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Prescriptions and Referrals

PRACTICE POLICY ON PRESCRIPTION OF MEDICATIONS

This Practice has in place policy and procedures to identify individuals who seek to procure PBS medications in excess of what is required for their designated condition or specific needs.This Policy exists to care for and for the protection of Patients, Community and Doctors. Please do not be offended if your request is refused under the above conditions. All of our staff have been instructed to treat our patients with respect and courtesy whatever their requests.

Similarly we ask for respect and courtesy from our patients. When prescribing or supplying medications the doctors take all reasonable steps to ensure a therapeutic need exists and doctors do not prescribe to support drug dependence.

It the patient’s responsibility to give a complete and accurate medical history to the Doctor and it is an offence not to do so with the purpose of obtaining drugs.

Patient prescriptions are recorded on computer so that quantities and repeats supplied may be checked. If “stockpiling” is suspected, this practice undertakes to refer the situation to the HIC, who, through their 'Prescription Shopping Project' have statutory authority to explore the matter further.Patients are advised that an appointment for a consultation is required to issue a repeat prescription.

REPEAT PRESCRIPTIONS

Repeat Medication is a medication that you are required to take continually, the GP will advise you in your consultation if your medication is on "Repeat".

Under Medicare Act and also due to legal constraints, repeat prescriptions can only be issued after a patient has been seen and reviewed by the treating physician

REFERRAL POLICY

It is a legal requirement under the Medicare Act that a referral to a specialist be given by the treating physician only after due consideration and this obviously requires your physical presence.

In theory, one does not actually need a GP referral to see a specialist in Australia, however if the patient requires Medicare to pay them a rebate to assist covering the cost when visiting a specialist, a GP referral needs have been obtained by the patient first. In Australia and other Commonwealth countries in particular the GP referral system is a kind of triage system, so that patients see the appropriate specialist at the appropriate time (resources allowing). It’s not perfect but it is viewed as an efficient system.

People with chronic diseases (a disease lasting longer than a month or so) may be seeing several specialists and have had several investigations and your GP should be synthesizing a summary to be relayed in the referral. This liaising between specialist and GP often goes on after hours and behind the scenes, on an ongoing basis long after the initial referral and attendance.

Lastly the referral requires the specialist to write a diagnosis and management plan back to the referring GP (sometimes on several occasions), countless times patients return to their GP to get a better understanding of what the specialist said, and often the GP coordinates the treatment plan.

MEDICATION REVIEWS

When your "repeat" medication is first issued the GP will authorise this medication for a certain length of time. Once this period expires, you will be asked to book a consultation for a medication review, this could involve a series of questions or it could involve a more medical examination (i.e blood pressure checks, blood tests etc).

It is vitally important that you have continual medication reviews when necessary with the GP / Nurse. This will ensure your health and well-being whilst you are taking the medicine and it will allow the GP to monitor your symptoms to ensure you are on the best care plan. Whilst Upwey Doctors will do everything we can to ensure your medication review goes ahead, in extreme cases you could have your medication refused if you do not attend your medication review.

DRUGS OF DEPENDANCE

This practice has in place a policy regarding the supply of drugs of dependence to patients.

The practice does not prescribe the following routinely:

morphine, pethidine, codeine phosphate, oxycodone, methadone, dextromoramide (Palfium), fentanyl, amphetamines, methylphenidate (e.g. Ritalin), hydromorphone, flunitrazepam, buprenorphine, benzodiazepines, anorectic drugs (Duromine, Tenuate Dospan), dextropropoxyphene (Doloxene, Digesic, Capadex), and anabolic steroids.

As such, should any of the above substances be prescribed, doctors at this practice will undertake to:
Clearly ascertain the identity of the patient the prescription is for. Take all reasonable steps to ensure a genuine therapeutic need exists for the patient themselves. Not issue prescriptions to knowingly support a drug addiction. Not issue repeat prescriptions unless a pre existing permit from the ACT Chief Pharmacist exists for treatment with an S8 drug (as required by the regulations). Procure a permit if intending to treat a patient with an S8 drug for a continuous period of greater than 8 weeks. Not to prescribe S8 medication on the first visit of a patient.

For patients that are not regular clinic patients the doctor needs to:

  • Consult a previous prescriber
  • Contact the Chief Pharmacist
  • Contact HIC
  • Insist on a further means of identification

Doctors must notify the ACT Chief Pharmacist if they believe a patient is drug dependent.These drugs will be supplied according to the regulations, therefore supply will be absolutely according to recommended dosage and may be less than normally allowable quantities. Such supplies may not qualify for PBS subsidy. The earliest date of next prescription will be clearly recorded and adhered to. Additionally, your pharmacist may be requested to limit supply to daily or a few days at a time.

SPECIAL MEDICINES FOR OVERSEAS TRAVEL

Vaccines and other prophylactic medicines (e.g. special antimalarials, yellow fever vaccine) may not be generally available or only accessible from specialist medical practices or may need to be especially obtained by our practice or local pharmacy on prescription. Some may need to be commenced/injected a month or so before departure.

Our practice advises that if you are travelling (especially to 'off the beaten track' or 'exotic' destinations) that patients consult us at least 2 months before departure to ensure that appropriate medication precautions can be taken.

SUPPLY OF PBS MEDICATIONS FOR OVERSEAS TRAVEL

This practice complies with Government Regulations pertaining to the supply of medicines for overseas use. Please check with your Doctor well before traveling.

It is recognized by this practice that it is illegal to supply medications for Australian citizens not within the country at the time the prescription is written for use other than the designated purpose for which it was prescribed, for anyone other than the person named on the prescription.

These are considered to be very serious offences under both state and federal law and may be punished by hefty fines and/or jail terms.