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Old 07-15-2006, 02:16 PM   #1
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After Hours - Can you call your Pain Doctor?

Here it is, Saturday and I am having a tough time. I am in a LOT of pain and my PM&R doctor does not have an "on call" doctor. When I go in, I either see my doctor or his partner. They operate "interchangeably" all the time. Both have prescribed meds for me.

How does your PM&R doctor, or whoever takes care of you, handle after hours problems?

In May I was in a lot of pain, more than my meds could block, so I called and left a msg with his receptionist, asking for him to call. He did not. I called back the next day and left a msg. And again on Wed. When I saw him about a week later I asked him why he didn't return my call and he looked at me...sort of exasperated like...and said he was busy.

I understand we are all in pain. But I have called his office "after hours" 4 times in 221 days. I don't think that qualifies me as a "problem caller".
I am looking for another PM&R doctor right now. Folsom or Roseville, CA.

In summary...how do you reach your pain dr. after normal office hours?

 
Old 07-15-2006, 03:30 PM   #2
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Re: After Hours - Can you call your Pain Doctor?

dl-
My pm doctor gave me a list of their rules regarding nighttime and weekend calls. They have a strict policy about after hours/weekend prescriptions. No prescription will be called in to a pharmacy during these hours. It goes on to state that if you have an urgent need during these times, you should go to the ER. (I recently had to read over mine when I had problems with the Avinza and his office told me to go to the ER. I never went- I'm touging it out until my appt. this Monday) The problem with going to the ER is that when you are in pain management, the ER won't really be able to do much because of your contract with the pm doctor that states that you can't receive narcotics from any other doctor.

Now, with my pm doctor, if I call and the office isn't open, they do have the cell number of his assistant, but that's basically for advice if you need it.

I did read one of your posts about your phone calls going unreturned and I find that unacceptable. I know pm doctors are busy, but each patients problems/questions are very important, so at the very least, they should be able to return a phone call within 24 hours. 3 days is a bit ridiculous. I really think it would be a good idea to find a different pm doctor if you aren't getting quality care from your current one. You deserve better treatment than that.

Lezlee

 
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Old 07-15-2006, 05:30 PM   #3
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Re: After Hours - Can you call your Pain Doctor?

Ozzybug...thanks.

I will try to switch Monday. I have a dr. in Folsom who handles two of our friends and they love him.

This is my first attempt "after hours" that I recall. Those other calls were during business hours.

Since I signed the contract with this dr. - - no pain meds anywhere but thru him, I feel they should make some effort to be available.

I would hope the ER would save our life if we were "dying" and I assume they would. But if you stop and think about it, which I hadn't done until today. It seems they are really hanging it out by telling us we can't get pain meds anywhere but thru them.

Bottom line for me would be to get the meds I need and tell them our contract is null and void on Monday. Remember, not only did they not return any calls, they sat on my paperwork at least 5 or 6 weeks...the paperwork
for me to go see the medtronics surgeon about putting a morphine pump or the electronic pain relief in.

I wonder if their contracts bind them in any way? Hmmm. I will take a look at mine AND before I sign another one, I will know what to check for. Live and Learn.

 
Old 07-15-2006, 06:52 PM   #4
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Re: After Hours - Can you call your Pain Doctor?

Jon,
thank you for clearing that up. Until the last few years I saw a doctor once a year and that was for my flight physical. I didn't think 4 calls in that length of time should make me a pain in the rear, especially when 3 of the calls were at the same time.

Now I have many, many doctors. I do like this doctor, but wonder what is going on when a call is not returned day after day.

Is the a "proper protocol" for switching doctors? I do want to see the contract I signed. IF I am not allowed to go to the ER for meds, etc. and they won't call me back...AND I have serious med problem I would think the PM&R dr. could be in trouble, legal or professional.

As far as clearing up the issue of the 3 un-returned phone calls, the dr. sort of shrugged and told me he was busy. I wanted to say "untill midnight?" But I didn't.

If I am lucky, I will have a new dr.on Monday. These people were the ones who did my discogram. I don't remember much, except during one of the painful episodes I felt a hand "hold" my hand and it was real small. How sweet for someone to care enough to "hold my hand" at a time like that. I tried to find out who it was so I could send her flowers, but they wouldn't tell me.

BTW, when I spent 4 days in Cardiac ICU, I wrote those nurses a letter that was published in the Hospital news letter. Those ladies were angels. I WAS
a pain for them. My heart stopped twice and they brought me back. I woke up and saw my wife and kids all standing around crying. I thought I was dead for a little bit.

Thanks again

PS...Jon..I saw my PM&R doctor yesterday. I asked him again about our contract versus going to the ER. He said for me to go to the ER, they will provide the proper meds for me. I asked him if the ER had his phone number and he said no.

Last edited by mergatroy; 07-18-2006 at 08:34 AM.

 
Old 07-17-2006, 08:06 PM   #5
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Re: After Hours - Can you call your Pain Doctor?

I saw my PM&R doctor today, actually I saw his assistant, but I was told, in front of my wife, to go to the ER. He said the ER had their phone numbers.
I don't know if he was joking or not (about the phone numbers) but he was serious about the ER.

If I were an insurance company I would NOT like that. They get to spend major bucks because my doctor doesn't want to be called. I do see the dr. viewpoint,
but being on call usually comes with the territory doesn't it?

Anyway, the next time this happens I will go to the ER. I didn't tell him, but I was to the point of wondering if this was going to be my future...if this was all I had to look forward to........ Well, I usually feel that stuff coming on and I can do something else. Hour after hour of severe pain is hard on us. Real hard.

I am still looking into this other dr. I want to talk to him. I was told he is a
PM Physician, NOT a PM&R dr. Does anyone know the difference? The nurse made a point of emphasizing that point. PM Physician....Hmmmm.

Thanks for the help.

 
Old 07-18-2006, 08:38 AM   #6
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Re: After Hours - Can you call your Pain Doctor?

I saw my PM&R doctor yesterday, he said I could go to the ER. I asked him about our contract and he said the ER will provide whatever meds I need at the time. I forgot to ask him if that means whatever meds I need while in ER or will they give me a 2 day prescription to last me until I can get in to see him.
Bottom line is I can go to the ER for relief.

 
Old 07-18-2006, 10:25 AM   #7
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Re: After Hours - Can you call your Pain Doctor?

Hey dl-
My cousin is in pm for severe Chrons and has had to go to the ER on ocassion, and when she goes in she lets them know she's a pm patient. They will then call her pm doctor because they have access to him after hours. They get instructions from him as to what they can do for her with his approval, so I'm sure his assistant was telling the truth, BUT it would be good to get clarification about whether they can just treat you in the ER or if you will get in trouble if they release you with written scrips. Better safe than sorry I would think.

Hope you are having a good day!

Lezlee

 
Old 07-19-2006, 05:17 PM   #8
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Re: After Hours - Can you call your Pain Doctor?

Ozzybug...good point. THAT is what I was trying to say to my PM&R doctor yesterday. I was having trouble expressing myself as elequently as you.

I tried calling the Roseville Sutter ER today. No luck getting through. I will call back. If they cannot reach him, will they even treat me?

I would like to know what would happen if I went to the ER and came out with another prescription. My guess is they would not be thrilled with it, but I would remind them they aren't around.

Also, if you are out of state and need treatment, good luck getting opioids. For example, we were up in Anacortes, WA for about 18 days. I asked the Pharmacist at W. and she told me no. I could NOT have Avinza. I told her I had a prescription with Walgreens in California. Tough. She said she needed a piece of paper saying I could have it. I reminded her my doctor is not licensed to do business in Washington, so how can we get it in their pharmacy. Turns out there isn't any way. I had enough, but wanted to confirm what I had heard.

So if your doctor writes a prescription in Texas or New York, it is not acceptable in THAT W. in Anacortes. I might drive across the border and buy them in Canada? I know you cannot buy Nitrolingual in the USA without a prescription, but can buy it up there for $15 a bottle. Same stuff.

It would appear each of us had better know where we are going and what the ground rules are before we leave. I did get another prescription at Walgreens in Anacortes.

 
Old 07-19-2006, 08:14 PM   #9
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Re: After Hours - Can you call your Pain Doctor?

In most states that I am aware of you can not fill a prescription from one state to the next, particularly if it is schedule narcotics, it is illegal. The doctor must have a DEA's liscense in the state you are filling the prescription.

Always fill your prescriptions before going on a trip and be sure you have enough to get you through your alloted days. If you are planning on being out of state for more than 30 days or longer than the remainder of your prescription let your doctor know. Most will be willing to work with their patients.

My doctor has a policy regarding ER's. I can not get any prescription medication from them unless they have called him, but I can get an injection if necessary. I also must report to him within 24 hours of being in an ER and receiving any type of medication. Failure to do so will result in termination of his services.

I have found in my experience that going to the ER is completely useless. They do not give out any prescriptions, you only get what you need at that given moment (which is understandable given many do abuse medications). Basically in a nutshell when it comes to pain they are only good for accute pain for the period of time you are there. Some hospitals may be the execption but I've not really read on the board any there were different. Definately do not expect them to give you anything stronger than you have.

I was in my PM Program for almost a year when I was in a car accident. I had had an ACDF a year previously and was rear ended at a stand still. I was taken to the hospital via ambulance because of severe neck pain. While all checked out ok bone wise, I did have a broken screw and damaged muscles. Because I was seeing a PM (who ironically practiced at that hospital) they gave me 1 Vicodin and told me to go home because what I had at home (morphine) was much stronger than anything they could give me. I was appalled! I wasn't expecting a prescription but sheesh you would of thought an injection of demmerol or something would have been appropriate given the situation at the time.

Barb

 
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