DOCTOR'S SUSPENSION WORRIES GROUP

The recent suspension of a Cape Breton doctor's licence to prescribe
narcotics won't only deprive his patients of adequate pain
management, it will also scare other doctors away from the legitimate
use of the drugs, a national pain expert says.

Dr. Roman Jovey, president of the Canadian Pain Society, said last
week the College of Physicians and Surgeons of Nova Scotia's
five-year suspension of Dr. Peter Littlejohn's licence to prescribe
controlled substances was unnecessarily punitive

The college disciplined the New Waterford family physician for
prescribing opioids before trying other therapies, increasing doses
inappropriately, not referring patients to pain management
consultants and not following consultants' advice among other things.

Opioids include drugs like Dilaudid, MS Contin and OxyContin, the
abuse of which has led to a number of deaths in Cape Breton.

Dr. Jovey, who works in Mississauga, Ont., was in Halifax giving
workshops when the decision was released last week.

"I think a College of Physicians and Surgeons in a province with the
resource restrictions you have has to take that into consideration,"
he said. "They have to put themselves in the shoes of that doc on the
front lines, working in an underserviced area, trying to do the best
they can with inadequate tools. You can't criticize a doc if you
don't give them the tools and resources to manage pain in ways other
than prescribing drugs."

Dr. Jovey was called as an expert in Dr. Littlejohn's defence during
the investigation of the complaint against him. He did not discuss
any details of the investigation itself.

He said the sanction was a major topic of conversation at the
seminars he led in Halifax.

"I can predict the net effect is (doctors) are going to tell even
legitimate pain patients who aren't at risk, 'I'm sorry, the college
is looking over my shoulder, I can't prescribe this any more,' " Dr.
Jovey said. The last provincial budget committed $300,000 to a review
of pain management services across Nova Scotia.

Health Department spokeswoman Sherri Aikenhead said a survey of
doctors offering pain care and wait times for treatment has been
completed, and a committee including representatives of the various
district health authorities is working on recommendations that should
be ready by September.

Late last year, doctors at the province's only dedicated pain
management clinic in Halifax began declining all but urgent
referrals, citing a 1,400-person waiting list and delays of up to
five years for a consultation.

Halifax injury lawyer Ray Wagner said such backlogs give him sympathy
for family physicians like Dr. Littlejohn.

"When you've got someone that's acutely injured in a car accident or
a slip-and-fall or whatever it may be, he has to treat them because
to send them off to an expert or specialist in either anesthesiology,
or pain management or (another therapy) takes some time."