For years, family practice journals have recommended that adult attention-deficit/hyperactivity disorder (ADHD) be handled by specialists (psychiatry or neurology), not family doctors, for multiple and complex reasons. After many discussions, our office is now on board with this recommendation. We are happy to give appropriate referrals for this diagnosis.
The Beers List was developed in 1991 for use by doctors and clinicians to improve the care of patients 65 years and older. This list includes medications that should be avoided in all elderly patients, if at all possible, and also lists potentially harmful medication interactions. The most relevant of these medications includes addictive and controlled medications (for pain or anxiety) but also includes certain anti-inflammatory and diabetic medications. Our office tries to stay very mindful of the Beers List and advises changes to medication regimens accordingly. Please note that insurance companies see the family doctor as the “quarterback” of a patient’s care team and rely on us to adjust and stop medications, even if they have been recommended or ordered by specialists.
Aside from our patients that are 65 years and older, we recognize that patients at any age should not be on routine medications that are addictive or controlled substances. These may include pain medications, muscle relaxers, and anxiety medications. Our office stays very mindful of this, advising changes to medication regimens accordingly, and making appropriate referrals to specialists. Again, it is noted that insurance companies see the family doctor as the quarterback of a patient’s care, and therefore, will send us recommendations to adjust or stop medications, even ordered by specialists.