I can't go into too much detail on this because of doctor-patient confidentiality, but suffice it to say I got rid of two patients this week because of drug related incidents. One guy came to me in January as a new doctor visit and he was on multiple narcotic medications and controlled substances. When he started with us he signed a pain contract saying, among other things, that we had the right to discharge from the practice with a positive drug screen. I ran a random one on him this week which turned positive for cocaine.
The other lady showed up at our office twice this past week and both times was unhappy with my suggestions and asked for controlled substances. Keep in mind no one at our office had met her before this week. Unfortunately, narcotic addiction is a huge epidemic in the medical field. There are people out there who literally have a full time job of trying to score drugs from various doctors and emergency rooms. I feel a bit bad for the first guy because he has legitimate medical problems and has always been polite. In general, however, I have very little tolerance for this kind of behavior and am afraid that if I let him slide the word will get out that I'm nice and all of his friends will show up. And I don't particularly like the idea that I might be supporting someone's drug habit and/or drug business (OxyContin [Oxycodone] is $1/mg on the street and he was taking 60 mg twice a day). The bottom line is he signed a contract and he violated the terms. We sent him a letter saying that I would still take care of him medically but would not fill any more prescriptions for controlled substances. I doubt I'll ever see him again.
I've had a lot of patients lately who are crazy or druggies or lazy (young male who is morbidly obese who wants disability despite not being disabled) or some combination of the three. In general I love my job but I would be absolutely thrilled if I could have some normal patients for a change.
Have to agree with this one. I like to be in control and even the pain meds I had when I had my kidney stones were strong enough to make me feel a lost of control. Only took them when I had to and when I was at home or would be before they kicked in. Surely these people can't be fuly in control when taking these drugs.
ReplyDelete@Joseph: Some of the drugs are pretty strong and people react differently to them. I've had to use Narcan (the narcotic antidote) more than a few times in the hospital to reverse the pain meds because people had some how received too much. The flip side to this is that sometimes people are in pain and do need the medicines.
ReplyDeleteAgain I feel kinda bad about booting people but sometimes you make the bed you sleep in. The bottom line is that when you are given a medical license and a DEA number, people are entrusting you to protect and help make the community safe. Supporting one's drug habit/business does not do this.