fired by pain management doctor

[topperdoy]

I am a social worker. I had a client who was taking pain medicine exactly as prescribed for over 3 years with same pain dr. My client's name came up for a random pill count, but he had lost his cell phone and couldn't find it for several days. The doctor sent a letter saying he could no longer see this client as a result and had to assume there was misuse of the medication which wasn't true. My client called the doctor and tried to explain. The doctor said that this was regulation and he couldn't see this young man nor could he help wean off the opiates safely. Dr referred the young man to several other doctors who said they don't do pain medication. My client has inquired and other pain doctors have said they thought that my client's pain doctor didn't handle this properly and would not take my client on as a patient. So, he is now on his own to figure out how to wean himself off these serious meds. He is on a large dosage. Doesn't this seem like malpractice?

[Tuckamore]

Hello and Welcome to our Pain Management Forum.

I'm so sorry to hear about your client. Sadly this happens way too often. If it's not a circumstance as you described - it's a PMP that doesn't know how to correctly interrupt a UDS (Urinary Drug Screen) or a human error in the processing, etc. It breaks my heart and leaves all we chronic pain patients on opiate therapy frightened out of our shoes.

This happens to patients that have had a "clean" record for years, ppl that always take their meds responsible - sometimes senior citizens or even those with a terminal illness - this "One Strike You're Out"  - Guilty without a judge or jury, accept the government climate is more than sad - it's a violation of our rights. I think it borders illegal. No one cares at this point. It hasn't happened to enough ppl in the right places - those ppl with big pocketbooks and lots of clout. But than again maybe it doesn't happen to those ppl because of the station in life.

It'll take years - if ever before this pendulum even begins to swing back. You can help - we all can help. Write/contact every governmental representative and agency you know - and a few you don't. Make our voices heard. What the government is doing to Chronic Pain Patients, the innocent and the terminal is criminal.

Your client is fortunate to have your support. If you make calls to these Clinics that are refusing to take him as a patient and make your opinion known it may help. HIPPA may be an obstacle but with his approval you can do it. It sure can't hurt.

Phil has offered good suggestions as has Remar - they always do. Once a decision has been made to discharge a patient, I've never heard of a reversal. I agree that I would look into patient abandonment laws - but pain patients seem to be "abandoned" often and there is no quick recourse nor sanctions taken on the physician.

I wish your client the best. He'll need your support and any other support you can muster. I hope you'll share with us then conclusion of his journey.

Peace,
~Tuck

[remar]

I'm so very sorry you're client had this happen. He must be devastated and so scared. I just don't understand how any Dr could abandon a patient who is on a high dose of serious medications. In my opinion, some of these Drs are taking these new laws way to far. They tried to call him for a random pill count, not a scheduled one. It's probably in your clients contract that there will be random drug tests and he has to be available to take them. Have you been able to read his contract to see if it does indeed say this? I don't see this as being fair to a patient because what if they need to go out of town for a family emergency? What if they lose their phone like your client did and not be able to afford another one? Are chronic pain patients supposed to by glued to their phones and homes because they can be called at any day or time to come in and do a pill count or a drug test? This is so unfair. You received great advice from Philnoir.He is extremely knowledgeable. I hope your client can find another Dr very soon. Or, get in to see a addictionologist like Phil recommended.

[philnoir]

Let me clarify... that clause should read:

"One strike and you are out"

Android spell checking software needs to be equipped with a leash.

[philnoir]

Hello and thank you for sharing this information.

First, this is an abominable situation for anyone to experience. This physician needs to be reported to his state medical boards for patient abandonment.

A physician who prescribes a treatment has a moral obligation to continue that treatment except for special circumstances. Not answering a call for a pill count does not qualify.

Your patient may have reason to proceed against this physician for violating ADA.

But for now your patient needs immediate support by a licensed addictionologist. Legally, only such a doctor can treat a dependence crises. This law must change, but until it does, develop relationships with these specialists to support your opioid dependent patients who are abandoned by their doctors for 'one-strike and your out' clauses in their controlled substance contracts.