That’s about it, Vinyl. I am a doctor’s daughter and a nurse for over 20 years and I still get treated like shit (that is, as a widget or concerns dismissed) in some respects. I am an “insider” (ha!), educated and knowledgeable. God knows what an average ER looks like…*
I don’t put all the blame on the docs. Truly, they are now as hapless as the rest of us. I do blame insurance companies for a great deal of the heartlessness of modern health care.
*I do know what the ER at my hospital looks like (it’s not pretty), and the less educated you are, the worse you are treated, generally. There are, of course, exceptions.
This from the woman who let her son steal from her HOW many times and then whined about what a good kid he was?
Yet cancer survivors recovering from surgery like the OP’s mother are drug seeking addicts looking to abuse the system? Gotcha. Vinyl Turnip, good luck to your mother, and I hope a bloody helicoptor flies right through the “doctor”'s window.
I gotta tell you, I don’t really give a shit who’s selling what on the corner. If I or someone I love is in terrible pain, I expect the doctor to do his damned job and do what it takes to fix the pain. Maybe Cletus is going to sell his pills to Bubba but why should I, or my wife, or my parents, have to suffer through terrible pain as some sort of Puritanical absolution for Cletus’s sideline?
That said, this isn’t unique to the USA. My father, here in Canada, had a hell of a time convincing his doctor that his agonizing, keep-him-up-all-night arthritic knee pain was not responding to ordinary Advils and Tylenols. Thankfully, that jackass retired, and my father’s new doctor was like “You seem to be in a lot of pain. Let me prescirbe you some really powerful stuff so you aren’t in pain anymore, that being a fairly important part of my job.” My father’s quality of life has improved dramatically.
I don’t really give a hoot if some idiot on another prescription is selling his meds. Let the rednecks, the losers and the shitwits get high.
And then there are the practitioners (and there are many nurses who fit this bill, but thankfully their numbers are decreasing) who think (and practice this way: the addict is here as an inpatient, so let’s NOT feed his habit OR address his pain issues because being an addict is a Bad Thing and he is a Bad Person. Yeah, 'cause this 3 day admission is going to break that Demerol/T3 habit… :rolleyes: And woe betide the patient whose pain is NOT relieved with morphine or Darvocet as an inpatient–you get labeled as a difficult pt quickly and can almost never regroup from that. :mad:
I had outpatient surgery a few years ago and my OB/GYN (who did it) was most reluctant to give me anything except Motrin for the pain. Thing is, I wasn’t bothered by the minor cramping post procedure–I was in agony from my stiff neck from having LMA (laryngomask anesthesia). I told her so, and she gave me ONE Tylenol with codeine. After an hour of no relief, she allowed me one more “for the road”. She was great with labor pain, so IMO she just doesn’t get post op pain. She is not alone. Chronic pain is a completely different animal–a formidable adversary that needs a skilled practitioner.
I was assuming that RickJay meant his right to pain relief outweighed all considerations. So I suggested that if he shared responsibility; loss of livelihood, fines and imprisonment for example, he might want health care providers to excersise some judgement.
OTOH, if he meant that society should remove all responsibility from health care providers so they can give pain meds out to all comers so they never miss anybody in pain I retract my comments, but I don’t think that’s a workable solution either.
Well I think some middle ground from this zero tolerance crap would be nice. Quite frankly I’d rather a few addicts got their drugs if it meant less people had to suffer.
Addicts choose whether or not to get help, but there’s no choice for OP’s loved on in the pain.
Is the puritan culture worth friendly fire against innocents?
Oh I concur, I never sided against the OPs loved one. I have no reson to think he’s been anything but honest in this thread.
As a California ER nurse I’ve given lot’s of narcotics to lot’s of drug seekers, and I’ve taught many new nurses that it’s better to be fooled by a seeker than to deny a real kidney stone pt.
Having said that I’ve also seen people harmed by long term narcotic meds that were overprescribed, and I wanted to share some of the thought process from the other side of the line with those that seem to be asking for no pain, all the time.
Why should I share responsibility for other people’s behaviour? Cletus selling his Oxycontin is his problem, not mine.
No, I am not suggesting pain medication be sold in 7-11s next to the Twizzlers, but the puritanical lengths doctors often go to to avoid giving pain medication to people who need it are ridiculous, and I speak not as someone who wants drugs (as I wrote in another thread, opiates do nothing for me anyway; I guess I’m just not wired that way) but the experience of my loved ones. We need to get over this obsession with drugs as a necessary evil (or complete evil, in the case of weed, LSD, and crap like that); it’s not reducing additions, it’s not helping anyone get treatment for pain OR addiction if it comes to that, and it’s costly.
The point I’m trying to make is that the doctor who prescribes Cletus his Oxycontin is held responsible. If you don’t want Cletus’s actions to affect your acces to pain control you’d have to change that.
Pain clinics are set up to manage chronic pain over the long term. Pain a month out from a surgical procedure is just not really what they do. They also can’t really handle pain of the immediate and unbearable sort, not least because it usually takes a month to get in to one.
What usually happens here is that the surgeon refers the patient back to the primary care physician if pain treatment is necessary for more than a couple of weeks. From your description of the story, a PCP should absolutely be able to handle this. If the pain went on for months and months and showed no signs that it might eventually improve, the comprehensive approach of a pain clinic might be a better option at that point.
So if I fault the pain clinic for anything, it’s for accepting her as a patient in the first place. I would be more likely to fault whoever sent her to the pain clinic, especially if it was the PCP.
(Note: this all assumes that the pain clinic and the medical community work the same way as the ones I’m familiar with, and there isn’t more to the story.)
I figured I’d follow up on this story— thankfully, my mom’s pain has diminished on its own over the past few days. The hope, which seems to have borne out, was that it was not chronic pain so much as a longer-than-normal recovery time from her surgery. Why her surgeon referred her to a pain clinic at all—particularly in light of your comments, DoctorJ—remains something of a mystery.
While she was still in pain, she attempted to contact the pain clinic three times over several days and none of her calls were returned. For what it’s worth, she informed the surgeon that they were ignoring her and plans to write a letter to her human resources manager describing what happened.
I can think of regulations that haven’t been implemented (yet, hopefully) that would go a long way to preventing abuse while still allowing legitimate pain to get treated properly, especially in Canada where we have a single-payer system that theoretically could be better controlled. Making doctors afraid to prescribe useful, efficacious medications is not one of them.
In what way? Criminally responsible? I find that herd to believe.
FWIW, I just called a friend who is an ER nurse in North Carolina, and she says that there the doctor is definitely not responsible for what a patient does with his legally prescribed medications.
What does that have to do with making her wait eleven days?
In general, as long as you’re prescribing appropriate drugs for appropriate conditions, performing due diligence to screen out abusers (checking the narcotic reporting system, doing urine drug tests, getting old records, etc.), and documenting appropriately, you’re OK. Being overly permissive or sloppy about documentation can get you in trouble with the medical board, or it might get your narcotic prescribing privileges revoked, but you’d have to go pretty far before it rose to the level of criminal charges.
There are other reasons why a doc wouldn’t want to be overly permissive with narcotics. Chronic pain can be frustrating and time-consuming to manage, and it’s understandable that a doctor might not want to spend all day every day doing it. The biggest problem (in my area) is that if you are seen as loose with narcotics you’ll be overrun with people looking for them–some obviously legit, some obviously not, but mostly in that vast, undefined middle. Then you have to spend all day sorting through them and fighting with the ones you don’t want to write for. Meanwhile, those obviously non-legit patients are out in your waiting room causing scenes and generally scaring off better patients, hoping that if you won’t believe their bullshit at least you’ll write them something to make them go away.
Not that my experience should be generalized to everywhere; my town is the epicenter of the “hillbilly heroin” epidemic. It’s like having an office on the south side of Chicago and a license to sell crack. So as much as I’d like to not care if Cletus sells his Oxycontin, there are plenty of reasons why I have to.