[Magdalen] Drug research.

[Sibyl Smirl]

On 8/29/16 7:52 AM, Jay Weigel wrote:
> Prescriptive authority is a little different from certification.
>
> On Mon, Aug 29, 2016 at 7:46 AM, ME Michaud <michaudme at gmail.com> wrote:
>
>> Varies state-to-state IIRC.
>>
>> http://www.mass.gov/eohhs/gov/departments/dph/programs/hcq/
>> dhpl/nursing/nursing-practice/aprn/practice-and-prescriptive-
>> guidelinesauthority.html

Well, I don't know of myself, but assuming that the doctors/nurses whom 
I have known were not themselves doing something illegal, both may vary 
not only from state to state, but from time to time.

When I was a child, more than sixty years ago, the doctor to whom my 
parents would take me was a DO, not an MD.  He maintained his office in 
Columbus, the County Seat, which also had a hospital where he practiced. 
  He did house calls, and had a picture up in his office which I'd guess 
was his ideal, of a country doctor driving his horse and buggy through 
the rain on a very muddy road, to see a patient.  I would suppose that a 
huge percentage of the time of such a doctor was taken up just between 
one place and another.  He also had pictures in his office (waiting 
room) of many of the thousands of babies he'd delivered.  If one needed 
a doctor, in my time as a child, it was a good idea to phone his office 
first, and if he was having an office day, they'd probably tell you to 
come in, and then you'd wait your turn in his waiting room.  He lived in 
a large, beautiful old house in Columbus, and the downstairs was office, 
while he and his wife and daughter lived upstairs.  I gather that even 
in the Fifties, he was old-fashioned.  He also maintained a small 
dispensary for the commonest things, including many herbal medicines, 
but he didn't give these to his patients in the form of raw herbs to 
make teas, but passed them out in the forms of syrups, salves, etc. 
Occasionally, if in his judgement that it was what was needed, he did 
write prescriptions for things that he didn't have on hand, which one 
could take to the pharmacy and have filled.  He did deliver my baby, in 
1974, but that was not long before he stopped delivering babies, because 
the insurance for obstetrics got so high that he couldn't afford to do 
it any more without making his own fees so high that his patients 
couldn't afford him.

More recently, in different sorts of clinics, I have had prescriptions 
for medications written by Nurse Practitioners under the authority of 
the MDs for/with whom they worked.  I would guess that Nurse 
Practitioners can do this in both Kansas and Missouri, because the one 
who wrote me new prescriptions at the Mental Health Center (for meds 
which the Psychiatrist MD, who was only there one day a week, had 
already determined) lived and had worked in Joplin, until the tornado 
blew away the nursing home where she'd been a Head Something, while my 
Mental Health Center was in Kansas.  Their rules for writing 
prescriptions seemed to be somewhat complicated, but she'd ask me 
questions about how I was doing, when she was writing me a new one, and 
the talk-psychologists whom I saw once a week kept track of me to make 
sure that the prescription I was taking wasn't "going bad" on me.  The 
original prescriptions that the MD Shrink wrote could only be for 3 
month's worth, one month at a time renewable, and when I needed a new 
one, having run out of pills and renewals, the Nurse Practitioner could 
write it.  The pharmacy where I took the paper prescriptions was very 
big on enforcement of rules, especially those related to timing and 
dates.  These pills, btw, were antidepressants and a tranquilizer for 
panic attacks (Xanax/generic) that I needed to keep on hand.


-- 
Sibyl Smirl
I will take no bull from your house!  Psalms 50:9a
mailto:polycarpa3 at ckt.net