Dialogue Volume 15, Issue 2 2019 - Page 14

FEATURE The proposed policy recognizes that there are some patients who may, for good reason, remain on doses that are higher. 14 DIALOGUE ISSUE 2, 2019 between the physician and the patient,” said Dr. Wooder. In fact, he said, the proposed policy recognizes that there are some patients who may, for good reason, remain on doses that are higher than the doses specified in recom- mended guidelines. Dr. Wooder said that in such situations the proposed policy simply asks physicians to document their considered reasoning. Other proposed changes include: r  emoving unnecessary overlap with guid- ance and/or expectations communicated in existing clinical practice guidelines; additional expectations for physicians with respect to establishing treatment goals and realistic patient expectations; and additional detail to help physicians fulfill the requirement to review a patient’s pre- scribing history in advance of prescribing opioids for chronic pain Please read the draft policy at www.cpso.on.ca and provide us with your feedback. Your comments are important to us. MD more understandable,”said Dr. Wooder, a Stoney Creek Family Physician. While the draft policy proposes to remove a signifi- cant amount of existing content, some additional information has Dr. Scott Wooder been added to address those key areas of uncertainty which have been articulated during the preliminary consultation. For example, in response to questions about how to respond to patient noncompliance with a prescription monitoring plan, we’ve added new expectations; and in response to ques- tions about the prohibition against blanket no-refill policies, we’ve provided additional explanation. While the draft policy clearly leaves the prescribing decisions in the hands of the treating physician, it also emphasizes the need for discussion and collaboration with the patient, whenever possible. “There was a concern that some physicians may abruptly taper or even discontinue their patients’ prescriptions. And we felt that we needed to address that, and make clear that such decisions should be a collaborative effort