TOXICOLOGY ASSOCIATES

PHYSICIAN RESPONSIBILITIES

OVERSIGHT:

The program physician is responsible minimally to be familiar with the current State and Federal regulations. The program physician is responsible for performing all of the functions designated to program physician in the State regulations.

INTAKE PROCEDURES:

Review documentation of addiction to assure eligibility for Methadone maintenance.

Confirm that the patient has a basic understanding of Methadone substitution maintenance treatment.

Review current medications and the basis for their use.

Explain the titration procedures, especially emphasizing that complete resolution of withdrawal discomfort my not occur with the first dose but may require several days of dose adjustment in order to find the appropriate daily dose of Methadone.

Review the medical history recorded in the records. Discuss with the patient any abnormalities reported in the review of systems.

Perform physical examination (see Physical Examination protocol). Minimum physical examination is mandated by the SMA. This should include general appearance, head, eyes, nose, throat (thyroid), chest (including heart, lungs and breasts), abdomen, extremities, skin, and neurological. The physical examination form provides space for appropriate notations.

Sign an order certifying eligibility for Methadone maintenance treatment.

Write the initial order for Methadone (see guidelines in the treatment protocol).

Order dose-finding titration as per titration protocol.

Countersign dose adjustments performed during titration procedure within 72 hours.

Review as soon as possible requests for special takeout medication and approve if appropriate so that request can be forwarded to SMA for consideration.

Changes in frequency of clinic visits can be ordered only by the program physician or the medical director, and will not be changed until the physician has signed the order.

Perform annual evaluation and sign treatment plan.