Wednesday, April 24, 2013

docs: put on your big boy/girl pants and change

Could it be that there is teeny tiny movement starting around the overprescribing  of pain medications that is an epidemic in this country?  In January Mayor Bloomberg (gotta love this guy) announced an initiative at the 11 public hospitals in NYC.  The VOLUNTARY initiative states that emergency departments "will not prescribe long-acting opioid painkillers, can only prescribe up to a three-day supply of opioids, and will not refill lost, stolen or destroyed prescriptions". What a concept....Read about it here.

In Washington state, a health care system has placed limits on how painkillers are prescribed.  Doctors are told " abide by the guidelines or face the consequences".  The states also now requires patients who are on high does of pain killers with little improvement to be referred to pain clinics.   Read the article by Kevin Pho MD here.

Here's the thing: This is really great.  Finally someone is paying attention and putting the responsibility for the epidemic where it lies: doctors.   The thing is, what politicians don't recognize is that health care has become a business, like any other business.  What is a business' goal?  Make money, stay afloat.  How do you do that? By making the customer/patient happy, so they will come back.   Lots of patients are made happy by getting that almighty narc script. Hospitals are even being paid more or less based on patient satisfaction, and therein lies the dilemma.  

Doctors fear patient complaints, poor satisfaction scores.   So what. The only people who will stop this epidemic will be doctors.  They are going to have to stand up as a group and say no.  They are going to have to stop whining about losing control of their practice, blah blah blah. 
They are going to have to put on thier big boy/girl pants and take responsibility for, change a culture, that they have created. 



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