whether he/she feels comfortable and being reliable for what he/she writes is a different story. A cardiologist can write a cream for acnes too if he wants...as long as if something happens to the pt, he's reponsible for that.

Back to your question: HELL YEAH, he can write fentanyl for that patient. This is not OUT of their scope of practice!!! If a dentist writes for fentanyl patch, then heck no....got it?

 

[eightball]

dont feed the troll

 

[rxforlife2004]

Oh and I forgot I have seen an Oxycontin prescription written by a psychiatrist. Can psychiatrists write for pain meds?

nO, Psychyagists can only write dulcolax suppository....! period! and you need one

 

[crazybob]

dont feed the troll

👍

 

[crazybob]

Oh and I forgot I have seen an Oxycontin prescription written by a psychiatrist. Can psychiatrists write for pain meds?

Oh and I guess you wouldn't dispense a beta blocker Rx written by a shrink?

 

[MountainPharmD]

http://www.deadiversion.usdoj.gov/21cfr/cfr/1306/1306_04.htm

a CARDIO-logist deals with the heart in normal practice... not pain... you idiots

Wow....you are soooooo right...We are the idiots....yep. Cardiologist never ever have to deal with pain issues. I mean open heart surgery is a simple painless procedure.

I better stop filling those birth contol prescriptions from general practioners because its out of thier scope of practice since they are not OB/GYN's.

I better stop filling antibiotics unless it was written by an infectious disease doctor. It would be out of any other doctor's scope of practice.

This will be fun. I could make fun of this fool for a week before I get bored!

 

[MountainPharmD]

http://www.deadiversion.usdoj.gov/21cfr/cfr/1306/1306_04.htm

a CARDIO-logist deals with the heart in normal practice... not pain... you idiots

The link you posted, what does it have to do with anything you have posted so far concerning scope of practice?

 

[type b pharmD]

The link you posted, what does it have to do with anything you have posted so far concerning scope of practice?

Well the first paragraph does say a physician can only prescribe controlled substances if doing so is in his or her normal course of professional practice.

Last time i checked, a physician's "professional practice" was defined as seeing patients, diagnosing problems, and prescribing medications!!

Now maybe if the dr was prescribing them to people at the mall or at a ballgame or something, that would be "outside of their normal course of practice". But the OP obviously got it wrong

 

[crazybob]

A prescription for a controlled substance to be effective must be issued for a legitimate medical purpose by an individual practitioner acting in the usual course of his professional practice.

An order purporting to be a prescription issued not in the usual course of professional treatment or in legitimate and authorized research is not a prescription within the meaning and intent of section 309 of the Act (21 U.S.C. 829) and the person knowingly filling such a purported prescription, as well as the person issuing it, shall be subject to the penalties provided for violations of the provisions of law relating to controlled substances.

Since the patch is a C-II, this would be related, but I'm not sure what the OP was trying to point out.

 

[BMadjuster]

This is one angry little troll, not to mention ignorant about anything related to medical practice.

 

[confettiflyer]

yeah i feel dumb for answering his question...haha, he's too stupid to understand "unlimited scope of practice." 😴

 

[Praziquantel86]

http://www.deadiversion.usdoj.gov/21cfr/cfr/1306/1306_04.htm

a CARDIO-logist deals with the heart in normal practice... not pain... you idiots

I'll take the high road here and try to be helpful.

Any physician is, with extremely limited exceptions (maintenance therapy for drug abuse is the only one that I can think of), able to write prescriptions for any drug they see fit to best serve their patients. Although a cardiologist does indeed specialize in disease of the cardiovascular system, it isn't inconceivable that a patient seeing a cardiologist might have a chronic pain condition.

Here is one scenario: a patient with breast cancer receives doxorubicin and develops heart failure secondary to therapy. She now sees the cardiologist to manage her heart failure, and he also prescribes pain medication to deal with residual pain. Or another one: a patient is in pain, and seeing a cardiologist.

Might the patient be better served by seeing a pain management specialist? Maybe, but it might also be another physician's appointment to schedule while juggling a busy life and chronic pain...and result in the same prescription.

Understand that the patient might be seeing a cardiologist, but that cardiologist is a physician first. Physician's treat patients to the best of their ability.

Off the soapbox.

 

[Farmercyst]

Merged scope of practice threads. Keeps the subject matter in a single thread.

 

[BMadjuster]

Merged scope of practice threads. Keeps the subject matter in a single thread.

Are you within your scope of practice, merging threads like that?😉

 

[crazybob]

Are you within your scope of practice, merging threads like that?😉

A degree in SDN 🤣 jk

But really, I thought the prescriptions were fine as long as it's valid and a proper diagnosis and treatment recommendation was made.

 

[GreyFox2002]

I'll take the high road here and try to be helpful.

Any physician is, with extremely limited exceptions (maintenance therapy for drug abuse is the only one that I can think of), able to write prescriptions for any drug they see fit to best serve their patients. Although a cardiologist does indeed specialize in disease of the cardiovascular system, it isn't inconceivable that a patient seeing a cardiologist might have a chronic pain condition.

Here is one scenario: a patient with breast cancer receives doxorubicin and develops heart failure secondary to therapy. She now sees the cardiologist to manage her heart failure, and he also prescribes pain medication to deal with residual pain. Or another one: a patient is in pain, and seeing a cardiologist.

Might the patient be better served by seeing a pain management specialist? Maybe, but it might also be another physician's appointment to schedule while juggling a busy life and chronic pain...and result in the same prescription.

Understand that the patient might be seeing a cardiologist, but that cardiologist is a physician first. Physician's treat patients to the best of their ability.

Off the soapbox.

Or a patient suffers from severe atherosclerosis, causing high grade pain in the lower extremities due to claudication. The patient also is an alcoholic and has cirrhosis of the liver, so tylenol or any tylenol containing opiates are contraindicated. Thus, a CII narcotic would be the only appropriate option. NSAIDs would not be an appropriate in this patient due to CV disease.

Obviously this guy has no idea how to think outside the box.

 

[Old Timer]

Look at the degree after his/her name. It's either MD or DO. He or she got a medical degree and not a cardiology degree. He specializes in cardiology and that is in addition to his medical degree. His licensed to practice medicine and not cardiology and there are not seperate licenses for each specialty of medicine.

You do not have to come up with some convulted reasoning about ischemic pain. He can prescribe anything he wants and he does not cease to be a doctor because he specialized in cardiology.....

Gee wizz..... is there really anyone who thinks otherwise?????

 

[RX CARE]

For the heck of it, it reminded me about the 'scope of practice thread' ...😀😀

http://www.sfgate.com/cgi-bin/article.cgi?f=/c/a/2010/01/30/BAU21BPL3N.DTL