Clearly you are better at training dogs than I am. I’m lucky I can get mine to leave his Uzis in the garage.
[quote=“Contrapuntal, post:40, topic:482132”]
That’s a false equivalency
QUOTE]
so is equating vet/dog to Dr/human in this case, do you really need me to spell out the reasons?
[quote=“outlierrn, post:42, topic:482132”]
If you are able, that would be nice.
I think our difference of opinion is; to me, an emergency is life and death. To you, pain constitutes an emergency. Okay. Even if I give you that, if a practice is full of patients who are ALL in pain, there is simply no room. I don’t understand why this is a hard concept for you. The patient has an option to wait or go to the emergency room. No one is denying her treatment. The doctor is busy and I think getting in with a specialist in less than two weeks is pretty darn impressive so she apparently was “worked in” just not soon enough for everyone’s liking.
The standard of care generally requires that the doctor reexamine the patient before increasing or changing her pain medication. That said, a pain management practice should certainly be able to get her in within 11 days.
Sure there’s room. He can work an extra half hour that day. Or see her tomorrow. I don’t understand why this is such a hard concept for you.
A car repair shop I can understand having an eleven day wait. But for a doctor who has already diagnosed (and apparently mistreated) a problem to make a patient wait eleven days is unconscionable.
I know from participation in past threads that you and I are likely to have a starkly different viewpoint on this topic (even if it didn’t involve my own mother), so I don’t really want to get mired into this discussion any further. However, I did want to make clear that she was not given Duragesic—the patches contained a topical anaesthetic— nor would she have tripped any of the red flags you listed.
If he’d done a reasonable evaluation of her in her visit just a couple of days before, then a full appointment shouldn’t be necessary. A few questions to sort out what happened with the meds he prescribed, and if necessary, having her or her son come into the office to bring the old meds before picking up a new prescription, ought to be enough to sort it out.
[quote=“Contrapuntal, post:43, topic:482132”]
You’re serious? Very well,
Humans are known to see multiple Drs seeking pain medications, to lie about the fact, to sell meds they don’t want in order to buy ones they do, to lie about their allergies to recieve meds with a better recreational effect, to increase the dose and frequency of their meds in order to increase the recreational effect and to sue their doctors and nurses when things go bad for not protecting them from themselves.
In my experience dogs do none of these things, therefore a vet does not risk the wellbeing of their pts or their practice by being aggressive in pain mamagement to an extent that would be irresponsible in a human Dr.
for the record I am not suggesting the above applies to the OP, nor am I taking the doctors side in this case.
Sorry to hear about this, Vinyl Turnip. As others have said, your mom needs a better doctor. This is just in no way acceptable. I think her best course would be to go to another doctor and tell him the whole story and show him all the drugs she’s had prescribed so far.
Well, there’s good news and bad news. The good news is you will most like not have to worry about dealing with this pain clinic any more. The bad news is you’ll have to start all over with a new pain clinic, only now she’ll have the added history of having been discharged from another pain clinic for violation of her patient contract.
The first bit is certainly not going to have you crying into your pillow every night, understandably, but the second part has the potential to suck mightily.
[quote=“outlierrn, post:49, topic:482132”]
What prevents a pet owner from doing these things?
[quote=“Little_Plastic_Ninja, post:52, topic:482132”]
shhh, most people don’t know that. Besides dog doses are smaller, Pomeranian pills ain’t gonna do squat. Vet meds are sometimes marketed under a different brand name which would limit there resale value.
Couldn’t you just take more of the dog pills?
11 days wait? They are so overworked that they’ll keep someone in pain with no treatment for 11 days? And forbid them from going to the ER?
Fucking Hell…
Vets very rarely send home narcotics–we send home maybe twenty or so controlled substance scripts a month, and the bulk of those are epilepsy meds that don’t really have any street value. We have three pets on Ultram, which just recently became controlled, and we see a handful of ugly bronchitis cases that need narcotic cough control or seizures that need valium to keep them under control until the other meds have a chance to work. That’s it, and we’re a fairly busy clinic.
There just aren’t a lot of veterinary situations where sending home narcotics is the most appropriate choice, and the decision to do so is based on the state of the pet, not anything the owner says and does. So there’s not really much the owner can do to manipulate a script out of us. Plus, it’s more expensive to get this kind of thing from your vet. You gotta pay out of pocket for the exam, and usually some kind of workup, and then the drugs themselves, instead of paying the copay for your insurance or medical card. That’s a lot of hassle for to get five days of pills for someone a fifth of your size, that aren’t the right size and shape and color to sell readily on the street.
Even so, once in a very great while we get an owner who twigs our radar as the sort of person who would take Fluffy’s cough medicine and let her hack her little lungs out. That’s when we ditch the pills and instead put the injectable form into a bottle of massively bitter vitamin/mineral supplement. But the vast majority of the time, the animals who are getting controlled substances at home are our long-term patients who come back in for their rechecks showing all the signs of having actually gotten the medicine. Actually, most of them are owned by people who, Og love 'em, call the emergency pager at 3 am to report that they gave that pill and now the dog is sleeping really soundly, and wanting to know if that’s normal.
I understand that she signed an agreement, but what, practically speaking, prevents her from seeing another doctor? I assume she won’t be walked into a jail’s cell if she does do.
Welcome to the wonders of the American medical “care” system. It’s lovely here-not like that horrid socialized medicine at all…
First let me say that I am sorry that your mother is having such pain. I am also sorry that our much lauded health care system has failed her (sorry, but not in the least bit surprised).
IMO, as an RN, there are a couple of things here that are wrong, wrong, wrong:
- Receptionist (hereinafter referred to as bitch) is acting as Gatekeeper to “Doctor”. I have no doubt she’s a post-menopausal woman who regards Doctor as sitting on the right hand of God and will keep all those pesky and petty patient issues away from her darling. If she happens to be a young 20-something, I pity her. I loathe Bitches. I have had this scenario happen to me one too many times: I call the office because Dr X isn’t answering his pager to update him on a pt. I am immediately put through to him (I’m put on hold, but I get him-or her). I call the office (as a patient now) to ask “Doctor” a question–my call is not returned that day or the next day until I call again and ramp it up a notch.* (our pediatrician has a designated time of the day that he spends answering calls–a wonderful thing). I understand why this(pts not getting through to “Doctor”) happens, but it still sucks.
I have had receptionists ask me my symptoms–which are NONE of their business. I don’t care how they have to code the damed insurance claim. I will admit to simple check ups or Paps. Anything else is between me and “Doctor”. I have heard receptionists (and med techs–who are NOT registered nurses, not even licensed practical nurses and frankly, med techs don’t know dick) dismiss symptoms of other pts and dismiss my own.
“Doctor” tends to be unaware that such stuff goes on–but scrub-attired people’s words carry weight with unsure, anxious people. IOW, they know not what they do and sometimes it can be harmful. And to cap it off, most folks think that these morons are nurses! Galls me no end.
- Your mother is receiving poor care. Inhumane, dismissive “care”. This is not acceptable. Unfortunately, recourse will take time, but I hope you seek it. Here’s some advice on how to do so:
Call the clinic. Ask to talk to “Doctor”. Leave a message. If this is not returned within 24 hours, time to kick it up a notch.
Call the clinic and ask to speak to the manager of the office or clinic. Usually there is such a person. Get their name and an appointment to meet with them on the phone or in person. Do not be fobbed off by the minion who answers the phone. REMAIN CALM AT ALL TIMES. REMAIN CIVIL. DO NOT BECOME SARCASTIC, ANGRY OR RUDE–you will get nowhere and the staff will feel vindicated and righteous. Trust me–I know of this. Speak with authority and the assumption that you will get through to this manager person.
Be relentless (think Panzer division here, not kamikaze). Insist on speaking to some type of manager/executive type at the clinic (do not bother entering HMO hell–they actually don’t care if the pain is addressed; they just want the bill to be small).
Once you have got either a phone convo or meeting with this manager person, BRIEFLY recap your mother’s issues. Do not stray into too much detail here. Say something like, “My mother saw Dr X 2 weeks ago. She was prescribed A and B drugs, which were ineffective. We called to have this issue addressed and we were brushed off etc”. I might even put in the bit about the bad apples–horrible PR by the person who said , btw.
Inform this manager person (if something has not already been done about this after your relaying of info) that you are aware that pain is considered the 5th vital sign by the Joint Commission: http://findarticles.com/p/articles/mi_qa3977/is_200309/ai_n9274424]article1. Warning–the article is more of an editorial.
Here’s another one (same caveat): article2 and that you feel that this clinic has failed your mother in this regard. Hell, if I were there, I might mention Press-Ganey as well (but see below**). Calmly tell Lisa or Susan or Kurt (the manager) that you need to know 2 things–what to do NOW about your mother’s pain issues, and/or what the fallout is IF you decide to go elsewhere for treatment. (and if you do, you best write all this down so you have documentation of what happened with your mother and the timing of events etc. I’m not saying it will help, but it will help your presentation of her history at the next clinic and may make the staff more supportive of you at the new place, which frankly, I think you should go for–this place sounds like hell on earth. I’d lose my job if I treated any pt that way, drug seeker or no!)
All of this is work and hard work at that. I doubt your mother is up to the task (what with being in pain and all). If you do this, I would have you also talk to her PCP and the surgeon who referred you to this clinic. They all need to be in the loop.
*I do not expect “Doctor” to drop everything just to answer my question-as an RN, I can pretty much answer my own question, most of the time. I do expect a call back. What aggravates me and every other patient on the planet is the gatekeeping that these techs and receptionists do. One doctor I had wasn’t even aware that his office staff was doing this! The world is run by medical office receptionists (or so it seems sometimes).
It was a receptionist who told my MIL that since my FIL already had an appt on Friday with the oncologist, she KNEW that “Doctor” wouldn’t see FIL today (a Monday). MIL did a smart thing and called his pulmonologist instead, who did agree to see and immediately admitted him (direct admit from the office) to ICU. The oncologist apologized to MIL when he heard this, but FIL now has a new onc. In that scenario, I only partially blame “Doctor” (he gets some because he should be aware of what his office staff is doing and saying–or his office manager should be), the majority of the blame (and a deep circle of hell) goes to that receptionist.
**My RN life is now ruled by some stats wonks that go by the name of Press-Ganey. These are pt satisfaction surveys sent out with every post op (and discharged pt, but I only deal with surgical pts). IF you can get people to send them back in, the scores are everything and I mean everything. If ONE person sends back a survey (and that’s about our return rate some weeks) and it’s “bad” (in that we didn’t score 5/5–maybe we did 4/5, but that’s not good enough. No, I am not making this up), we are called on the carpet and berated etc. It’s horrible, but it’s a powerful weapon for you, IF the clinic uses such a feedback mechanism…
Lastly, good luck. It sucks to be in pain, and the heartless responses I have read here both disgust and alarm me. Even if your mother WAS an addict, she still has pain issues. 
They surprise me, too. It makes me wonder if the people talking about pain as if it were nothing are people who have never had serious pain in their lives, or people who are so broken by your healthcare system that they don’t even know how low they are setting the bar. Every minute is an hour when you have serious pain; telling someone to suck it up for eleven days because of bureacracy is past incompetent and edging into sadistic.
Whether it’s motivated by an unwillingness or inability to treat patients satisfactorily, I see a common thread: find a way to make it their fault. The patient is definitely lying about—or at minimum, grossly exaggerating—the severity of their pain. Because we choose to run our practice in such a way that we can only see each patient for five minutes every two weeks, the patient is being unreasonable when they request interim visits, or want their calls returned. Like a Marine recruit, the patient starts treatment as a faceless, worthless maggot (and presumed criminal), required to work their way up to personhood and trust through some esoteric series of procedures known only to the caregiver, who in the end will likely classify the patient on looks and/or personality alone.
If you claw your way to the summit, you may still find that you’re still undertreated, shruggingly written off as an inescapable consequence of the past behavior of all those “bad apples.” And even though you’re still in debilitating pain, isn’t it a comfort to know that the doctor/nurse/pharmacist no longer considers you one of those?