Thank you for taking the opportunity to provide feedback on our draft Standard of Practice.
 
Your input will inform the Standard of Practice and ensure that it:
  • reflects current practice issues,
  • embodies the duties of medical professionalism, and
  • is consistent with the College’s mandate to act in the public interest.
Please note: All feedback collected through this survey is anonymous.

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* 1. Which best describes you? (select all that apply)

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* 2. If you are a physician, do you prescribe medication?

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* 3. If you are a physician, do you dispense medication (not including medication samples)?

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* 4. This standard has been modified to state:

Before prescribing a medication, physicians are expected to:

  1. Ensure they have the required experience and expertise to prescribe the medication safely and effectively.
  2. Undertake an appropriate clinical assessment of the patient, including taking a patient history, reviewing relevant medical records (e.g., HEALTHe NL), performing necessary examinations, and ordering necessary investigations.
  3. Reach a diagnosis, differential diagnosis, and/or have a clinical indication to prescribe the chosen medication.
  4. Consider the risks and benefits of prescribing the chosen medication as well as the risk/benefit ratio of adding the medication to the patient’s existing medication regime.
  5. Provide the patient with information about the material risks and benefits of the medication and obtain the patient’s consent. It is prudent to document this discussion, especially when material risks are disclosed.

Do you support this policy change?

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* 5. The standard has been modified to state:


The College recognizes there are circumstances where a physician may prescribe without conducting an assessment. In these circumstances, the onus is on the physician to demonstrate that they could safely provide the prescription. These circumstances may include, but are not limited to:
  • In an emergency to protect the health or well-being of a patient;
  • In consultation with another regulated health professional, where that other regulated health professional has a continuing relationship with the patient and agrees to supervise the patient's ongoing treatment, including the use of the prescribed medications; and
  • When providing on-call or cross coverage for another physician, where the other physician assessed the patient, and where the on-call/cross coverage physician has access to the record of the patient for whom the prescription is issued.

Do you support this policy change?

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* 6. This standard has been modified to state:

Physicians must inform patients of the need for follow-up care to monitor whether any changes to the treatment plan are required. Patients should be informed of their role in safe medication use and monitoring effectiveness. Patients must be monitored for any emerging risks or complications. Medication therapy must be stopped, following appropriate protocol, if it is not effective, or if the risks outweigh the benefits.

Physicians must consider the risk/benefit ratio when providing long-term prescriptions. The duration of the prescription must be balanced with the need to reassess the patient and the potential harm that may result if the patient runs out of the medication.

Do you support this policy change?

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* 7. This standard has been modified to state:

The following information must be included on a prescription:
  1. patient’s full name;
  2. name, dose, route, and quantity of the medication;
  3. directions for use of the medication;
  4. date the prescription was issued;
  5. refill instructions, if any;
  6. printed name and signature of prescriber; and
  7. any additional information required by law (e.g., Prescription Monitoring Act)
Do you support this policy change?

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* 8. This standard has been modified to state:

Physicians must respond in a timely manner when contacted by a pharmacist or member of a pharmacy team regarding prescriptions authorized by the physician. 

Do you support this policy change?

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* 9. This standard has been modified to state:

Physicians must not permit staff members to authorize a prescription unless there is a direct order or medical directive in place and a mechanism to identify who authorized the prescription and under what authority.

Do you support this policy change?

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* 10. This standard has been modified to state:

Unless the prescribing of opioids and controlled substances falls outside of the physician’s scope of practice or clinical competence, or the physician has a restriction imposed by the College prohibiting prescribing, physicians must not adopt a blanket policy refusing to prescribe these medications and must make prescribing decisions on a case-by-case basis with consideration for each patient’s individual circumstances.

Do you support this policy change?

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* 11. This standard has been modified to state: 

A physician who dispenses medication must document the exceptional circumstances in the patient’s medical record.

Physicians must only dispense medications to their own patients and for purposes which are relevant to the medical consultation provided to the individual patient.

Physicians who dispense medications must employ dispensing standards of practice equal to those required of pharmacists.

(Note: Physicians who provide medication samples at no cost to patients are not considered to be “dispensing” medication for the purposes of this Standard of Practice.)

Do you support this policy change?

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* 12. Please share your comments and/or concerns about the draft Standard of Practice.

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* Please feel free to answer the following additional questions regarding your demographics.

Information collected will allow us to ensure we have reached a diverse group of survey respondents and identify any trends. 

Optional Question 1: In which NL Health Services zone or geographic region do you reside?

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* Optional Question 2: How do you identify?

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* Optional Question 3: Which category includes your age?

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