I am at a total lost right now. I just went to a new pm dr and I know all about not going to another dr and all that jazz but this doc scared the beejezzus out of me. He said that he had sent people to jail for going to another doc and for something else. Could you guys help me out and tell me what he is talking about? He has got my brain going in circles wondering what the heck he is talking about. He came off so harsh I was afraid to ask him what he meant. I have been in pain management for years. I guess I was never really sure what they were talking about and it didnt really matter but he made me wonder....YA KNOW!!!!
It sounds like he is operating off some type of scare tactic. I am not sure I would like that one bit.
Sometimes doctors will come off as harsh while trying to set up the ground rules. Maybe this is what he is doing and then he will become gentler once he becomes more comfortable with you.
As far as the jail thing, I have no clue what he was talking about unless he discovered criminal activity and reported it. Who knows?
Good luck and I hope that things work out for you. Starting with a new doctor can be very scary and interesting in the beginning.
Maybe he was trying to say that if he gives you pain meds and you go to another Dr. that you could be sent to jail. That is all I can think of. I think I might run right out and find another doctor if he said that to me. Is he setting you up to fail? Very odd. At your first meeting that is an odd thing to say. Did you just leave another Dr. to go to him? Maybe he thinks you were seeking drugs or something. They have that mentality instead of thinking that the last Dr. did not help and you are looking to feel better. Just a thought.
It sounds like he thinks you might be doctor shopping to get drugs. Or he was just saying this in case that's what you are up to. If you aren't then don't worry about it!
Fred
Sounds like he's just coming off like a real tough guy and setting the ground rules up front....Most notably about not going to see more than one Doc for pain meds...It's called "Dr shopping", which is illegal is most states now. Most states have computerized records where they can type in your name/social and within seconds find out what scripts you've had filled and where. It's usually one of the fastest ways to get caught drug seeking.
If you haven't done it, you have nothing to worry about. Unfortunately, the field of PM has changed quite a bit lately, and many Docs feel the need to be super strict. Just make sure you follow all the house rules.
I'm not sure why you have changed pain docs but if you had a long term relationship with the last one, and left in good standing, make sure this new doc has all of your records from him/her. I would think that this doc is one of those types who likes to weed out any doctor shoppers or drug seekers from the get go. I personally don't agree with this tactic, but unfortunately many PM's have adopted it out of necessity. It's a sort of "CYA" kind of thing.
It's obvious he's had problem patients before and doesn't want to risk that happening again. But it would be nice if he took a more compassionate approach. Did he require you to sign a narcotic agreement or contract?
Take care and hang in there. If you are a compliant pain patient and have no history of abuse or diverting, you have nothing to worry about.
Thanks guys. I used to go to a pm dr who gave narcotic meds but last year I decided that all the medication for all the years I took it might not be the only way I could win my war with pain so I started doing the nerve blocks and spinal shots. When I switched drs I had to be weened off of my meds but I at least tryed the shots which helped for only a short time and were getting very expensive.After about a year of that I decided it was time to go back to the meds because for me it was the best route to take. I guess I should of payed closer attention to all the new laws and how the system works. I did sign a agreement. Like I said I know about the rules but I had no idea a doctor could send you to jail. I guess I am still unclear on what dr shopping really means. In our area he was the only one accepting new patients. I kinda didnt have much of a choice in the matter. I thought that maybe he was just trying to scare me. I never had a pharmacy ask me for my social security number or anything like that. Is that something I should ask about just to be on the safe side with this doc. He hasnt asked me anyhting aside from the first visit I had with him. Now he just walks in and signs the script and does a little tape on my history and reads off what I filled in on the monthly sheet about how good or bad my quality of living is. He doesnt ever ask me anything directly. Something does seem fishy with him but I dont have much of a choice. What do you all think I should do, if anything?
If I had a choice I wouldnt be going to him and no I dont have another doc rxing to me. He just came off in a bad way. One of the first things he said to me was I put alot of people in jail for this and that and if you go to another dr I will catch you and put you in jail. He also said that he put people in jail for something else. I cant remember what but I was thinking that I do go to my family dr. (not for pain but for ADHD). Is that considered dr shopping? He knows I go there. Anyway sorry for being so long winded, he kinda just freaked me out.
As long as you aren't receiving pain meds from more than one Doc, you are fine. When you signed your contract, there was probably a clause in it which gives the Doc permission to search your current pharmacy records. Every time you get a script filled, it gets automatically registered in a big database (most states). The Doc can pull the info from there if he gets suspicious. Some Docs do it randomly just as a "audit" kind of thing.
Also, if he knows you go to your family Doc for ADHD, you're fine. My Doc asks me each visit what meds I'm taking. Where trouble pops up is if you don't say anything and then they do a search, and other pain meds or controlled substances show up.
Sounds like you are fine....The Doc just came off wrong.
Everyones advice has been right on, Ex in particular, but I wanted to chime in with my 2 cents.
Doctor shopping is a felony, It is when a patient sees more than one doctor within 30-90 days and accepts narcotics for the SAME condition, and fails to let the doctors know about each other.
People who do this are abusing their meds or selling them, they generally use their insurance for one doctor and one pharmacy, and then pay cash to see other doctors and go to other pharmacys, so as you can see, it is fairly obvious, once discovered, who is doing this and who is just switching doctors.
If you use one pharmacy, and/or one insurance, and let each doctor know anytime you are seen for anything else, even in an ER, and all meds prescribed, you are fine.
I may be wrong, but I believe these are federal laws, so they dont change from state to state. Its really not something you can do 'accidently', and if any question arises, a quick look at the facts makes it clear one way or the other, so like everyone said, no worries.
My new pain doc is also much stricter than my last, it takes some getting used to, I had my first urine check at todays appointment, but I really think more and more doctors are just treating all patients the same, that saves them from having to guess which new patients might be trying to pull a fast one and which are not, and its better to know up front whats expected, imho.
Different docs have different approaches to pain management, I guess. My doc is more "old school" or hands on. We sit and talk each visit and we discuss my options or any changes in meds that may be necessary. He has never asked me to sign a contract and he has never even talked to me about one.
I guess some docs have just been burned by other patients in the past and are uber cautious. It really seems like your new doc has a very jaded, strictly business type of approach. But if he is willing to at least listen to what your pain levels and quality of life are, and provide the care that you need to have some relief from the pain, I guess you should stay put. I believe that you have the right to end your contract with this doctor, if you find another more compassionate doc down the road at some time, but I'm sure the others here who have contracts would know more about that than I do.
Make sure you get a copy of the pain management contract, read it, and follow it to a T. It sounds like this guy will dismiss you if you don't follow it exactly. Everyone is correct about the doctor shopping issue but you might not realize it, say if you go to an Urgernt care, ER, or even a dentist and he prescribes something for pain. I know in most contract you have to let the PM doc know within 48 hours and before you fill the pain med(say from a dentist) or you could be dismissed. Please let all doctors, dentists, psychiatrists, any doctor what meds you take. It is your responsibility to do this and also your resposibility to follow the contract. I think what he meant about placing people in jail is if he finds out you have been doing anything illegal like doctor shopping, he can report you to the police, then they could arrest you.
brian
p.s. take your meds as prescribed because if he does a urine/blood test and does not find the medications in there that he is prescribing, you could also be in trouble and dismissed
Last edited by brianpain33; 04-29-2008 at 04:49 PM.
While I agree 100% that a strict doctor might kick you out of his practice for filling a narcotic from, say, a dentist, I doubt very much if any criminal charges could ever be brought for that, because its not fraud, like getting 2 scripts in a short amount of time for the same complaint.
While I agree 100% that a strict doctor might kick you out of his practice for filling a narcotic from, say, a dentist, I doubt very much if any criminal charges could ever be brought for that, because its not fraud, like getting 2 scripts in a short amount of time for the same complaint.
JMHO
Fabby, you are correct. Getting meds from a dentist would presumably be for a different condition, which is perfectly legal. However, it still may be a violation of your contract if your PM Doc doesn't permit controlled substances from other medical professionals. But.....Most PM Docs would permit it assuming they were told up front. Sharing information is the key.
I really think more and more doctors are just treating all patients the same, that saves them from having to guess which new patients might be trying to pull a fast one and which are not, and its better to know up front whats expected, imho.
Yes, I think you are correct. Having SOP makes sense for the Doc. Additionally, I'm actually very pleased that Docs have gotten strict because it protects the Doc, the practice, and all the patients. If a drug seeker / abuser / diverter infiltrates your Doc's clinic, that person could threaten everyone involved by potentially putting the clinic @ risk, and shutting it down. Then, where would you be?
Many probably don't share the same opinions as me, but I think it should become standard practice that all PM patients be given a drug test @ EACH appointment. UAs can be cumbersome, time consuming, and less reliable......Whereas blood tests are deadly accurate. It would literally take less than 2 minutes for a nurse to draw a quick vial of blood @ each appt. This would weed out lots of abusers, thus, leaving us honest patients left to receive the care we deserve. Just a thought.
I would have no problem ever giving a blood or urine specimen if I had a pm doc who required it, but the doctor shopping thing has always bothered me.
I went to 3 or 4 docs when trying to get a diagnosis, never came out really & ask for meds, at one time I did ask for something to keep me calm when my heart rate would go on the war path, but never pain meds. Heck did not even know what was out there for pain. When I joined here & started reading I discovered it could very easily look like I was doctor shopping when I did not even know the term existed. Till this day that bothers me, I feel you have the right to get help you are paying for & deserve, & my family insisted that I go to doctors till I found one that would finally try to find what was going on, & indeed get me the heck out of that pain. But to anyone looking at the amount of doctors I believe 3 different in 8mnths can't look to good.
I would definantly try to clarify the "sent people to jail "if you intend to see this guy. I would think if you used illegal drugs maybe. Have to break the law to be sent to jail, a contract is a contract not a law, who ever he sent or help to send to jail did more then violate a contract.
Mistakes happen, its come up on this board even so I sure would just make sure you understood. I would have no problem signing a contract & once again with drug testing but hey I would make sure I understood everything & recieved a copy of any contract signed. Can't blame doctors for trying to protect themselves & if they are doing their job you wont have need for any other pain meds, but at the same time be careful that you understand anything you are signing. Sammy
Hi all and thanks. I just this morning found out that the dr I am going to was involved with some sort of scandal involving dr's writing to many scripts. He was definetly investigated by dea. I feel for him but on the other hand it still has my nerves shot. It makes me go over every scenerio that I could get arrested for in my mind. About 3 years ago I did go to my family dr for headaches because the pm dr I had told me to go to my pcp for that. My pcp who has been my pcp for about 25 yrs wrote a script for me and said that should take care of it. I never asked him what it was but when I got home I discover it was the same pain meds as I was taking. Instead of writing a script for some type of migraine med he wrote it for pain meds. I didnt think it was a problem and nothing ever came of it. What I am sayinf is that I guess something like that could be seen as dr shopping. I have heard alot of people say they go to other dr's for there pain but I guess I was just having one of those blonde moments. It never really occured to me that it was against the law. I dont do it and I know what it says in my contract. I would nver go to another dr just out of fear that I would be dropped. I just never thought that it was illegal and that somehow a dr could have u arrested for it. I have never heard of that happening to anyone. It scares me to think that one little screw up could send someone to jail. Whew things are getting tough for us guys. I think from now on I will have to pay more attention to whats going on with my scripts. As much as this dr scared me he hadnt done a urine check on anyone that I could tell. They go in for about 5 minutes then there out the door. I remember way back when... I never had a case of nerves about going to the dr like I do now. I think its ashamed that I have to be affraid to see my doctor never knowing what might happen. I remember one time about 3 or 4 years ago a lady was arrested as soon as she walked out of my old doctors office. I dont know why that happened but I just brushed it off. All this stuff just make me wonder how this system works. I wish I could find out more about it in order to protect myself. This makes me feel really mad that I am having to be affraid just because other people break the law. Now I have to be fearful of a paranoid dr. Thanks for listening and for helping me out here.
mshatch:
just make sure that you follow the pain contract to a T. If you don't have a copy of it, then get one. Also, before getting any scripts filled from another doctor, ask the pharmacist if they are scheduled(controlled substance) meds, then you will know NOT TO GET THOSE FILLED or you could get in trouble. Please be aware of scheduled meds including sleeping meds(ie Ambien), anxiety meds(xanax, klonopin, ativan), and even nerve pain med(Lyrica).
brian
Of course you could always look at the list of scheduled meds at the FDA governement site to be better informed.
I think there is very little chance of ever being arrested unless you have some clear pattern of using cash at different pharmacys and obviously trying to hide things, you were treated by one doctor for migraines, a whole new complaint from the regular one.
You still get your day in court, and I doubt very much if a DA would prosecute a case unless he had documents and statements showing you went from doctor to doctor, saying 'my left shoulder hurts, oxy is all that works.' and then paying cash for numerous oxy scripts at different pharmacys, all for the same complaint.
I doubt if anyone has ever done jail time because a ENT gave them a codiene cough syrup, or a dentist gave them vicodin, again, IMHO, you are at much higher risk for being booted out of a strict doctors practice than you are of 'accidently' going to jail.
Many PM contracts actually say right on them that we are NOT to use our pain meds for other pains that arise, such as dental. The key is 100% disclosure, I write my doctor a note explaining where when and why I saw another doctor, what was prescribed for me, and I always point out that I disclosed that I was under contract with him to the other doctor, thats all you can do.
It is scary, and while there is always a risk that someone will say, hey, explain this situation here, Its a huge leap from that to being prosecuted, believe me, there are plenty of people out there going to 10 doctors and who knows how many pharmacys, they dont need to waste their time arresting people for a record keeping error.
It does kind of point out why it helps us to stick to 3 pharmacys or less, that can help a lot if any questions arise.
Hey guys thanks for all the help. I am finally starting to calm down about it. Its has never been this hard for me but I guess times are a changing in the pm world. I appreciate all the info. I had no idea that that many meds were scheduled. I knew for the most part that the meds I take were scheduled. I even looked up info on what meds were scheduled. My family dr is 76 years old. I have to tell him over and over again that I go to pain management. If I didnt God knows what kinda stuff he would prescribe and best of all you cant read a word he writes. I really cant say thanks enough for all the help you guys have given me. The support here is outstanding. I cant believe how much better I feel.
