Dear Everyone in pain,
I am not the gait keeper of your opiate pain medication, and I am not the drug dealer either. Chances are, if you are under 40, and you haven't been in some kind of serious accident or have an active major illness (cancer comes to mind), then the pain you are in really shouldn't require opiate analgesics (aka, Norco, Vicodin, Oxycontin, Percocets). Chances are also, if you have a nickname for your medications like "my vic's" (pronounced Vikes) then you are not in so much pain that you would need an opiate analgesic. Or your pain comes from someplace higher that needs other interventions that opiate analgesics cannot achieve.
The drug addiction epidemic in this country is vast and expanding. Many news outlets have been blaming physicians for this problem. It is true that we, as doctors, have the ability to put people on these medications, and if they have a tendency toward addiction, it may turn into one once they are given the opportunity.
It is amazing how many people come into my door at the office already saying that their home medications include Norco 5/325 three times daily for pain (or higher doses), and when I ask them why they are on these medications it seems an injury happened five maybe ten years ago, and technically speaking should be well healed by now. But that patient assures me that they cannot function without those medications and that I would be a cruel hearted you-know-what if I were to take them off of that medication. Part of the problem is that patient's lie. I do it too sometimes, to my doctor. We have this crazy tendency to want to please others so we leave out important details, like "oh yeah, I am a recovering alcoholic or BTW I often smoke crack but only like twice a week and its been like a whole week since the last time I did." I as the physician don't get that information from the patient, I had to find out because when you come in my door asking for those medications I make it a point to always check your urine to see if you a)have been taking the medications b)are taking other things you didn't say you are and c)that you are not doing other illicit drugs.
This comes on the heels of the ACA which now links hospital reimbursements to patient satisfaction. Believe me, I want my patient's to be satisfied with their care, but on the same note, often times patients do not know what they need and will fight you tooth and nail, or go somewhere where they will give them what they WANT, not what they NEED. So am I going to be considered a bad doctor because I don't give my patients what they want all the time? Maybe.
It is this "Have it your way" mentality that is crushing medical practitioners. Everyone comes in having either already diagnosed themselves, or having been to the ER where they don't treat chronic pain, they just want those people to GOMER and so they give them their Vic's or their Norcos. Then I am the one trying to clean up this mess. Often times I will lose patients because I do not give them what they want. There are plenty of doctors down the street who will give you whatever medicine you ask them, but I'm not that doctor. I will work with you, try to treat your pain and find out the cause as best I know how. But I will not be your drug dealer. I will not be complacent in this epidemic. I will not.
I am not the gait keeper of your opiate pain medication, and I am not the drug dealer either. Chances are, if you are under 40, and you haven't been in some kind of serious accident or have an active major illness (cancer comes to mind), then the pain you are in really shouldn't require opiate analgesics (aka, Norco, Vicodin, Oxycontin, Percocets). Chances are also, if you have a nickname for your medications like "my vic's" (pronounced Vikes) then you are not in so much pain that you would need an opiate analgesic. Or your pain comes from someplace higher that needs other interventions that opiate analgesics cannot achieve.
The drug addiction epidemic in this country is vast and expanding. Many news outlets have been blaming physicians for this problem. It is true that we, as doctors, have the ability to put people on these medications, and if they have a tendency toward addiction, it may turn into one once they are given the opportunity.
It is amazing how many people come into my door at the office already saying that their home medications include Norco 5/325 three times daily for pain (or higher doses), and when I ask them why they are on these medications it seems an injury happened five maybe ten years ago, and technically speaking should be well healed by now. But that patient assures me that they cannot function without those medications and that I would be a cruel hearted you-know-what if I were to take them off of that medication. Part of the problem is that patient's lie. I do it too sometimes, to my doctor. We have this crazy tendency to want to please others so we leave out important details, like "oh yeah, I am a recovering alcoholic or BTW I often smoke crack but only like twice a week and its been like a whole week since the last time I did." I as the physician don't get that information from the patient, I had to find out because when you come in my door asking for those medications I make it a point to always check your urine to see if you a)have been taking the medications b)are taking other things you didn't say you are and c)that you are not doing other illicit drugs.
This comes on the heels of the ACA which now links hospital reimbursements to patient satisfaction. Believe me, I want my patient's to be satisfied with their care, but on the same note, often times patients do not know what they need and will fight you tooth and nail, or go somewhere where they will give them what they WANT, not what they NEED. So am I going to be considered a bad doctor because I don't give my patients what they want all the time? Maybe.
It is this "Have it your way" mentality that is crushing medical practitioners. Everyone comes in having either already diagnosed themselves, or having been to the ER where they don't treat chronic pain, they just want those people to GOMER and so they give them their Vic's or their Norcos. Then I am the one trying to clean up this mess. Often times I will lose patients because I do not give them what they want. There are plenty of doctors down the street who will give you whatever medicine you ask them, but I'm not that doctor. I will work with you, try to treat your pain and find out the cause as best I know how. But I will not be your drug dealer. I will not be complacent in this epidemic. I will not.
