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So an NP recently quit the private practice I'm at because she was looking for a job with benefits which is fine. Then....I inherited a number of her patients. Almost a good half of them on are Adderall IR as first line treatment. Nearly another half are on some sort of benzo with Xanax being relatively common. The ADHD diagnosis was thrown around pretty loosely, even applied to the guy that smokes pot daily and is getting early oxycodone refills. Interestingly when I called him and told him he needs further work up including a UDS, he disappeared, never to be heard by the clinic again. Some of these ADHD diagnoses are newly made in people in their 40's with no pediatric history. Today I discontinued stimulants on two people. One person got irritable on the Adderall IR. Another person lost too much weight on the Vyvanse and she turned out to be on huge doses of benzos from her PCP which explains the inattention. I discontinued a bunch of Xanax on a guy who was also on a good dose of oxycodone. W...T....F... man....
I guess it is good that the clinic caught this early. I believe the liability would be on the medical director of the clinic who is an MD. These are just all patients from today. I guess this explains why I kept getting these bogus ADHD referrals despite me not being easy to get stimulants from, the stimulants were coming from elsewhere in the clinic!
I guess it is good that the clinic caught this early. I believe the liability would be on the medical director of the clinic who is an MD. These are just all patients from today. I guess this explains why I kept getting these bogus ADHD referrals despite me not being easy to get stimulants from, the stimulants were coming from elsewhere in the clinic!
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