NGR 6172 MIDTERM STUDY GUIDE

NGR 6172 MIDTERM STUDY GUIDE Week 1 Chapter 1: “Prescriptive Authority and Role Implementation” It is generally agreed that providing health care includes: assessing health status, promoting health lifestyles, identifying/diagnosing normal and abnormal conditions, providing referrals, selecting appropriate measures, implementing treatment, and supervising on an ongoing basis -prevention, diagnosis, prescription, and treatment Physicians were the first health care practitioners to gain legislative recognition -very broad scope of practice; exclusive right to practice; preeminent position in a hierarchy of health occupations; monopoly in healthcare The role of the physician changed dramatically and driven by new technology and medications, physicians have been attracted into specialty, leaving primary care -Medicare reimbursement has fueled the growth of tertiary care -emergence of nonphysicians; delivered high-quality and cost-effective care Physician Payment Review Commission recommended changes in Medicare and the shift directly increased financial reimbursement to clinicians who were providing primary care and thus increased more providers to primary care -increased access of care Physicians and dentists are the professionals who traditionally have been given right to prescribe -has been thoroughly documented by the pharmaceutical industry -types of medications prescribed are more closely monitored -less research has been conducted on the appropriateness of physician prescriptive practices, although the literature suggests that some physicians may write prescribes for problems that might well respond to nonpharmacologic therapy New drugs go through a trial: awareness, interest, evaluation, and trial It has been suggested that financial ties to drug companies may influence physicians’ prescribing practices Guidelines forbid pharmaceutical companies from giving to prescribers nonpatient care-related items exceeding $100 Problems in the Prescribing Practice of Physicians -Writing up-to-date prescriptions because of physician failure to keep abreast of changes -Pharmaceutical companies influence practice and providing drug samples -lack of time has become major; decreased patient encounters, inadequate history taking, failure to define problem, and an overreliance on drug therapy -consumers pressure to prescribe medications; overuse of antibiotics -illegibility of prescriptions; use of preprinter prescription pads, fax machines, and computer forms have helped -providers may fail to detect or anticipate drug interactions; herbal and OTC Chapter 2: “History Review of Prescriptive Authority” Research on the practices of nonphysician providers has demonstrated that they are qualified to provide primary care -some nonphysician providers have added diagnostic and assessment skills to their pharmacology knowledge