I've been neglecting the blog, I know. Its the weather. Its still winter here and I can't stand it anymore.
Anyway...
There is a horrible prescription pain med problem in this country. One we don't want to face. Its an epidemic. Its an epidemic doctors in particular, don't want to face. Their part in it is shameful.
I'll give you an example of how completely out of control this problem has become. There was a man who
came in who had someone managed to get over 800 tablets of pain meds (two different kinds) in 2 months. 800 tablets! Thats insane.
Thats just one person. Imagine the millions of pills people get each month in this country. Why does this keep going on? Because doctors are a bunch of fucking wimps who can't say no. Its easier to say yes and pass it along to the next person. I don't know how they sleep at night.
I can hear all the doctors say: Patients expect his. We'll get complaints. Blah blah blah. Doctors have created this epidemic and they are responsible for stopping it.
Overall, I blame the suits that swear by the Press Ganey bullshit. Even though the doctor group doesn't work for us, they've essentially forced some of the zero bullshit docs out of the hospital beat them into submission with the whole candy man mentality. It sucks. I've personally seen more than one good doctor go from fighting the narc battle to completely giving in because it isn't worth the backlash. That said I'm sure some candyman wimp doctors set that precedent in the first place. It sucks that this is what it's come down to.
ReplyDeleteIf you have patients who genuinely need care, it's easier just to give the seekers what they want so they'll leave. The drawback is that they keep coming back.
ReplyDeletePersonally, I don't care if people take drugs. Let them take as many as they like - refer them to a pain clinic - just as long as they're not clogging up the ER.
It would save time for everyone if the drug seekers just went to a pain clinic and got handed meds.
"I can give you 8 pills and refer you to a pain clinic that will repeatedly give you lots of lovely drugs, refer you to rehab, or I can preform lots of tests and investigations to see if you actually have an actual health problem? Oh, you'll take the drugs? Great! Next patient please!"
mnowas
Lets trade guns for drugs.
ReplyDeleteIn Califrutopia, they've got a lovely state-run system:
ReplyDeleteIt tracks every prescription a patient has filled back to Whenever They Started Logging This Stuff.
I have a bunch of all-star docs who look up patients who appear to be Problem Children, and they show unrestrained glee and telling people with 23 pain med scrips "No. The gravy train ends here." when Mister Vicopercocrackho has "lost" his bottle of Rx spending money for the 9th time this year.
The little pouty pissed off looks on their faces almost makes wasting the time to document their formerly weekly fairytales in triage worthwhile.
We stopped doing Demerol in the ER, and that whittled a lot of them out of the waiting room. Now they can go after everyone else, and the state database backs them up.
If we could just mandate that their answers to Press Ganey surveys are automatically shredded before opening, that's be a trifecta in my world.
I am waiting for the day DEA visits my ER. We are so busy that most of the docs and PAs just give the drug seekers what they want just to get rid of them. I had a patient last week that put on a "pain performance" like no other- scaring other patients while waiting to be seen. This was his 13th visit this year!!He had been turned down at our sister hospital the day before but our PA made a "bargain" with him: 2mg of dilaudid if he'd leave...and didn't I think that was a good idea??? Hell no!! I work with wimpy drug pushers. Let's just keep feeding the bears...
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