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Old 10-09-2012, 01:51 PM   #1
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How often should a doctor give a complete physical exam to someone on Pain meds

For those who are taking narcotic pain meds, how often do you go in for a complete physical exam? Are doctors who have patients on narcotic pain meds supposed to be more diligent about requiring their patients to have regular physicals?

It's been an extremely, extremely long time since I've had a physical (you would fall over if I told you how long it's been), and my family doctor (who prescribes my narcotic pain med) has never mentioned having me make an appointment for a physical. When I spoke to family members about how long it's been since I've had a physical, they were appalled. I never knew until now that people my age have a physical anywhere from every 1 to 3 years. I would think that a doctor would especially want to give a physical to a patient who he prescribes narcotics to, right? And when I've made appointments to be seen for feeling sick, he's never had me wear a gown and has never examined me.

What do you all think? Obviously time to look for a new doctor to get better care. I miss my old doc that had retired many years ago...he was superb!

 
Old 10-09-2012, 02:11 PM   #2
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Re: How often should a doctor give a complete physical exam to someone on Pain meds

To be honest, I've been in PM for most of my 54 years (since mid-20's, give or take) and I've never had a pain specialist have me get a physical. I believe there's an assumption you're being seen by a GP and they are the one's responsible for Rx'ing a physical exam. Specialist are just that, and I don't know of any personally that ask you take have a physical. Just my two cents but I'd ask my GP about one if I were you. Good Luck!

 
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Old 10-09-2012, 02:31 PM   #3
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Every year since age 55

I also have and take meds for BP ang other cardiac problems. My Primary Care Physician does a complete every year plus complete blood analysis every six months. PM doc only asks if my PCP is regularly looking at my blood work with the pain meds in mind. PM does want me to update him every visit as to any other Rx changes including OTC meds and nutritional supplements.

 
Old 10-09-2012, 02:40 PM   #4
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Re: How often should a doctor give a complete physical exam to someone on Pain meds

Hi there...

A few quick questions...you say that this is your "family Dr."...but then you mention your Dr. who retired years ago...

How long have you been seeing this new Dr.? And what type of Dr. is he (his speciality)?

If you came to him to take over your PM a few years ago...then I'm thinking that he probably feels you are being cared for by another Dr. for regular issues and he is just doing your PM.

However...if he is just a Primary/General Practioner....then as mentioned by Whoopee...all you have to do is to tell him you want a physical...simple as that.

But if his speciality is PM...then that is not part of their practice. I've been seeing my PM for 6 years now and he would never think to do a physical. He knows that I have a GP for this.

In regards to being on opiates and having a physical...there really isn't any correlation and something that is required.

The only thing to really monitor is if you have been on a short acting medication that has Acetaminophen in it. If you have been on this for years and have any concerns about your liver...then you can request a blood test be done (liver panel)...But again, if they aren't a GP...they may request you get that ordered by a GP instead.

 
Old 10-09-2012, 04:40 PM   #5
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Re: How often should a doctor give a complete physical exam to someone on Pain meds

To answer some questions:

The doctor who prescribes my pain med is a family doctor (general practitioner), and he's been my doctor for over 20 years. I became injured in the last decade, so he was already my doctor when I got injured. I don't have a pain management doctor. I have been to many specialists who told me that they do not know how to handle chronic pain. So somehow my family doc ended up prescribing my pain med. I mentioned my former GP because he was a remarkable doctor who took great care of me, unlike this one doesn't examine me at all when I'm sick. I'd love to find a doctor like my former one.

Thanks for the answers. I didn't know whether doctors wanted patients who are on pain meds to receive regular physicals.

 
Old 10-10-2012, 08:31 AM   #6
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Re: How often should a doctor give a complete physical exam to someone on Pain meds

I dont really think it's the PM specialist job to do a complete physical exam. If he is prescribing something that requires blood monitoring or that may have other side effects that need to be checked, For instance, if your PM is prescribing testosterone, then he should be checking your T levels, Estrogen levels and prostate function and do a cbc as T can cause an increase in red cells and krit levels. But as far as turn your head and cough type physical, That's what a GP is for or if your a cardiac patient the cardiologist will do a cardio work up every 2 years even if I'm stable, but it's not a general exam, it's specific to my cardio issues.

As far as how often do you see the actual PM doc verses a NP or PA in a PM group, My group requires a doctor oversight apt at least once a year even with stable patients that haven't or dont require med changes. I've been seen at this practice for over a decade and never had a single issue as far as UA or pill counts, etc. Ive earned the privlidge to only be seen every 3 months through years of absolute compliance with the contract and other office regs. I'm seen by a NP 3 times a year and see one of the actual docs once a year. If I have any other health issue, I go to the appropriate doc. I do have a GP, however I see my cardio, PM doc and Hemotologist/oncologist far more often than my GP. I think the last time I saw my GP was for a physical prior to having my pump changed 2.5 years ago. That was required for surgery. I kind of look at it as I have enough wrong with me that I'm not in a hurry to go looking for new things to treat or reasons to see another specialist any more often than I already do. Of course if you feel it's time for a comprehensive physical or wellness exam, by all means follow up with your GP. If he finds anything unusual, he will have no problem pointing me in the right specialists direction or an existing one I allready see.

My first visit with the PM doc was a very comprehensive exam pertaining to my pain issues but anything else simply isn't his responsability IMO and my PM docs. If I mentioned an allergy problem or anything not pertaining to CP he would recomend seeing my GP just like any of my other specialist would if I brought up an issue that didn't relate to why I was seeing that particular specialist.
Good Luck, Dave

 
Old 10-11-2012, 04:21 AM   #7
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Re: How often should a doctor give a complete physical exam to someone on Pain meds

I see a nurse practioner once a year in my doctors office for all that fun female stuff. She does a full physical knowing I only see the doctor for medications, and injections.

 
Old 10-11-2012, 07:47 PM   #8
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Re: How often should a doctor give a complete physical exam to someone on Pain meds

chronic pain sux. How were you injured by the way?. Is it the your neck?

 
Old 10-12-2012, 12:24 PM   #9
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Re: How often should a doctor give a complete physical exam to someone on Pain meds

Hello-

A yearly physical is a bit of luxury these days. Many of us need to wait until we are actively ill, and then we seek out care for that specific instance -and that's with health insurance. Without it the bar gets raised even higher before seeking medical care from an ED. Is there some ailment that you feel will be uncovered by having a general exam? Unless requested I don't think most doctors will go ahead and do a general physical -and bill the patient for that time, without the consent of the patient, right?

 
Old 10-12-2012, 05:53 PM   #10
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Re: How often should a doctor give a complete physical exam to someone on Pain meds

I agree that nowadays we need to be our own advocate and ask about things such as this. Most of us are seeing specialists that will keep track of our bp, weight, maybe listen to our lungs, etc, but if it hasn't been done recently, at least getting basic blood work every year is a good idea. Another thing adults often forget is vaccinations. They aren't just for kids. Other tests are by age and gender.

I know for women a lot of gyn doctors keep in mind that their patients may not see a doctor otherwise for preventative care, so may do some general checkup sort of stuff. Mine asks me random health questions such as if I always wear a seat belt or binge drink lol. I have a primary doctor I see quite often, but haven't got a true check up from him...I'm always coming in for a health issue. I might have to ask about this. For one I'm probably due for some blood work.

I don't think its a pain doc's responsibility to check that a patient gets a physical. Its more if they prescribe something that requires follow up tests such as blood work, or if they spot something they think you should follow up on (mine referred me to a sleep specialist, psychologist, acupuncturist, and more). Best wishes.
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Old 10-12-2012, 08:58 PM   #11
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Re: How often should a doctor give a complete physical exam to someone on Pain meds

My pm doctor doesn't give complete physicals. He just takes blood to check to see if medication is effecting my liver in anyway. He will also do an EKG to see if any damage has been done to my heart. No complete physicals

 
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