All You Have To Do Is Check
Painkillers are a problem. As a doctor, you are damned if you do and you are are damned if you don’t. A new report from a Cambridge-based research group found that many docs prescribing narcotics in Massachusetts for injured workers fail to follow recommended treatment guidelines for monitoring their patients. Here is a surprise: nearly one in 12 injured workers who are prescribed narcotics are still using them three to six months later. Pretty soon doctors are going to be found liable for addicting these patients. The bottom line is that narcotics are habit-forming and should be used for short periods of time in most cases. Every doctor should check their state Prescription Monitoring Program and grill patients about their med use. If they lie then they don’t get a pain pill. We have to be that diligent.
OK. So what do you do when you write a RX for 30 tabs with 1 refill, but the pharmacist fills it for 60 tabs with 0 refills? When confronted about this he then tells me he did it because Medicaid won’t pay him for the refill within 30 days of the original RX. I reported it to the state board of pharmacy, who investigated and then sent a letter informing me that the pharmacist didn’t do anything wrong. Any suggestions? Is it worth my trouble to pursue it farther? Or do I just never write refills on controlled substances?
I have no idea what to tell you. Wow.
The biggest problem that I see is that doctors write for too many pills in the prescription. When I was in practice [retired after 58 years], I wrote for exactly what I thought would be necessary, NO MORE… Then I was very antsy about further scrips…..RCT.
I’ve been saying this for thirty six years and have even left jobs because I was forced to hand out narcs like candy. None of those “smart” [acutally dammed stupid] doctors would listen to me, but oh would those sheep listen to big pharma and the “pain societies”. Makes me want to puke.
When looking forward to engaging in this work, it never occurred to me that I would have to be responsible for other peoples’ misbehavior. I was trained to be a counselor, not a damn nanny or some surrogate parent for any joker who wants to chuck self-responsibility. It is both demeaning and infuriating that society now attempts to put that obligation on me, a burden that I refuse to accept.
If they lie, they don’t get pain meds. Period. And nowadays, people don’t even see the problem with the lie. “Sure, I lied, but I’m in pain”. Lying breaks the doctor patient relationship. What if doctors lied? “Sure you have chest pain and peaked T waves, but it’s just gas”.
I couldn’t agree more!