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Illinois medical license defense attorneysIn 2019, there was a substantial drop in the number of physicians meeting with pharma sales reps. According to a report conducted by the Decision Resources Group, just over half of physicians polled met with a pharma sales rep. Certain practice areas are also seeing an increase in the number of physicians not interacting with sales reps. What’s the cause and what are physicians turning to instead?

The main factor affecting sales rep contact is a lack of time. Between caring for patients and accomplishing necessary administrative tasks, physicians are less available to meet and spend a substantial amount of time with pharma reps. Medical Marketing & Media reported that zero to 2% of polled doctors favor a 30-minute phone call, web conference, e-detail, and in-person visit, leaving pharma sales reps with limited windows to effectively interact with physicians.

For pharma reps who do manage to get in the door and speak with physicians, the most effective way of engaging the physician is to present information less through the perspective of the pharma company, but rather from the perspective of the customer. Technological devices such as tablets have also proven an effective way of presenting information when meeting with physicians, as they allow easy access to animations and videos facilitating demonstrations of how treatments work. 

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specialized nurse defenseIn recent years, the nursing field has undergone unprecedented growth that shows no signs of slowing down anytime soon. This growth is occurring alongside healthcare needs which are becoming increasingly complex. The result is a widening array of specializations in which nurses are able to practice. Specializations may involve either a narrowing and deepening of some focus or a combination of aspects of different areas with a simultaneous narrowing of focus. Common areas of focus include psychiatry, obstetrics, and geriatric nursing, among a variety of other options. What are the benefits these specializations are bringing to the nursing profession?

In nursing, there has become a greater demand at higher levels of the practice than lower ones, and those who specialize find that they are in higher demand. This enables those nurses to command higher salaries. Specialization also enables a nurse to become an expert in the area in which he/she is providing care, which can increase opportunities for career advancement. With more research and technological advancements emerging, specialization in the nursing career path has led to numerous opportunities.

Specialization, along with subsequent certification, gives patients and medical institutions a sense of assurance that a nurse is highly competent and skilled in a specific area of care. What’s more, it provides nurses with the opportunity to pursue work that is personally meaningful and fulfilling by specializing in an area of nursing care that is of the most interest to you.

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travel nursingA rising trend in the nursing world is taking on travel nurse opportunities. Travel nurses are RNs that work for independent staffing agencies, taking on assignments in different care areas on a temporary basis in order to fill short-term employment gaps. Due to nationwide nursing shortages, health care facilities turned to travel nurses to fill the void. Through the use of travel nurses, nurse-patient ratios have balanced out, which leads ultimately to patient safety and lower patient mortality.

The position of travel nurse is ideal for those who enjoy adapting to different work environments and traveling to new places. Travel nurses also experience higher-than-average pay, adding another facet to the profession that many find attractive.

Not only has the nursing field expanded to suit a travel-friendly lifestyle, but nursing has expanded from the traditional hospital setting to more outpatient settings, enabling nurses to work closer with communities. Ambulatory nurses can work in such areas as home health, military health clinics, community health centers, and telehealth. This shift toward ambulatory care nursing resulted from a need to control health care costs and the development of new health care technologies allowing for quality treatment outside of the typical hospital setting.

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telehealthA relatively new health care option that is changing the way patients interact with their doctors and nurses is telehealth. Telehealth is the method of providing healthcare services from a different location than where the patient is through the use of technology. Telehealth has provided patients with a sense of control over their own health care, resulting from easier access to their medical documents and doctors/nurses from home. What common forms does this take, what are the perceived pros and cons of this trending healthcare service?

There are three main forms of telehealth: live video conference, store-and-forward, and remote patient monitoring. Live video conferencing includes such circumstances as a nurse walking patients through pre-op preparation or examining a rash. Store-and-forward occurs in instances where a patient takes a photo of a mole and sends it to his/her doctor, and remote patient monitoring is when certain devices measure and wirelessly transmit such information as blood pressure and heart rate.

The Pros

Telehealth has enabled many patients who experience chronic conditions to replace the frequent in-person visits with remote patient monitoring, allowing for more convenient contact between patient and nurse. Telehealth has significantly increased access to healthcare services for patients living in more rural areas, where those in need of healthcare services usually must travel hundreds of miles to receive treatment. Telehealth is also resulting in personal savings to patients. With no travel time required and no need to wait in a doctor’s office, patients are able to save what would otherwise be wasted time. Moreover, telehealth means patients can avoid urgent care or emergency room visits, leading to cost savings for patients.

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Nursing EducationAccording to the U.S. Bureau of Labor Statistics, nearly 1.1 million new registered nurses will be needed by 2022. These new nurses will replace the expected 500,000 retirees and fill the 100,000 new RN positions created each year. With this need for new nurses comes a need for nurse educators to provide proper training. Nurse educators play the crucial role of ensuring that new nurses are prepared to meet the growing demand for their services.

There has been a shift in thinking for hospitals, with more seeking nurses who have acquired a bachelor’s in nursing (BSN) under the belief that such training leads to better expected patient outcomes. Nurse educators are in an important position within this hospital system. They are trained nurses who can deliver the most crucial information to new nurses, given their intimate understanding of the challenges of the profession and how to best convey critical knowledge that is essential to a hospital’s success. As for nurses, this increasing need in the education field has a certain additional incentive. There is a reported $20,000-$30,000 pay gap between nursing faculty and practicing nurses, inducing more nurses to turn to teaching.

Another area offering career and education growth for nurses is through the Doctor of Nursing Practice programs. Due to a physician shortage, there is an increased need for direct providers, and nurses are entering such programs in order to fill the gap. The doctoral programs prepare nurses for careers in health administration, education, clinical research and advanced practice, allowing nurses to become experts in their profession and assume a variety of leadership roles.

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Chicago Realtor License Defense LawyerOn Thursday, November 19, 2020, the Department of Justice (“DOJ”) announced that it planned to file a lawsuit against NAR, along with a proposed settlement that targeted NAR’s rules, policies, and practices, which the DOJ says are anticompetitive. The DOJ’s proposed settlement attempts to bring a level a transparency and competition to the real estate industry.

The proposed settlement posed by the DOJ would require NAR to change rules regarding broker commissions and service charges. NAR would have to change rules that currently enable MLS participants to not display or distribute MLS listings based on the compensation offered to the brokerage or agent, and rules that permit MLS participants to represent/suggest that their services are free to a client with no cost. The proposed settlement also calls for an end to limiting access to lock boxes to real estate brokers with respect to those properties listed on the MLS.

NAR agreed to comply with the proposed DOJ settlement agreement and will modify some of its rules and repeal others in order to resolve the antitrust lawsuit. NAR must comply with the settlement agreement within 45 days.

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Third-party payer interferenceWhen seeking out medical treatment, the most important relationship that arises is between the doctor and the patient. One of the main problems threatening that relationship is third-party payer interference. Third-party payers have seen a rising power in the exam room over the actual doctors treating patients. While the medical field has sought to empower patients in making their own medical decisions, third-parties are interfering with this ability. How have third-party payers acquired such influence?

Even though doctors are taught to recognize the patient as top priority, third-party insurers make the ultimate determination related to patient access to treatments and medications doctors have recommended, not only to improve patient health, but to save their lives. As unfathomable as it may seem, it is fairly common practice for patients to be denied the treatments their doctors have described. Patients are often unaware that when insurers deny this access, they can appeal the decision and fight to receive the treatment their doctors recommended. However, obstacles to overturning the insurers’ denial, even if patients are aware of this option, often scare off patients from pursuing claims.

As frustrating as denial is on the patient side, it likewise hinders a doctor’s ability to most effectively treat their patients. It is generally unethical to deny a patient treatment, especially if other treatments have proven ineffective. Yet, doctors are required to jump through third-party insurers’ hoops to eventually provide the treatment they recommended in the first place. For instance, certain types of therapy treatment require that a patient must first fail on a less expensive medication, even if it is likely to be less effective. Doctors also find themselves caught up in a situation where patients must independently prove they require the treatment or medication recommended by a doctor. Patients must demonstrate this through a doctor using certain diagnostic procedures or lab studies in coming to a conclusion regarding treatment.

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Wheaton licensure defense attorneyThe nursing profession has never lacked its challenges, but two major issues have increasingly affected the quality of work environments for nurses: short-staffing and extended working hours. What negative effects are resulting from these problems?

Short-staffing of hospitals has become a top concern for nurses. The U.S. Bureau of Labor Statistics estimates that, by 2022, there will be a need for more than 1 million registered nurses due to occupational growth and replacement hiring. What is viewed as the most dangerous concern for short-staffing? A lack of sufficient patient care. In hospitals suffering nurse shortages, nurses often do not have time to provide the necessary care for patients or their families, as they are rushed to assist a patient and then move on to the next one. Such feelings can lead to moral distress, in which nurses become physically and emotionally drained when they repeatedly cannot provide the care they feel is necessary.

In order to address problems that arose due to short-staffed hospitals, some nurses are required to work longer shifts involving extended hours and overtime. This solution creates an inherent problem: nurse fatigue. With an increase in fatigue affecting nurses, there is a corollary risk of increased medical errors involving patients, as fatigue can lead to mistakes or oversights related to patient care. The typical number of hours a nurse should work in a week is at most 40 hours, working no more than 12 hours in a day. Nurses who work beyond that start to experience cognitive decline, resulting in a higher probability of mistakes being made that can adversely affect patients.

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Chicago license defense lawyerIn October 2019, the Illinois Department of Financial and Professional Regulation announced a new requirement for prescribers renewing their Controlled Substances Registration in 2020: the completion of 3 hours of continuing education on safe opioid prescribing practices. The requirement applies to individuals that are prescribers under the Controlled Substances Act, which includes such licenses for dentists, optometrists, physicians, and veterinarians.

The change does not come as much of a surprise given the continuing spotlight on opioid addictions and overdoses turning into a nationwide epidemic. While most lawsuits have been filed against opioid manufacturers relating to their misleading marketing of these drugs, there is no doubt that prescribers of opioids, most specifically physician prescribers, have been viewed as playing a crucial role in this problem. The Centers for Disease Control and Prevention reported that in 2017 more than 70,000 people died from drug overdoses and of those deaths, nearly 68% involved a prescription or illicit opioid.

In a study conducted by Johns Hopkins Bloomberg School of Public Health examining about 350,000 prescriptions written for patients operated on by nearly 20,000 surgeons from 2011 to 2016 – the latest year for which data was available – researchers found that many doctors wrote prescriptions for doses of opioid tablets after surgeries, including operations that resulted in relatively little pain for patients. The highest-prescribing 5% of surgeons performing these less painful procedures prescribed 40 to 70 pills on average.

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Chicago medical license defense lawyerPatients have the right to keep their health records private and to know if their information is shared with others. Generally, a healthcare provider may only release an individual’s information with written consent, unless the information is critical for any treatment the patient will receive or if necessary to protect the public at large. In today’s technological world, the majority of patient data is stored in hospital or clinic systems and software. While certainly an efficient manner of securing information, technologies’ ever-changing state may also leave the information exposed to certain vulnerabilities, such as hacking.

Then how does one keep patient information secured from ever-present threats? Unfortunately, there is no single security measure that can be implemented as a sufficient defense. Rather, one must implement multiple defenses that serve as protective mechanisms to slow down any potential attack and make data access more difficult.

Typical defensive measures include firewall and antivirus solution protections, spam filters to block malicious emails and proper security awareness for staff to avoid phishing tactics, data encryption for all portable devices, and intrusion detection systems that monitor irregular network activity. Holders of confidential patient information are also advised to have extensive backup systems in place to ensure patient information is never lost.

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Chicago medical license defense lawyerIllinois is one of 33 states that has legalized medical marijuana. While such legalization has expanded the ways to address patient pain, it has left physicians in the tricky position of determining whether to prescribe a substance that, while legal at the state level, still faces a federal ban. The question physicians face now is whether their license may be put in jeopardy, even if cannabis is approved for medical use. The answer, of course, is “it depends.”

The risk to physicians is generally minimal, thanks especially to a declaration by the Justice Department in 2013 stating that attorneys would not pursue actions against physicians who recommend medical marijuana in states that have made such use legal. However, this has not stopped state agencies from threatening loss of license to those physicians who do not play by the appropriate rules.

Physicians who neglect to conduct required examinations and report the necessary medical histories when prescribing medical marijuana run the risk of having their actions investigated. Physicians are typically required to maintain accurate medical records, check pharmacy databases to ensure patients are not obtaining certification from other providers, and complete the minimum amount of medical education on the benefits and risks of medical cannabis. What is viewed as the most important requirement for physicians to follow? To maintain an ongoing doctor/patient relationship. A physician should never provide a recommendation for medical marijuana to a previously unseen patient without ensuring the appropriate relationship is established. Such action could result in the physician being taken advantage of by a patient who has already received certifications from multiple providers.

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Chicago licensure attorneyElectronic health records (EHRs) make information related to patient-centered records available instantly and securely, containing patient medical history, diagnoses, medications, and treatment plans that greatly assist with overall diagnosis and treatment. However, missing, incomplete, or ineligible documents may hurt patient care and be used as evidence if a patient claims negligent treatment. In order to best protect yourself, here is advice on how to ensure properly maintained EHRs:

Understand How the Data is Tracked

Each time someone at the practice or hospital goes into a patient record, data tracks who signed into the EHR, the physical location of the computer, and the exact update made to the EHR. This means that any possible delay in patient treatment that a physician seeks to rectify by having the EHR reflect assistance in a timelier manner can be pulled in the digital “audit trail” to demonstrate patient record manipulation.

What Should Be Documented

EHRs should be kept up-to-date to ensure you can demonstrate appropriate, timely patient care was provided. Since the EHR is used as a communication tool amongst all practitioners involved in the patient’s care, you want to document patient medical records in the manner that you would want documented if assuming management of the care of a patient you did not know. Do not forget to include a diagnostic rationale, especially in circumstances where the medical record could suggest another course of action that was overlooked.

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b2ap3_thumbnail_shutterstock_1720841986.jpgHealth professionals will likely have to deal with difficult patients throughout their careers. They are the ones patients look to when experiencing high levels of stress or anxiety over the health issues facing their day to day lives. Such interactions can test the limits of health care professionals who have a duty to remain respectful and composed, so as to not compromise the integrity of their relationship with the patient. Then how should one deal with disrespectful patients?

The most obvious answer: remain calm. A patient acting disrespectfully is generally acting on feelings out of anxiety or a perceived lack of attention rather than attacking you personally. In such situations, it is important to keep control and address the patient in a way that can cool down the situation. Having a response ready for such moments can help diffuse the tension and set boundaries with the patient. For example, if a patient begins using explicit language toward a doctor or nurse, a simple response of, “let’s keep it professional,” can allow the health care professional to call out unacceptable behavior while moving on to the necessary task at hand. When facing unacceptable patient behavior, it helps to remain firm, refusing to engage in arguments or unnecessary apologies. Keep the interaction professional, and if necessary, pursue a follow-up conversation within a day of the interaction to foster a sense of open communication.

Another tactic is to always approach difficult patients with a level of empathy. Remember, you are dealing with patients during the most sensitive, anxiety-inducing moments of their lives. Making patients feel as if you are really trying to understand them and that you genuinely care can go a long way in helping an otherwise disrespectful patient calm down. If you feel the reason for ‘acting out’ extends beyond the stress that comes with health issues, you can suggest that the patient find a social worker or someone to talk to about their difficulties. Be sure that in taking such an approach, you handle the suggestion sensitively to make sure the patient does not feel abandoned.

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Chicago medical license defense lawyerMedical adherence is the act of taking medication as prescribed by a physician, which involves taking the proper dose, at the correct time, and for the recommended length of time. In order to achieve the full benefit of medications, patients need to adhere to prescribed treatment regimens. Patient non-adherence can result in adverse consequences to a patient’s health and result in additional medical costs and physician visits.

Why would a patient willingly not adhere to a medication treatment meant to provide help? It should not come as a surprise that the rising cost of prescription medications is a barrier for many patients. According to a Truven Health Analytics-NPR Health poll, 67% of patients do not take their medications because they cannot afford them. However, most physicians are surprised to learn that high costs account for only a small amount of patient adherence. Most patient non-adherence is intentional-based, resulting from such factors as a lack of understanding medication instructions or the reasons for taking certain medications, or confusion surrounding dosing schedules.

What impact does this have on a physician? A patient’s inability to follow a prescribed medication treatment should not create liability exposure for physicians. Unfortunately, that is not always the case. If a patient suffers harm due to their non-adherence to medication treatment, a physician’s efforts in ensuring adherence may be looked into by the Illinois Medical Board. Given that physicians are believed to have a better understanding of the ramifications of a patient’s failure to pursue treatment, physicians are under a greater burden to ensure adherence.

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Illinois Professional License Defense Attorney Wearable TechnologyArtificial Intelligence has come into everyone’s life in one way or another over the past decade. One of the fastest growing areas using this new technology is the healthcare industry. There have been many advancements over the years and new ways of using it coming out every day. These advancements have even come into light with physicians using data they receive from wearables like smartwatches.

Companies like Microsoft and Apple have entire teams dedicated to healthcare. The teams create software that give customers and physicians the ability to see all types of data, from a person’s heart rate to glucose levels, throughout the day. While these wearables generate a lot of information, physicians are in the precarious position of having to decide if, how, and when to use this data. Sometimes more info is not always better: studies have shown some wearables customers use the devices for the sole purpose of improving their health, and this creates an issue if the physician is not sure how to use the information to benefit the patients.

While wearables will continue to be an exciting field for medical advancement, it can also be a concern for doctors. Most of these wearables are not FDA approved, or worse there are concerns about the confidentiality of patient information (Violations of State and Federal Confidentiality Statutes). Doctors not only have to worry about how to use the information, but they also have to worry about the legal risk of their use.

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Chicago Artificial Intelligence and Surgery LawyersArtificial Intelligence (AI) has come into everyone’s life in one way or another over the past decade. One of the most significant growth areas using this new technology is the healthcare industry. There have been many advancements over the years, and new ways of using it come up every day. These advancements even arrive on the surgical side of a physician’s practice

Robots empowered with AI have been used to assist surgeons in performing intricate surgeries. These robots limit the amount of human error, which can cause adverse outcomes for the patient. Since robots can be used to get into smaller areas than a surgeon’s hands are able, robots also make the surgery less invasive. Techniques like these allow for faster post-operative recovery and higher patient satisfaction. While robots, at least in the near future, are not going to take over and replace a surgeon’s knowledge and judgment, they will continue to expand the field.

One hurdle to the growth of AI in surgery is patient and physician trust in machines and AI. As it becomes more and more commonplace to see certain operations being assisted by a computer, there will come the point where the type of surgery may be too much for the patient/surgeon to trust the machine.

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Illinois Artificial Intelligence and Medicine AttorneysOver the past decade, artificial intelligence (“AI”) has entered everyone’s life in one way or another. The healthcare industry is one of the most significant growth areas for this technology. There have been many advancements over the years, and new ways of using it arrive every day. The advancements, in large part, enter the medicine side of a physician’s practice.

One area of advancement with AI in medicine is diagnostics. Computers have been able to use data from around the world to diagnose patients so the treating physician can find the root of the problem as quickly as possible.

Therapy has also made advancements due to AI. Some including patients gaining the ability to use electronic therapy dogs or even software that allows a cost-effective way to speak about their problems.

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Chicago Medical Negligence Defense LawyersPatient-centric care is what our healthcare system has moved towards, but when is that too far? What happens when patients start to tell doctors how they want their treatment plan to look? As patients gain more and more access to information, they may become a more informed “customer”; this can be both good and bad. Patients can have a better understanding of what their issue is, but, their informal knowledge does not replace a medical/osteopathic degree.

One of the ways patients are starting to have more control over the system is through patient satisfaction surveys. Patients now have the ability to “rate” the care they received. While the idea behind this patient satisfaction surveys helps the hospitals see potential areas of concern, the survey itself can also cause problems. When administrations spend too much time looking at this type of data, it can create problems that don’t actually exist. Just like looking up a Google review, one must take the information with skepticism. Most people who are happy (or at least satisfied) with their experience do not take the time to fill out the surveys. Rather, the surveys are completed by patients upset about something (whether right or wrong). This type of survey can cause issues for physicians.

While most hospitals and administrations have started to guard against misuse of patient satisfaction surveys, sometimes they don’t mitigate the impact on doctors. If the hospital tells doctors how to treat patients by way of strict review of the patient satisfaction surveys, doctors may feel like they lost their independent judgment. That loss of judgment can result in the overprescribing of opioids or running a test that isn't needed. This could ultimately cause a problem with the Illinois Department of Financial and Professional Regulation, and your license. If a problem does arise, Williams & Nickl is here to help you get through that process and back on the right track. Our firm focuses on professional license defense to ensure the Medical Board does not violate your rights, and you have a chance to move on from your issue.

Illinois Professional License Defense AttorneyPatient-centric care is what our healthcare system has moved towards, but when is that too far? What happens when patients start to tell physicians how their treatment plan should look? As patients gain more and more access to information, they may become a more informed “customer”; this can be both good and bad. Patients can have a better understanding of what their issue is, but as the saying goes ‘your Google search does not replace a medical/osteopathic degree’.

Patients often use Google before they see their physician. Patients want to understand what is going on before they see a doctor or to determine whether they will even make an appointment to see one at all. There are several problems with this approach, the most important of which is a patient believing their symptoms fit a hundred different diseases. This belief can cause an overreaction, and entering a physician's office very anxious and stressed. When this happens, the patients may start to ask for unneeded tests, procedures, and medication. Physicians are then put into a difficult position: should they try to calm the patient and assure them or give in and run multiple tests to prove that WebMD did not actually diagnose them with the diseases. In some cases, the patient could actually be correct in their assumptions and not be overreacting, so physicians must use their judgment on the best course of action for that particular patient.

Sometimes poor medical judgment results when doctors are pressured by patients, and this can cause multiple issues including overprescribing opioids or running tests that aren’t needed. Any of these scenarios could cause the physician a problem with the Illinois Department of Financial and Professional Regulation, and their license. If a problem does arise, Williams & Nickl is here to help you get through that process and back on the right track. Our firm focuses on professional license defense to ensure the Medical Board does not violate your rights, and you have a chance to move on from your issue.

Chicago Defense Attorney for Doctors and NursesPatient-centric care is what our healthcare system has moved towards, but when is that too far? What happens when patients start to tell physicians how they want their treatment plan to look? As patients gain more and more access to information, they will be a more informed "customer"; this can be both good and bad. Patients can have a better understanding of what their issue is, but, as the common saying goes, your Google search does not replace a medical/osteopathic degree.

One way a patient can start to dictate how they are treated is by requesting specific medication. Pharmaceutical manufacturers plaster TV, print and internet sites with drug advertising with the urgent request “Ask your doctor about it!” Drug companies would argue that informative ads empower the consumer patient to obtain the medication they want, but physicians would counter that the consumer is not educated enough to make such a decision. Studies have shown that patients are more likely to get their medication of choice when they request it. This is true not only for the drug brand but also the drug type. Speculation occurs, as it is unclear whether the physician simply wants to pacify the inquisitive patient or if they truly believe the medication is the most appropriate treatment.

While listening to your patients and adhering to their requests can be harmless, patients dictating their medications can cause a lot of issues, including the overprescribing of opioids. This could ultimately cause a problem with the Illinois Department of Financial and Professional Regulation, and your license. Many have stated that the best practices are to work with your patient to make the decision together. Let your patient know how you came to your decision and do not be afraid to say NO, especially when it comes to controlled substances. If a problem does arise, Williams & Nickl is here to help you get through that process and back on the right track. Our firm focuses on professional license defense to ensure the Medical Board does not trample your rights, and you have a chance to move on from your past issue.

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