Poky - its done on a case by case basis, but in general terms, no tricyclics, benzodiazepines ( which regionally are prescribed here a ton - either as an adjunct to anti depressants, insomnia aid, or anti anxiety), and there are some sustained release meds for other purposes (Ambien CR comes to mind) that aren't allowed. Some of the reasoning is the meds themselves, other times it is because of the severity of illness needed to be present to require these meds. His MPH is in Occupational health, and he works with the Occ doc here to make the determination, so it's not just one doc's opinion at any point. Also, keep in mind that his paramedics work 24 hour shifts, generally, and may be awake and working for all of those 24 hours straight. All of those factors come into play.
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At dh's practice, each call pretty much has a monetary value that you can sell to other partners to do for you. But when you're young, you don't want to lose the $! There are people who sell most of their overnights to younger partners. Dh takes a few extra, because he's a spring chicken. Ha!
There's a guy in his early 70s who still takes overnight call. And there's stuff going on all night for at least 2 anesthesiologists, so you don't see the call room AT ALL when you're on. There are 3 in house and another 3 on back-up home call. It's busy! Dh is pretty beat after call, and we let him sleep for 3-4 hours before he joins in whatever activity dd and I are doing. I imagine this will get harder as he gets older. I mean, he was doing 30+ hour shifts during residency and from what I recall, they were only slightly tougher for him than what he's doing now.
Granted, he isn't almost asleep at the wheel after call these days.....married to an anesthesia attending
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