CUTT OFF

[Teresa101959]

hi...my primarcy care physisian cut me off of my vicodin 10/325 for failing a pill count by 4-5 days...but the month before that he cut me down by 60 tablets a month...then did the pill count at close to time to getting a new presc....heres how i look at it, i could be wrong,but i really dont think so...instead of cutting me off completely,especially after just cutting me 60 a month he should have realized my body has got to get adjusted to losing the extra 2 a day...he didnt allow for that...he didnt fire me....but says he just wont give me any more anything for pain and maybe one of my other drs will...i have a spine doc and a cancer doc...my spine is DDD...as well as twisting a bit in the lower (lumbar area) section...had surgery on the C6-7 this past sept to remove a disc that had slipped and was laying on and FLATTENING the spinal cord....but my question is should he have just cut me off like he did or give me time to adjust or what? im changing doctors bc i went n pd 50 bucks for my medical records from his office and they are so messed up...its like he was listening but not listening to me cause what hed type in his laptop was only a part of what i actually said and mostly what he said i said which i didnt....i also may file complaints against him for several issues....and i can PROVE my complaints thru my other doctors...all the spinal MRIs ive had ...etc.....can he just cut me off and expect me to be ok with it? shouldnt i had been given the chance to adjust before he cut me off?

[luvdolphins58]

Hi. What is the spray for spasms.  What kind of spasms  do you have. I  have  major spasms  pain etc... so far nothing  works  for them. Thx

[Tuckamore]

Remar, you're right according to my research and experience. I have never been charged - but they can charge. I even found differences between counties within the same state - and facilities within the same county. Federal Law does say that the ability of an individual to pay should be taken into consideration.

Rootsgal, Addiction is a disease. We want to be cautious about using that word on this forum.  

PMP don't get you "addicted" - your body may become dependent but addiction is very different. Statistics say that less than 4% of ppl that have true Chronic Pain ever become addicts. Sadly it's the ppl that don't need opiates, steal or sell opiates, abuse and misuse them that have put us Chronic Pain patients in the position that we currently face. No one can make you an addict - you either are or aren't, like alcoholism. Many ppl can drink alcohol - or even periodically drink more than they should and never become an alcoholic - yet for some it takes only that first drink. Alcoholism a disease just as Drug Addiction is a disease. We are not addicts.

Just wanted to clarify.

Thanks,
~Tuck

[remar]

I do believe Tuck is right about it being different in different states. It can depend on the Dr too. I've had my records transferred a few times over the years and have never been charged by any of the Drs. I live in Mo so maybe that's the way it is here.
I would think if you went to pick your records up instead of having them faxed it would be free, But, then again, maybe not depending on the state and Dr. We all need to do the research like Tuck did to see what the laws are in our state in case we need to have our records transferred.

[Rootsgal]

Unless it is WORKERS COMP.
Then it is illegal to charge you at all.

[Rootsgal]

My primary care doctor never does a count, He just has me fill out some questionaire once a year. (do you obsess about your meds? Do you have suicidal thoughts? stuff like that)
I almost ended up going back to pain mgmt clinic, until I made him aware, I cannot afford the urine screenings, every 3 months! ($600.00!)
I reduced my oxycodone from 40mg TID to 20MGS BID.
It took months but I did it.
I got off KADIAN, AVINZA (both are morphine) cold turkey, oxycontin, (which I hated anyway) Lyrica, and Neurontin. I reduced clorazepaim from 1MG at bedtime to .5.
I volunteered to take my pain medication in for a count, and he said I did not have to.
He said, "I am proud of you for weaning yourself off of all the medication, the PAIN MGMT CLINIC piled on you."
Funny how that works right?
One place legally addicts you to everything.
Meanwhile, your OWN doc, wants you off of most of it.
Pain clinics are all about robbing us for the tests. Big money in it and everyone wants in.
I am in the CT medical MJ program, and none of them accept Medical MJ as an actual prescription.
I use the CBD SPRAY for spasms and it rocks!
I use the vape oil cartridge pens (CBD) for pain.
Now sure where you live, but if you qualify. give it a thought at least.
You have nothing to lose at this point since he cut you off.
WISHING YOU ALL THE BEST~ I REALLY DO!

[Tuckamore]

Thanks to Weathergirl I found "law" on Medical Records. I found this interesting in light of the many ppl (and you) that say their medical records are not correct.

I went to the US Health and Human Services Internet site and it says this about Medical Records:

"Correcting information"
"If you think the information in your medical or billing record is incorrect, you can request that the health care provider or health plan amend the record. The health care provider or health plan must respond to your request.  If it created the information, it must amend the information if it is inaccurate or incomplete.  If the provider or plan does not agree to your request, you have the right to submit a statement of disagreement that the provider or plan must add to your record."

When I suggested you write a letter and ask that it be placed in your medical records - this must have been where and why medical facilities place letters in a patient's medical record. Now that's true in my experience - it may not be true every where and with every practice. However if you follow the guidelines above than they must place your letter of disagreement in your files - nationwide.

I hope this helps. I'd work to correct the statements you believe are incorrect. It'll be important down the line. I didn't do that once 20 years ago and was very sorry I didn't.

If you read my reply to Weathergirl you'll see my correction regarding my statement,  " You should not have had to pay for your first set of medical records, a second set they can charge for but not the first - at least that's what I've been told." Yes that's what I was told but it's not completely correct. I've searched and it seems to be state by state and often facility by facility. CA places a limit of 25 cents a copy but allows, "reasonable clerical fee." This would say the Federal Law allows for clerical fees too.

In my search of this subject I found multiple laws and fees per state, even per county and facility. I didn't realize there was such a huge difference. Most have "flat fees" per page. Regardless of charges or fees they must remain within the Federal Law.

Hope this helps.
~Tuck

[Tuckamore]

I think that law for medical records varies by state - or I have had just had kind clinics and hospitals. :o) I was told they could not charge for the first copy. In hindsight that may be the state rule - or the facilities rule. Thank you for pointing that out. It made me do my research.

It may have been the fee for "searching or retrieving"  of medical records I had confused - that they cannot charge you to preform. However I have never been charged for one personal copy of my medical records. I have never been charged for records between clinics or hospitals either. On occasion I travel between two states - and I request my medical records quarterly regardless of travel.

I called a dear friend who is in charge of a Hospital Records Department. I didn't totally understand the Federal Law I found. She state they cannot charge for the "time" it takes them to copy a medical file. They may charge for the actual cost of the copy (which should be low).  Obviously if they must mail them obviously they may and do charge a mailing fee. She says they never charge for the first personal copy but wasn't sure if that was their policy or state law.

US Dept of Human Services Site says this:
"A provider cannot deny you a copy of your records because you have not paid for the services you have received.  Even so, a provider may charge for the reasonable costs for copying and mailing the records.  The provider cannot charge you a fee for searching for or retrieving your records."

I am so glad you questioned my statement that they can't charge for the first copy - as I found "law" on personal medical records that you believe are incorrect.

Thanks Weathergirl.
~Tuck

[Weathergirl21]

You have been given great answers above, I just wanted to add that according to federal and state law, any practice is allowed to charge a fee per page or flat rate for your medical records which includes time and copying costs. It's all up to the practice whether they decide to charge or not as some go ahead and give the patient a copy for free but it's not illegal to charge.

The records are actually owned by each practice but we have the "right" to get a copy of those records when requested..

And as others have said, any Dr. has the right to stop prescribing you medications especially if you are not following the rules/guidelines set by them to take those medications. It is the Dr's license on the line when a patient "abuses" the meds by taking more than prescribed for any reason.

[Tuckamore]

Hi Tersa,

I am so sorry this happened to you! Unfortunately we have no rights! A physician can decide he/she is no longer going to RX opiates for us for any reason. Is it right - no! Do we have any legal recourse? No!

Your count was off - should he have cut you and expected your count wouldn't be off? Probably not! Five days is quite a few and he'll win in any argument - should he? No - but he will.  

You should not have had to pay for your first set of medical records, a second set they can charge for but not the first - at least that's what I've been told. I've never been charged for my first set of medical records. You did the right thing by obtaining your records. I encourage everyone to obtain their medical records every 3 months.

I'm hopeful you have a kind and concerned oncologist or spine doc. You may have to see a PMP. Time is imperative. You'll begin withdrawals (w/d) soon. Is your PCP willing to help you through w/d?  I'm concerned for you. There are some meds that can help you - ask for them.

Everything you said is correct - sadly you don't have much leverage. Someday some new, smart attorney will want to make a name for himself and take on one of our cases - as our rights have been stripped. There is no appeal, no second chance - no judge and jury - no nothing. How can this be fair - or right?

I'm as angry about this situation as you - it could happen to any of us. Maybe not a count, but for a multitude of other reasons. It happens all the time. This time it was you - next time it may be me. My heart goes out to you.

I'd contact your other physicians. If they are not willing to RX for you - try a PMP. If no luck there than call your PCP and ask for help during w/d.

As far as your medical records there is nothing you can do to change them. You can write a letter addressing all the things you think are incorrect. It should be placed in your records but to make sure it is ask that it be placed there.

Please let us know how you are doing. I look forward to more comments from you and hope you'll keep us updated. Again, I am so sorry.

Peace,
~Tuck

[philnoir]

Hello Teresa.... Welcome to the pain community.

There's a cold wind blowing when it comes to opioid pain medicine these days. You are not alone in being "cut off." Sounds as if your doc was looking for an excuse to take you off his opioid roles -- most are worried about their own risk in prescribing, first and foremost.

On such a low dose, you are not physically dependent on opioids, and are unlikely to suffer from withdrawal symptoms. This is fortunate.

You still need to address your pain.

If you live in an urban area, near a university teaching hospital, look for a pain clinic that your insurance will cover.

Yes, you have a legitimate reason to use opioid pain medication. You are not a 'lotus eater.'

So get busy.

You may also look for a pain/spine doctor in private practice. Look for doctors with the credential, DABPM after their name.

These docs have the training in pain and medications necessary to effectively treat your pain.

If you can find a doctor's website, you'll sometimes find a sample controlled substance agreement. Sometimes they'll list a service like "medication management." These are tip-offs that they are experienced in prescribing pain medication.

Those doctor review sites can also be useful, although I've noticed one is now hiding patient reviews -- eventually, the lawyers get in everywhere, like roaches.

You may need to interview multiple providers, but your search will pay off.

Best wishes.