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Old 11-09-2008, 09:00 AM   #1
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eddieJ85 HB User
Patient rights question..

Didn't know where else to post this, but since it has to do with PM I thought I'd do it here, have a question about patient rights and what doctors can/can't do.

Quick summary first, I'm 23, in the last 4-5 years I've had 3 major back surgeries(last one was a fusion) and various minor surgeries/procedures/ and tests. Problem is still on-going, despite running out of insurance.

Anyways, I ran out of insurance a while ago, yet the problem persisted so I eventually ended up going to the ER/fast track for meds. Now when I say ER, I don't mean a place where people come in bleeding and and injured, most people were there just for meds, like me, they even gave me a limited liability card so my meds and visits were free, so I'm not sure whether to call it more a free clinic, but yeah. Long story short I went to this place every now and then when I needed medication. This was a county hospital, they eventually gave me a referral to another hospital in the same county because this hospital had an actual pain clinic. To make it easier lets call the first hospital I went to A and the one I goto now for pain management B.

I began seeing a pain doctor at hospital B, and have for the last several months. Obviously I was given a drug test at least once during these times.

I passed my drug test, but my question about patient rights is..can a doctor share your results(good or bad) with other doctors?

Reason is I was recently in a small accident and had to go visit the ER, however at the time I was much closer to hospital A rather than B. Anyways I went and waited, they took x-rays etc. concluded there was no serious harm. I asked them for anything they could give me to help with the pain, even a small script, as it wasn't another few weeks until my next PM appointment and this was a friday evening, meaning I couldn't even get ahold of my doctor until monday.

Anyways, the doctor there did give me a small prescription of tylenol with codeine, however he made a comment that if I hadn't passed my drug test, he wouldn't of been able to give me it.

Now, here is the thing: I never once took a drug test at that hospital, the ONLY test I ever had done there was x-rays. So I have to conclude that he got the results from the doctors at hospital B. I obviously know that any doctor could tell another doctor about test results if he so desired, but I thought that they couldn't legally share that info with other doctors unless you ok it?

Now I don't care if they know I passed a drug test, but to me I want to have a doctor who doesn't do anything shady, and if you are indeed not allowed to tell other doctors the result of drug tests..well I'd consider it a bit shady, and then I begin to wonder if I'm with the right doctor..

So, I guess that is my question, can doctors legally do that? Can they put information like that in my medical records? Something like "not a druggie passed test" or something? I always thought that doctors could not do that.

Does the fact that even if the various doctors were at different hospitals..but both were in the same county..does that give them some sort of right to share that information with each other?

Or, is it because I am limited liability..would that give them the right to do that? I did first get the card at hospital A, and it was able to be used at hospital B as well(of course I eventually had to update it). So when I had to goto the ER at hospital A I gave them my liability card, which has my medical record number on it, and since it was after 5pm on friday, I highly doubt this random doctor went and called my PM doctor, so then that means this information was in my medical records itself.

Sorry for sort of rambling and this being a bit long..but is this legal? Or should I say something to the doctor next time I see him?

Last edited by eddieJ85; 11-09-2008 at 09:03 AM.

 
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Old 11-09-2008, 08:16 PM   #2
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lfoster21 HB User
Wink Re: Patient rights question..

The info. should have been in your medical file. I know that when I began with Pain management, I was told that if I were to do anything to make the Dr. think I was abusing the drugs (and they had a list of things that I was not allowed to do), it would be in my permanent records (along with all my other medical history). An example that he told me was if I called in for a refill and I am out of my pills a week too early, that would be a red mark in my file. Then, no other Dr. or the ER, would be allowed to px. me any narcotics. I hope that all makes sense . In short, I would guess that the info. about your drug test, was in your permanent medical file. They have to have this system, other wise people would hop from Dr. to Dr. and from ER to ER, in order to cont. to get meds.

I hope this helps you.

Lorie
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Last edited by lfoster21; 11-09-2008 at 08:18 PM.

 
Old 11-09-2008, 08:36 PM   #3
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Executor HB UserExecutor HB UserExecutor HB UserExecutor HB UserExecutor HB UserExecutor HB User
Re: Patient rights question..

Sorry to hear about your troubles. I hope you start to feel better.

I have to admit that it was kinda hard to follow your story. However, I will say that you are walking on shaky ground. Do you have a pain contract? If so, it drives everything. If not, then you have more leeway, but are still obligated to follow certain protocol. In general, pain patients are to avoid obtaining meds from different Docs, especially for the same condition. Even "different conditions" are in question because it means obtaining pain meds. This is why a "contract" is provided by most pain Docs.....They stablish ground rules for the patient, or outlines the expected behavior of the patient.

Quote:
Originally Posted by eddieJ85 View Post

So, I guess that is my question, can doctors legally do that? Can they put information like that in my medical records? Something like "not a druggie passed test" or something? I always thought that doctors could not do that.

Does the fact that even if the various doctors were at different hospitals..but both were in the same county..does that give them some sort of right to share that information with each other?
It's hard to know exactly what's going on without more detail. However, if the offices / hospitals are part of the same regional / national medical network, then all the records are accessible. For example, national organizations will often own multiple hospitals and physician offices.

Additionally, your state may have some type of prescription monitoring program. For example, in Virginia, all controlled Rxs are entered into a database that can be accessed by any physician, hospital, or pharmacy at any time. Many states have implemented some sort of prescription program.

Honesty is the best policy, and you should inform your pain Doc of any Rx you obtain. The fastest way to be dropped by a physician is for a patient to be accused of Dr shopping. ER's in particular, have implemented systems to guard against drug seeking behavior for this very reason.

I hope you begin to feel better.

Last edited by Executor; 11-09-2008 at 08:39 PM.

 
Old 11-10-2008, 05:16 AM   #4
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ozzybug HB Userozzybug HB Userozzybug HB Userozzybug HB User
Re: Patient rights question..

I can only add that my PM doctor forwards my medical information/notes and such to my primary care physician and vice versa. My primary care doctor was the one who referred me to PM, so I guess because of that, my PM sends copies of the notes from my appointments and such to my primary. I don't know if this is standard everywhere, but that is what happened with me. It doesn't bother me that this happens because now my primary care doctor knows everything going on with me and the meds I take so it helps him to treat me for other things (sinus infections, other sicknesses) without giving me any kind of med that will have a bad interaction with the meds from my PM doctor. (I have to note that I don't receive any kind of opioid med from anyone other than my PM doctor)

It could be that because hospital "A" referred you to hospital "B" for further treatment, hospital "B" now forwards copies of your records back to hospital "A".

I don't think it sounds like anything shady is going on, but I also agree with Ex in that you really need to let hospital "B" know that you were treated after your auto accident by hospital "A" and also let them know you were given a scrip for the tylenol w/codiene. Especially if you are under a pain contract.

Take care & good luck!

Last edited by ozzybug; 11-10-2008 at 05:18 AM.

 
Old 11-10-2008, 01:02 PM   #5
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eddieJ85 HB User
Re: Patient rights question..

Quote:
Originally Posted by lfoster21 View Post
The info. should have been in your medical file. I know that when I began with Pain management, I was told that if I were to do anything to make the Dr. think I was abusing the drugs (and they had a list of things that I was not allowed to do), it would be in my permanent records (along with all my other medical history). An example that he told me was if I called in for a refill and I am out of my pills a week too early, that would be a red mark in my file. Then, no other Dr. or the ER, would be allowed to px. me any narcotics. I hope that all makes sense . In short, I would guess that the info. about your drug test, was in your permanent medical file. They have to have this system, other wise people would hop from Dr. to Dr. and from ER to ER, in order to cont. to get meds.
See, thing is, that has happened to me before. Immediately after my fusion, I was on oxycodone for a bit and I went through several refills, running out too early 2-3 times..and I never heard a word about it, and was able to still get refills from the PM doctor and eventually from my surgeon once I stopped going to PM for a bit.

Last edited by eddieJ85; 11-10-2008 at 01:03 PM.

 
Old 11-10-2008, 06:43 PM   #6
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lfoster21 HB User
Re: Patient rights question..

You'd still be allowed to get refills from you PM dr. or your surgeon, if he agreed to do so, but you would be watched much more carefully and would not get your scripts filled as early etc. The 1st few times that you run out early, could be legit. So, the Dr. would not necessarily say anything to you...but they would be watching you carefully, to see how often it happens. The more it happens, the more control they would keep over you and your meds. If it cont. to happen, they can refuse giving you the meds. and it would be difficult to find other drs. who would then take over your meds.

I don't remember where you live, but I am in VA, and that is how they do it where I am.

Lorie
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Last edited by lfoster21; 11-10-2008 at 06:47 PM.

 
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