LET­TERS TO THE ED­I­TOR Mon­i­tor­ing sys­tem prompted in­ves­ti­ga­tions

Simcoe Reformer - - OPINION -

i write in re­la­tion to an opin­ion ar­ti­cle au­thored by dr. ellen Thomp­son “opi­oid crack­down hurts chronic pain suf­fers”, Nov. 7.

dr. Thomp­son in­cor­rectly states that in­for­ma­tion pro­vided at the na­tional “opi­oid sum­mit” held in ot­tawa last year “re­sulted in an un­prece­dented crack­down by the on­tario col­lege of Physi­cians and sur­geons on 84 on­tario pain physi­cians found to have been pre­scrib­ing higher doses of opi­oids than the much-re­duced limit now adopted by the col­lege”.

in fact, the col­lege ini­ti­ated 84 in­ves­ti­ga­tions be­cause we had re­ceived po­ten­tially con­cern­ing in­for­ma­tion from the pro­vin­cial Nar­cotics mon­i­tor­ing sys­tem about their pre­scrib­ing prac­tices. New cana­dian guide­lines that rec­om­mend pre­scrib­ing lower dosages had not been re­leased at the time these in­ves­ti­ga­tions were started.

The col­lege has con­sis­tently stated that “un­der­stand­ing and ques­tion­ing pre­scrib­ing prac­tices is not in­tended to dis­cour­age ap­pro­pri­ate opi­oid pre­scrib­ing, and we stress that it is our ex­pec­ta­tion that physi­cians who are the sub­ject of an in­ves­ti­ga­tion will not sud­denly cease pre­scrib­ing to pa­tients cur­rently on opi­oid ther­apy as such an act would not be good med­i­cal care.” We are not ask­ing physi­cians to stop pre­scrib­ing opi­oids but, rather, to pre­scribe re­spon­si­bly and to stay in line with best prac­tices.

dr. Thomp­son opined that “cer­tainly a re­view of prac­tices, and re­me­di­a­tion where in­di­cated, would have been con­struc­tive.” We com­pletely agree and that is, in fact, the ap­proach we’ve taken in the vast ma­jor­ity of these in­ves­ti­ga­tions where fur­ther ac­tion was nec­es­sary. The col­lege will take a re­me­dial ap­proach, when­ever ap­pro­pri­ate, to help physi­cians prac­tise to cur­rent stan­dards. our goal is to sup­port ed­u­ca­tion and con­tin­ued pre­scrib­ing un­der su­per­vi­sion, where the physi­cian’s ca­pac­ity for re­me­di­a­tion is ap­par­ent. David Rouselle, MD FRCSC Pres­i­dent Col­lege of Physi­cians and Sur­geons of On­tario

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