We're all doomed (probably)

Re: We're all doomed (probably)

Tim Mainland — Mon, 23 May 2011 16:49:40 GMT

How did Clwyd get involved? Clwyd disappeared 15 years ago and Greenfield became part of Flintshire at the same time. When the RCVS can't even get the county right I do wonder......

Re: We're all doomed (probably)

Tim Cheyne — Mon, 23 May 2011 12:32:22 GMT

[quote user="Martin Jones"]

It's only a matter of time before I need a fluoroquinolone to get me out of bed in the morning. I need help.

[/quote]

It certainly appears so. Have you considered a Zimmer? --- Oh, no, wait; you probably do not have them in the practice.

Tim.

Re: We're all doomed (probably)

Martin Jones — Sun, 22 May 2011 22:01:24 GMT

[quote user="Tim Cheyne"]

Looking back I cannot recall taking any medicines from the shelves, let alone POMs.... Once started it can be a dangerous slippery slope.

[/quote]

True enough: once upon a time, a severe cat bite had me reaching for the amoxycillin. Now, the merest scratch leaves me mainlining amox-clav.

It's only a matter of time before I need a fluoroquinolone to get me out of bed in the morning. I need help.

Re: We're all doomed (probably)

Tim Cheyne — Sun, 22 May 2011 13:10:23 GMT

When I was first in practice there were large bottles (Winchesters) of Mist Diamorphine.Co on the shelves. It had a most delicious toffee-like smell but I am pleased to say that I was never tempted. Looking back I cannot recall taking any medicines from the shelves, let alone POMs; antiseptic, wipes, cotton wool and bandages, yes, when necessitated but medicines, no. I like to think that this is true of most of the profession. Once started it can be a dangerous slippery slope.

Tim.

Re: We're all doomed (probably)

James Laidlaw — Sat, 21 May 2011 22:43:54 GMT

[quote user="Martin Atkinson"]

I would hazard the proposition that there is not one single vet in the country who has not at some time taken a drug off the shelf to treat him/herself, for convenience first and cost secondly in all liklihood an analgesic or some antibiotic. I would then wonder at the hypocracy of elected members of the DC who discipline a member of their profession for doing what in all liklihood they have done themselves.

[/quote]

I for one don't ever self medicate with POM's. I hazard a guess there are many others out there too.

Re: We're all doomed (probably)

Bob Russell — Sat, 21 May 2011 10:53:06 GMT

Two minutes research on Google shows that on-line sales were straight forward for Reductil (all it took was a tick box questionnaire to be reviewed by an on-line Doctor for a prescription) until the drug was removed from sale following some issues in the US. No great crime there. The website also invites men with 'problems' to have a similar on-line consultation. I hasten to add I declined!

Propranolol is legitimately held on vets shelves so rather naughty to take without a doctors prescription. A vet with a weight problem (perceived or otherwise) and stage fright?

Re: We're all doomed (probably)

Michael Woodhouse — Fri, 20 May 2011 23:02:24 GMT

[quote user="Sarah Wheeler"]It was propanolol and reductil.[/quote]

Hardly Morphine and Ketamine.

Re: We're all doomed (probably)

Sarah Wheeler — Fri, 20 May 2011 20:45:04 GMT

[quote user="Bob Russell"]

I am not sure which drugs were involved but a vet trying to self-harm is probably perfectly capable of doing so and covering the tracks.

[/quote]

It was propanolol and reductil.

Re: We're all doomed (probably)

Mark Hedberg — Fri, 20 May 2011 20:08:43 GMT

I won't disagree with that in the slightest.

Re: We're all doomed (probably)

Martin Atkinson — Fri, 20 May 2011 19:25:38 GMT

Re: We're all doomed (probably)

Bob Russell — Fri, 20 May 2011 15:13:20 GMT

Not so sure it is illegal. Probably being very picky but possession and sharing of non-prescribed POM's is illegal under the Medicines Act 1968 but actually taking a non-prescribed POM does not appear to be. I am happy to be corrected on this one.

A vet in this situation may therefore be acting legally (on a technicality) unless possession with the intent to supply ones self is illegal. Again happy to be corrected on this one as well.

Despite this I am not recommending we start taking our own POM drugs!

Re: We're all doomed (probably)

Hannah Wynne Richards — Fri, 20 May 2011 14:38:25 GMT

Yes Bob It is illegal That is what PRESCRIPTION ONLY means The public aren't allowed todecide-only properly qualified professionals-doctors or in the case of animals are allowed to make that decision As to price Clwyd is in Wales,so there is no prescription charge, so can only be cheaper if an employee is stealing from the employer I'll buy convenience Wynne

Re: We're all doomed (probably)

Bob Russell — Fri, 20 May 2011 11:15:45 GMT

Is it illegal to take human POM drugs that have not been prescribed by a GP? Mood-altering drug taking is a welfare problem in most cases! the motivation for vets taking medication from the shelf is often going to be price and convenience.

This said it can be a slippery slope to go down!

Re: We're all doomed (probably)

Hannah Wynne Richards — Fri, 20 May 2011 10:33:27 GMT

I don'tknow what drug was involved, so can't really comment, except to say I would regard self-prescribing of a mood-altering drug far more seriously than an antibiotic or NSAID. DC can't not reprimand a veterinary surgeon who breaks the law,but if an antibiotic or NSAID, then a reprimand is sufficient-if a controlled drug,then I would strike off. I thinkthe case of the veterinary surgeon struck off for supplying an NSAID to his wife (with the full knowledge of his GP ) when she was in considerable permanent pain following a serious road accident was DC going well OTT

Wynne

Re: We're all doomed (probably)

Bob Russell — Fri, 20 May 2011 09:13:22 GMT

I am medically trained, very experienced in diagnosis, can investigate and consider from a position of knowledge my medical needs for minor issues. I have never understood the position in the GtoPC about self-medication.Mt GP always asks whether I want a prescription or if I have the medication on my shelf. He finds it a bit funny that we cannot be trusted with our own medication.

Access to POM's via the internet (real or counterfeit) is a doddle so to get all uppity when a qualified vet writes a prescription seems rather daft. Compromising another professional? Where? If a pharmacist is presented with a valid veterinary prescription he or she should can fill it with a clear conscience and without fear of problems from their regulatory body.

I am not sure which drugs were involved but a vet trying to self-harm is probably perfectly capable of doing so and covering the tracks.

Re: We're all doomed (probably)

J G Wray — Fri, 20 May 2011 07:39:07 GMT

[quote user="phipps"]So I do think the sanction was appropriate, fair and proportionate, and the better question to ask might be - why such harsh penalties in other cases of deception involving falsification of paperwork?[/quote]

I too am relieved to see that RCVS are capable of a degree of variation in sanctioning. There is still a problem with the process though. DC does not consider a case these days unless the evidence for culpability is overwhelming, with, preferably, admission of guilt. This is how other Courts operate when a guilty plea is entered. But, where are the cases where the VS involved denies culpability? One answer is that where these cases involve a prosecution by an external regulatory authority, e.g. the VMD's enforcement arm, RCVS then take their lead from them. In my experience VMDs enforcement arm are v lenient with miscreant VS, but then they are in the Real World, the effect of their action is there for all to see and no the profession's good standing has not collapsed as the RCVS would have it.

DC therefore exists only to determine sentence. This is then based on a number of factors which may be familiar to other Courts like health, but also involves an estimation by the DC members of the level of contrition and understanding by the subject VS of their crime. There's the rub. There's the lottery. Mr Okano offered no explanantion for his failure to check supporting evidence for certification he issued. RCVS therefore assumed something requiring a profound sentence. RCVS claim to take guidance from Counsel, but Counsel always make the point that if DC a re satisfied that the VS' defence is based on falsehood or lack of contrition then a severe sentence is merited. This is where the DC sentencing procedure is really weak, subjective and vindictive. Who knows how those on DC sleep at night?

Mrs Grecko was put through her process as much because others had been before - you may remember the VS who prescribed analgesics for his wife who had open wounds down to her spine following postop sepsis where the medical care was lacking - and because a pharmacist was involved. She was, in part, a political prosecution. Where are the cases of pharmacists who drag vets into their equation? The RCVS using Mrs Grecko to make a point to other professions is disgraceful.

JGW

Re: We're all doomed (probably)

Glen McIntosh — Fri, 20 May 2011 02:29:05 GMT

If you read the decision in full you will see that this case is less about self prescribing and more about the deception involved in writing fraudulent prescriptions (although the RCVS does not use the word fraudulent). As such I think she was lucky to walk away with just a reprimand based on previous similar types of cases, although I think it was probably appropriate.

As for self prescribing, yes, a large proportion of the profession may have done this on occasion during their career, but how many of us have written a false prescription in order to deceive a pharmacist into giving us drugs that we have self prescribed for ourselves. Very few, I would hope. Because we know that it is wrong. We should also know that taking a few synulox from stock for ourselves is also wrong, but we rationalise that it is a lessor wrong and therefore condonable because it is a victimless "crime". I suspect that a complaint made against a vet who self prescribed a few synulox from stock would not make it to the DC, but be dismissed at the PIC stage with advice (unless of course the vet in question was an employee and did not pay for the synulox and their employer accused them of theft).

So I do think the sanction was appropriate, fair and proportionate, and the better question to ask might be - why such harsh penalties in other cases of deception involving falsification of paperwork?