It appears you have not yet Signed Up with our community. To Sign Up for free, please click here....



Pain Management Message Board
Post New Thread   Closed Thread
LinkBack Thread Tools
Old 05-08-2008, 06:34 AM   #1
Senior Member
(female)
 
Join Date: Mar 2003
Posts: 118
Luvmypugs HB User
Question Doctor shopping question & new PCP question


Hi everyone. This post may be a long read so please try to help me out.
My first question is about Doctor shopping: I went to the pharmacy the other day to get a script and saw a sign about DS and I started thinking. I have seen several doctors since 1/08 who have given me pain meds (also antibiotics etc.) and not because I wanted to or went looking for different doctors. I first saw my OBGYN for extreme pelvic pain & bleeding and scheduled surgery, went to ER (first time ever) on 1/8 only to be told my appendix would have to come out that night, total abdominal hysterectomy 2/18, went to ER again on 4/3 because of severe vomiting, fever, nausea and HBP that had been going on over 24hrs, again went to ER on 4/5 with same thing and was admitted for a week due to severe food poisoning/bacterial infection, then saw my Ortho Doc last week for knee. Okay so during these past 4 months I have been on and off of pain meds, antibiotics, etc. Does this constitute as DS? I have really had a rough year and feel like I can't win for losing. I just don't want to be "labeled" as you all have talked about. I didn't ask for any of this to happen to me but it did.

I have not had a PCP for about a year and have finally made an appt with one I hope I will like. My question is, how do I approach this first visit? I have so many things going on with how I feel daily, aches, pains, no motivation but I don't know if unloading "all" my issues with a new doctor is right or okay. I have been able to retrieve my medical records from old PCP (no longer carries my insurance) and my Ortho doc that I will take with me. I am so frustrated with my Ortho doc right now over my knee. For those who read my previous post about the Talwin you know I just had an MRI which the Doc told me said I had a torn meniscus, my knee cap wasn't riding in the groove but lying on the bone and lots of fluid on the knee to which he gave me a cortisone shot, Darvocet (which is horrible) and wanted me to start PT 3 times a week. I called insurance to find out how much PT would be and they said my copay was $50 everytime I went. OMG I can't do $150 a week out of pocket for PT so I called yesterday and told the docs Coordinator that PT wasn't going to happen and if he wanted to do surgery or refer me to someone who would be willing to help me out with the pain then do it...I haven't heard back from them.

Now, besides my knee, Back in 2000 I had an MRI that showed I had a herniated disc and inflammation around my spine. I had a total of 9 epidural/caudal blocks which helped. In the past 2 years it has really been bothering me again but I did not tell my Ortho doc because if he won't help with the knee what makes me think he will help with my back!?! I have just been toughing it out and can't do it anymore. I have a very busy life. I have a child in kindergarten who is very active in soccer, school etc. I have a husband who works 12-13 hours a day so I'm basically a single parent . And I have 3 trips out of state coming up that I should be really excited about but because of the pain and no motivation I'm dreading this stuff. The thought of all the walking in the airports and while on my trips makes me almost cry.

So how do I approach the new PCP tomorrow? Should I tell her everything I just told you all and wait for her to turn blue and fall off her chair or be very conservative. My fear is she will think I only want pain medicine (which in reality would help alot) but I also want someone who will take into account all my other symptoms and help me figure out why in the past 5 years I have changed so much (physically and mentally).

Thanks for reading and any help would be greatly appreciated. I really look forward to hearing from you all. Have a great day

 
Sponsors Lightbulb
   
Old 05-08-2008, 06:51 AM   #2
Senior Member
(female)
 
Join Date: Oct 2006
Posts: 287
kim46 HB User
Re: Doctor shopping question & new PCP question

Hi,

I've been put in a similar situation by my insurance/RX department and my 20 year PCP's office manager accused me to doctor shopping (not true) and dealing my pain meds! I was furious last week; have calmed down but I'm reporting that doctor to the medical board.

I've done a timeline of medical visits and prescriptions which evidences why I was prescribed XYZ during X visit. I see my new PCP today and I'll let you know how it goes. The new PCP sugggested that I report my former PCP.

It's a fine line, I'm learning between being labelled and getting the care you need. I will only take pain meds from one doctor and use one pharmacy now.

Given what you have described above, I don't think you have anything to worry about but I too feel I've been "flagged" - my pharmacist said I haven't in my RX records. I think they're tightening down in my area due to the recent death of a movie star (at least that is what I was told by my PM doctor).

Good luck and I wish you well.

 
Old 05-08-2008, 07:00 AM   #3
Senior Veteran
(female)
 
Join Date: Oct 2004
Location: the DEEP S
Posts: 598
Blog Entries: 2
SpinalMalady HB UserSpinalMalady HB User
Re: Doctor shopping question & new PCP question

Hey Luv:

First about the Doc Shopping, I could be wrong (wouldn't be the first time ), but I think you had legitimate medical issues that have been documented (hopefully) and I think the DEA would be hard pressed to actually prosecute a case regarding DS. The fear we all have is "labeling" and having to defend our good names though, and it's a tough call as to whether or not someone will perceive your search for good, decent medical care as DS. Since you have your records in hand, I wouldn't worry too much about it. Make sure you keep a copy before handing anything over to the new PCP. JMHO.

Secondly, about the new PCP. My philosophy about great treatment from any health care provider is EXCELLENT communication. IF it were ME, I would tell the new PCP everything you just told us, provide them with a copy of your medical records, let them know that you have searched in vain for someone to help you in your situation. Let the PCP know how your pain limits your ADL's (Activities of Daily Living), and exactly what you cannot do because of the pain you are in. Let him/her know that it is not drugs you are seeking, but a quality of life, and are willing to do whatever (finacially reasonable) that will assit you to recoup that quality of life, or something as near to it as possible.

You may have to realize that some docs start of with other modalaties first to see if they help. If PT is NOT an option due to the co-pay, be sure to communicate that it is due to the financial hardship, and ask what other means you might be able to employ on your own, such as an exercise program or aqua therapy or something similar. This will help the doc realize that perhaps it's not only medication that you are after.

Unfortunately, when we enter into a new relationship with a health care provider, you have to realize that they don't know us from Adam/Eve. Therefore, our actions HAVE to speak louder than words to show that we are willing to participate in EVERY way recommended to earn whatever trust that particular physican feels he/she deserves. It's unfortunate, but with so much abuse/diversion and with the stringent DEA regs out there, there just aren't a lot of health care providers who are willing at a first meeting to just say, "Here take this and call me in 6 months...." or something similar and frankly I don't know a lot of CP'ers who would want that anyway. (Mind you, I'm not saying you are!) They just aren't willing to risk their practice over a first time meeting and even a transfer of patient records to let's say prescribe a strong dose of something unless the patient is shown to be terminal.

That's just my humble opinion. Hope that it helps some. And I hope you can find some help with this new PCP. Much luck.

~!~ Becky ~!~
__________________
\lm/ = "I Love You" in Sign Language

12/10/04 MicroD & Hemi Lami 100% Success
09/05 Re-injured post Katrina
06-07 In Pain Mgmt. trying to deal
3/9/07 2 Level PLIF due to CES

 
Old 05-08-2008, 07:05 AM   #4
Inactive
(male)
 
Join Date: Jan 2008
Posts: 4,017
Executor HB UserExecutor HB UserExecutor HB UserExecutor HB UserExecutor HB UserExecutor HB User
Re: Doctor shopping question & new PCP question

I think you have a very unique situation, especially given the ER visits for appendix and etc. What kind of pharmacy do you use...An independent or chain? Also, is the same pharmacist there all the time (or most of the time) or do they rotate heavily?

The reason I ask is because depending on your answer, I think I would be proactive and ask to meet with the pharmacist @ some point and sit down and explain what's happened to you and be upfront and say you saw the sign and didn't want them to think bad of you....Tell them that there is always "exception" or outliers and you seem to be one...That you've had a very unique streak of bad luck lately with the knee, appendix, OBGYN issues. I would explain in great detail....The sudden ER visits for appendix and etc account for much of it and are powerful.

The reason I suggest this strategy is because all it takes unfortunately is one phone call and all of a sudden your life is a living hell....All b/c of some hot shot pharmacist or whatever. Then, you've got to explain your way out and backtrack to all the Docs & etc....Not to mention few medical personnel will want to deal with you due to the stigma. Maybe the sign on the door is their way of letting everyone know what's coming as a warning so they don't have to call anyone and if someone is stupid enough to continue, they've been warned. However, I do think you have a unique situation.

I'd also try to get my new PCP to "coordinate" all my medical care. Tell her that you've decided to seek out a PCP because you seem to be having all of these issues and these different Docs are tough to deal with and you need someone to be air traffic control....Stress that you need someone to coordinate things. Explain to her that things have been spiraling down lately and prior to all these issues, you just didn't have time or think about getting a new PCP. However, your health has since declined and now is the time. I would stress that you're in this boat due to insurance issues (argggg).

You can't be accused of Doc shopping if you are seeing Docs for different conditions and they know about each other. Doc shopping is getting narcotics from different Docs for the same or near same condition and each don't know about the other(s). I think you're in the clear, but again, I'd try to be somewhat proactive....You know how the cliche goes...A ounce of prevention is worth a pound of cure. If that "call" is ever made, the first thing law enforcement or the pharmacy will do is find out if the scripting Docs know about the others, if the answer is "yes", it's case over. If "no", then all hell breaks loose...At least initially until things can be cleared up...Hopefully.

Lastly, how did you pick out this PCP? Is she patient / treatment friendly? If you really think you need some good care...Someone is really going to listen & help, make sure you've done your homework.

Good luck and I think you're on the right track.

Ex

Last edited by Executor; 05-08-2008 at 07:09 AM.

 
Old 05-08-2008, 07:53 AM   #5
Senior Member
(female)
 
Join Date: Mar 2003
Posts: 118
Luvmypugs HB User
Re: Doctor shopping question & new PCP question

Quote:
Originally Posted by Executor View Post
Lastly, how did you pick out this PCP? Is she patient / treatment friendly? If you really think you need some good care...Someone is really going to listen & help, make sure you've done your homework.Ex

Executor: Thank you so much for your valued input. I didn't research this doctor. I didn't know how. I basically went through the phone book and chose her. But, I did first try my sisters PCP because she loves her but she was not taking new patients. Then, I tried my mom's PCP (who is in the same practice as the one I'm seeing tomorrow) but he is not seeing new patients either. I chose this doctor because she is young and female (last PCP was a man) and I thought a female would be more compassionate . So no I didn't do my homework because I didn't know where to start.

As for a pharmacy, I use Walgreens and they do have several pharmacists but there is one that I have made friends with and he's about my age, very nice guy.

What should I take with me tomorrow to see the new PCP? Should I document anything about my health, symptoms etc. before I go and take it with me? I just have such high hopes of finding the "right" doctor!!!

Take care

 
Old 05-08-2008, 07:57 AM   #6
Senior Veteran
(female)
 
Join Date: Feb 2008
Location: NY
Posts: 1,884
cmpgirl HB User
Re: Doctor shopping question & new PCP question

LMP, I absolutely agree with what's been said so far. You have had an awful run of bad luck and unfortunately as this board indicates, bad things do happen to good people, far too often. I think you have legit reasons for all that has happened. It didn't help that you had a crappy PCP. They are definitely the ones who are supposed to be coordinating all of your care, whether they provide it or a specialist does. Just be honest with this new PCP and write it all down, before you see her, so you have a more detailed timeline. The more info you provide for her, the better she can get things straightened out for you. Also, bringing the records you have, is always a good idea.

Take good care and let us know how it's going. I will be sending good thoughts your way. Hang in there, OK? It sounds like you're on the right track. cmpgirl

 
Old 05-08-2008, 09:16 AM   #7
Senior Member
(female)
 
Join Date: Oct 2006
Posts: 287
kim46 HB User
Re: Doctor shopping question & new PCP question

Hi again, I've just returned from my new PCP visit and he is great. He advised me to report my former PCP to the medical board in my area, gave me the number and said that it was inappropriate for him to discharge me given that I had provided full disclosure to him, his nurses, etc., all evident in my medical records.

Phew. My new PCP will coorindate my various doctors. I feel like a huge weight has been lifted from me. There are good doctors out there and given everything you have been through this year, I don't see how it can be construed as DS. I brought a document recapping my various dr. visits, RX's, etc. but my new PCP didn't want to see it - the fact that I was upfront and straight up with him was sufficient enough and "refreshing" (his word).

Good luck - I'll be looking for your update.

 
Old 05-08-2008, 09:26 AM   #8
Senior Member
(female)
 
Join Date: Mar 2003
Posts: 118
Luvmypugs HB User
Re: Doctor shopping question & new PCP question

Quote:
Originally Posted by tarajb View Post
Hi, I've been put in a similar situation by my insurance/RX department and my 20 year PCP's office manager accused me to doctor shopping (not true) and dealing my pain meds! I was furious last week; have calmed down but I'm reporting that doctor to the medical board.

What exactly happened if you don't mind sharing? Did your insurance think you were filling too many scripts? And why would your PCP have any reason to accuse you of such? If you don't want to enlighten I'll understand. I guess I just don't understand why doc's and insurance do such things.

Take care

 
Old 05-08-2008, 09:44 AM   #9
Senior Member
(female)
 
Join Date: Oct 2006
Posts: 287
kim46 HB User
Re: Doctor shopping question & new PCP question

Hi LMP, I have no problem sharing.

My former PCP has prescribed Vicodin to me periodically over the last 5 years for migraines, endo, back pain, etc. I injured my back and in May 2007 I visited a back doctor. I have been in physical therapy since then and the back doctor prescribed percocet in addition to the Vicodin I was receiving from my then PCP. At my next PCP visit I disclosed to his nurse and to the doctor himself that I had been to a back doctor and was prescribed percocet for flare up of my back pain (Chronic Lumbar Strain).

Because I was prescribed the brand versus generic, my insurance company sent a letter to every doctor (4) I had seen in 2007 listing all prescriptions I had received, including innocuous things such as an antibiotic. I am also on Lexapro and Chantix (was) and suffered a really bad interraction between the meds - I had a 72 hour migraine, felt like I was on an acid trip - it was awful, the heightened anxiety, pacing the carpet, no sleep. Right in the midst of this I received a letter in the mail from my PCP that he was discharging me because I had violated office policy (I've never seen his "office policy") and I've always been upfront and honest about my RX. I have a PPO and can see whatever doctor I need to but I have always taken advice from my PCP and/or a referral.

In January 08, I asked him to run blood work on me as my back doctor wanted to know if I was diabetic. I'm also suffering from some peri-menopause and really want HRT therapy versus anti-depressants. He gave me the blood work up sheet and said "mark up the sheet for the hormones you want me to review"..........what??

I relayed all of this to my new PCP today. He can't believe the manner in which my 20 year PCP treated me. He said at the very least he should have called me in for a face to face. I took the letter to my former PCP, not knowing what rule I had violated and his receptionist called me a "drug dealer and if I wasn't dealing my drugs then I was an addict and needed help". She said this in front of a full room of patients and in front of 5 members on staff. I was humiliated. I kept my cool and said "ok, I won't take any more scripts for Vicodin from the doctor but I still need a PCP as I'm suffering a severe reaction to the Lexapro and Chantix". Despite the letter I received saying he would see me for emergencies until I secured a new PCP, he refused to see me and/or to return my calls. It's called "patient abandonment" per the new PCP and I may even contact a lawyer about the matter - I was so embarrassed, humiliated, I cried for 10 days. Thankfully my husband is a rock and said "he can't just treat you like that and who the hell do they think they are calling you a drug dealer", etc.

I also called my insurance/RX department. They insist that I take generic version of all meds. I'm not sure if the cost of my meds prompted the letter in addition to receiving Vicodin from my PCP and percocet from my back doctor. My insurance company recorded my call and I asked them if they would prefer that I have back surgery at $50K.........

It's been a difficult 10 or so days but I am feeling 100% better today because I managed to find a new doctor who understands that I require pain medicine and other things such as bloodwork to see where my hormones are lacking or over-abundant. I've researched HRT for 2 years now and started weaning off the Lexapro. I stopped the Chantix immediately and the new PCP wants me to start Wellbutrin tomorrow which will help me quit smoking in addition to helping me get through this stage I'm in with peri.

I hope I've answered your questions. Please feel free to ask me anything and I will be looking for your update.
Best wishes,

 
Old 05-08-2008, 10:02 AM   #10
Senior Member
(female)
 
Join Date: Mar 2003
Posts: 118
Luvmypugs HB User
Re: Doctor shopping question & new PCP question


I'm so glad your visit went well. Did your new PCP help you out with your pain meds? I'm just very leary of going to the new PCP. Who knows maybe I'll have good luck but I'm not getting my hopes up.

You may have posted earlier about your problems but may I ask what your primary complaint is? Have you had tests or did the new PCP do any tests to determine what all might be wrong? If you've already posted this, just lmk, sometimes I overlook things .

Take care

 
Old 05-08-2008, 10:21 AM   #11
Senior Member
(female)
 
Join Date: Oct 2006
Posts: 287
kim46 HB User
Re: Doctor shopping question & new PCP question

Hi again, no problem regarding questions as it also give me pause to reflect on the last 20 years of various medical conditions and RX'.

My new PCP didn't give me any pain meds because I'm getting pain meds from my back doctor. I find the Vicodin to be better than the percocet in that the percocet make me feel nauseous (sp) but I don't want to self-medicate (a slippery slope the last 2 years for me as I've taken care edited to say family members versus the detail I provided for each family member lost to cancer); The doctor asked me if I needed pain medication in addition to the percocet (eg continued Vicodin) but I declined. While I am in PT and visiting my back doctor I will take meds from him and him only and I signed a contract this week to that effect.

My back doctor also said that my PCP should not have dropped me like that. All he had to do was call me in, review (again) my history and I would have immediately stopped the Vicodins. I should probably be on a long acting pain medicine but for now I'm going to follow back doctors treatment plan but coordinate this treatment with my peri treatment via a new PCP.

My primary complaints as of 2008 is Chronic Lumbar Pain followed by endo, migraines and a very bad time with peri-menopause issues (hot flashes, sweats, sleep issues). I've suffered from endo for almost 10 years and migraines are new to me - they started in 2002.

Do you need your PCP to provide your pain meds? There are PCP's willing to prescribe for Chronic Pain but it's not an easy road for many from what I've been reading on these boards.
Best wishes!

Last edited by kim46; 05-08-2008 at 10:44 AM. Reason: condense info on family members

 
Old 05-08-2008, 01:50 PM   #12
Senior Member
(female)
 
Join Date: Mar 2003
Posts: 118
Luvmypugs HB User
Re: Doctor shopping question & new PCP question

Quote:
Originally Posted by tarajb View Post
Do you need your PCP to provide your pain meds? There are PCP's willing to prescribe for Chronic Pain but it's not an easy road for many from what I've been reading on these boards.
Best wishes!

I really would like for someone to provide me some relief. I have no one to do this. The only docs I see are my OBGYN and my Orthopaedic Doc. OBGYN doesn't prescribe any meds except my hormone and blood pressure patches and Ortho doc only wants to give me Ultram or Talwin and neither really help. I guess that is part of the problem with my expectations from the new PCP. I'm afraid when I tell her all that's going on with me and what I've been through this year she still won't offer any meds and I've been through so much that I know meds are one of the only things that truly will help me. I am open to any other suggestions but I am tired of suffering. I'm just going to go in there with an open mind, be totally honest and hope for the best. That's all I can do right?

Take care

 
Old 05-08-2008, 04:49 PM   #13
Senior Veteran
(female)
 
Join Date: Feb 2008
Location: NY
Posts: 1,884
cmpgirl HB User
Re: Doctor shopping question & new PCP question

LMP, You are absolutely right. That is exactly the approach you should take. Just keep in mind, that some PCP's will do pain management for their patients, and others prefer to refer them to a pain management specialist. It isn't that they don't understand your needs, per say, but they may just prefer to do general practice.

I think the first thing you should explain to her is that you are open to whatever methods there are available to help give you pain relief. That way, she isn't going to assume you are just looking for her to prescribe. Most docs just want honesty from their patients and your history, as you've described it here, does not make you sound like a drug seeker or addict at all. Just a person who has constant pain and wants whatever will help that pain.

Good luck. I'll be sending good thoughts your way. cmpgirl

 
Old 05-08-2008, 06:39 PM   #14
Inactive
(male)
 
Join Date: Jan 2008
Posts: 4,017
Executor HB UserExecutor HB UserExecutor HB UserExecutor HB UserExecutor HB UserExecutor HB User
Re: Doctor shopping question & new PCP question

Quote:
Originally Posted by Luvmypugs View Post
Executor: Thank you so much for your valued input. I didn't research this doctor. I didn't know how. I basically went through the phone book and chose her. But, I did first try my sisters PCP because she loves her but she was not taking new patients. Then, I tried my mom's PCP (who is in the same practice as the one I'm seeing tomorrow) but he is not seeing new patients either. I chose this doctor because she is young and female (last PCP was a man) and I thought a female would be more compassionate . So no I didn't do my homework because I didn't know where to start.

As for a pharmacy, I use Walgreens and they do have several pharmacists but there is one that I have made friends with and he's about my age, very nice guy.

What should I take with me tomorrow to see the new PCP? Should I document anything about my health, symptoms etc. before I go and take it with me? I just have such high hopes of finding the "right" doctor!!!
If there is one pharmacist that you have befriended, then I would think seriously about approaching him. Even better if he's the PIC....Pharmacist in charge. There's one @ each pharmacy. He can dictate who does what. Covering your bases with him would be preventative medicine, no pun intended.

Re: your Doc, I would use tarajb's idea and construct a nice & easy to read timeline. You have to remember that she will be coming from ground zero....No knowledge of you or your background. I would be sure to mention that you have family attending this same practice and that you're in it for the long run.

Again, I would emphasize that as your health has started to deteriorate, you need someone who is really caring and will coordinate everything....Your air traffic control tower. Cmpgirl is correct....Some GPs handle the pain, while others refer patients to PM. I would ask what her philosophy on the subject. I would NOT mention anything about being concerned about Doc shopping or anything like that....Not the way you want to enter into a new arrangement. At this point, you haven't been accused of anything....In fact, there's no "need" to talk to the pharmacy, unless you want to be proactive. Your call.

Also, if you don't get a good feeling from this new Doc, you could always pick a new one....I wouldn't "settle" for just any Doc...It's not that big of a deal to interview other Docs if this one doesn't gel with you.

Good luck and I think it will go well.

Ex

 
Old 05-09-2008, 06:13 AM   #15
Senior Veteran
(female)
 
Join Date: Dec 2006
Location: western us
Posts: 7,267
ms_west HB User
Re: Doctor shopping question & new PCP question

LMP, I actually chatted with the receptionist at my doctors office who I got along with well with when my gp left. He was taking care of my pm and I was scared out of my mind. She told me to go with this doc, my current doc, and not the others in the practice because they would not do prescribe chronic pain patients. Is there a nurse that you get along with well or a receptionist that you could ask this question to?

Last edited by ms_west; 05-09-2008 at 06:14 AM.

 
Closed Thread

Similar Threads
Thread Thread Starter Board Replies Last Post
Too many refills - cut off by doctor cardfan1188 Addiction & Recovery 5 11-16-2009 11:29 PM
How to go about getting a New Doctor??? ChronicCyst16 Open to All Other Health Topics 4 10-28-2009 04:12 PM
Question on doctor shopping don'tlikecold Addiction & Recovery 1 02-09-2007 06:27 AM
Obsessive shopping & a little about me & my OCD! AngelOfLight82 Obsessive Compulsive Disorder (OCD) 6 04-29-2006 07:54 AM
The Twins --with hope, relief--and some fear--have a Suboxone Doctor's Appt. Tuesday Twinlynn Addiction & Recovery 34 12-08-2004 08:57 AM




Thread Tools

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is Off
HTML code is Off
Trackbacks are Off
Pingbacks are Off
Refbacks are Off




Sign Up Today!

Ask our community of thousands of members your health questions, and learn from others experiences. Join the conversation!

I want my free account

All times are GMT -7. The time now is 07:57 AM.



Site owned and operated by HealthBoards.comô
Terms of Use © 1998-2014 HealthBoards.comô All rights reserved.
Do not copy or redistribute in any form!