Kissa

What is it exactly are you looking for in terms of a PM or rather what do you feel you'd like to change by finding a new PM? I think starting there will help some in deciding what to do for the right reasons.

You can probably be very sure your insurance is being billed for the time you spend with her assistant. They may also be billing your insurance for your drug screens. You can find that out by calling the insurance company and asking.

All PM's make you sign a contract and have the right to do a urine screen. Most PM's do not or do this on a really random basis, it is actually pretty important because it may potentially weed out those abusing medications. Unfortunately for those who have CP this seems a bit unfair, but it is a sacrifice we sometimes have to make.

PM's do control a large portion of your medication care. Some PM's make exceptions when it comes to ER's, I know mine does. If something happens and I end up in the ER and I need to get medication I can however I have 7 days to report this to the PM or else our contract is terminated. Some folks have indicated that some ER's will undermedicate you because they feel you are on strong enough meds, others have stated ER's offer the meds but the patient turns them down. The best advice in this situation is flat out ask your doctor what would happen or how the situation should be handled.

As far as being hearded in and hearded out, that is very normal and I think a great majority of PM's do this for a few reasons. The primary reason is it is a small speciality, the doctors are very few but the demand is great so many doctors double book or have an assistant help.

You do have the right to not be seen by the assistant and request you specifically see the doctor, I am not sure however how the doctor will react to this. I will not see my GP's assistant, she is wrong nearly every time I or my husband has had to deal with her so I am not willing to take that risk again.

If you have real concerns you have to be assertive and made them heard however don't over burden the doctor with 50 questions, try to ask a few of the most important ones first then over time ask others if you feel you still need to. This is true of all doctors. Some patients go to see a doctor lets say with a cold and while in the office they suddenly remember they strained their back, been having sinus issues and can't sleep much.. things like that, adding more illnesses to their grocery list unexpectedly. This is not fair to the doctor nor the patients waiting out side. I hope that made sense.

As far as finding a new one I honestly don't know how that would work. I would surmise that you should give notice to your current PM after making your appointment with new one, but remember it could be months before you can get into a new one which could be a sticky situation. You should be honest with the office and tell them exactly why you are looking for a new doctor. You can also tell the new PM when calling them the situation, you feel your level of care is not being met and you'd like to find a new doctor.

The real question is going to be if you go to a new doctor and they don't fit all your needs or try a completely different approach and you are not happy there then what will you do? If you skip from one PM to the next several times, yes this can be seen as a potential problem by the new doctors you are going to see. Because PM treatment is such a delicate situation with the abuse of medications doctors will screen their patients to be sure they aren't shopping. I am not saying you I am saying they can percieve that.

You could decide to not tell the new doctor about the old but this presents a really big problem. If you are on strong medications, lets say Oxy or MS C and you go to a new PM requesting this medication the likelyhood of them throwing you out would be great. How would you explain to them that this is the only medication that works for you? If on the other hand you don't tell the meds and they put you on something else much weaker you run a huge risk of withdrawals and severe pain. Being dishonest as you see is not a wise idea in this situation.


I guess what it boils down to is does your medication work? Is your only inconvienance being drug tested? You have to really ask yourself what are the valid reasons for wanting to change. Have you made an effort to speak specifically with the PM and voiced your concerns? I believe you should at least give this a try.
If your doctor is giving you a decent level of pain relief is that something you are willing to risk in the long run by changing doctors? These are the things I would think long and hard about before looking for a new doctor.

If your level of treatment of pain is nil and the doctor treats you bad, then yes, by all means you should seek out a new doctor.

Good luck to you
Barbie