Medical departments issues management

The medical director is, of course, not only a senior pharmaceutical physician but a senior manager and needs to be fully conversant with all the issues facing the company and understand all the principles and procedures which govern its operation. Nowadays this will include personnel issues, such as awareness of the laws related to employment. Without this broad understanding, the medical director will not be able to lead the activities of the medical department in a way that is optimal for the organisation whilst maintaining all the required professional and ethical standards. 

Depending upon the location and severity of the stroke at admission, patients may have cardiac and/or respiratory instability at the time of presentation to the emergency department (ED). They may need to be stabilized hemodynamically or intubated for airway protection or respiratory distress. Blood pressure management is often a crucial management issue, and the use of vasopressor or antihypertensive medications is common. In stroke patients at risk for malignant cerebral... 

Another regulatory issue is therapeutic interchange of medications. PBM clinical departments often set up internal protocols for alternate product substitution within a therapeutic class. The National Association of Boards of Pharmacy contends that therapeutic substitution is practicing pharmacy. In one of its position papers, the Academy of Managed Care Pharmacy supports the use of therapeutic interchange programs. The Academy of Managed Care Pharmacy contends that this decision is ultimately that of the physician. 

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