my new primary doctor

[curiousforever]

is grumbling about prescribing my meds.

he wants me to go to pain mgmt. which UCSD only *recommends* meds - which I told him.

There is not pain mgmt doc in town that does meds.

URGH.

[BrokenBladder]

Alot of PCP don't like to prescribe pain meds. I'm soooo sorry sweetie that you're having to go through this. I just don't understand how a pain mgt. doctor won't prescribe pain meds.
Forgive my fibro fog but what is UCSD?
If you need to talk please feel free to PM me anytime.

[Bobbi]

UCSD, I think is referring to University of California at San Diego or University of California, San Diego.


Curiousforever,

I'm sorry you're going through this :(. It's my PCP who prescribes most of my medications, though my rheumatologist and PM doc wouldn't hestitate if she preferred one of them to do it. It really sucks!

Can your PCP refer you to a specific PM whom RXs?

[ErinENj]

I know my PCP isn't comfortable prescribing my meds, simply because he doesn't really know about these kinds of meds. But if I have an emergency, like when I was switching docs he said that if I need him to, he'll prescribe them for a month or two, but no more than that.

I agree with Bobbi. I'd say to him something like, okay, fine you don't want to prescribe my meds anymore, then give me the name of a pain management doc that you would recommend who is local, and see what he says. If he can't recommend you to someone, then I would point that out to him and ask him what he expects you to do. You can't travel an hour to see a PM (I do and it's a nightmare!) but you also can't be without your meds, so what options are there. Which would he rather do, give you your meds, or have to treat you for the withdrawls and open himself up to a lawsuit if something bad happens to you because he refused to prescribe your meds.

It drives me so nuts when these docs don't want to prescribe these kinds of meds all of a sudden but won't look at the options you have for a doc who will prescribe what you need. They should know what options there are for you and look at that when deciding whether they want to continue treating you. It's really kind of egocentric because they're only thinking about how uncomfortable they are and not taking into account anything else besides themselves.

I hope that you're able to either make your doc understand your situation or can find someone who'll prescribe your meds without giving you more things to worry about. Keep us posted and if there's anything I can do, let me know.

[Mark N]

My PCP prescribes all of my meds and I am sorry to hear that your's won't prescribe your meds. They went to school to become doctors and they have refrence books to look up these meds so what is the problem? We get to know these meds that we take and if we have to switch to a new meds we can research and find out about them so why can't the PCP do the same thing?

I hope you are able to find one in your town that can do it for you. My PCP is 3 hours away but worth every bit of the pain it cost me to see him. I will be in town to see him as he wants to go over the forms for my SSDI hearing with me so he doesn't make a mistake on them. There are good PCPs out there but they aren't easy to find.

[Pharmacist.steve]

They went to school to become doctors and they have refrence books to look up these meds so what is the problem? We get to know these meds that we take and if we have to switch to a new meds we can research and find out about them so why can't the PCP do the same thing

All too many PCP are concerned about ADDICTION... any medical literature on a controlled substance will state MAY CAUSE ADDICTION.. that can be a very fuzzy line... that many don't want to even approach let alone cross...

The upper dose limits on opiates can be fuzzy as well... these PCP's knows that most likely started ... they will be "stuck" prescribing opiates for this patient for potentially a long time. IS prescribing opiates for a patient for an extended period of time .... for treating a disease/dependency or for the addiction the doc help cause?

[lobelsteve]

[QUOTE=Pharmacist.steve;58061] for treating a disease/dependency or for the addiction the doc help cause?QUOTE]

Addiction is a primary, chronic, neurobiologic disease, with genetic, psychosocial, and environmental factors influencing its development and manifestations. It is characterized by behaviors that include one or more of the following: impaired control over drug use, compulsive use, continued use despite harm, and craving.

A physician cannot cause addiction, but an untrained physician who cannot identify a patient at a high risk for addiction and precsribes ongoing opioid treatment for pain without "adequate and appropriate" documentation including validated screening tools, UDS, appropriate diagnostic testing, use of appropriate referrals and adjunctive treatments places their practice and their careers at risk for sanction by state medical boards, local law enforcement, the DEA, and litigation by families of the patients who are being inappropriately treated as medical malpractice.

You won't catch me taking out gallbladders, and I feel that most PCP's are biting off more than they can chew from a risk management standpoint when they Rx opioid therapy and cannot devote the time required for their patients to be screened and educated to ensure adequate and appropriate treatment.


................................................
So maybe it shows that I'm starting to lecture to PCP's in my area regarding Pain Medicine.

[Eppy]

Curious,
I am sorry you are having to go through this. My PCP won't prescribe my drugs either only ini case of emergency for 2 weeks or so. His response was that there are dr.s out there who are better trained than he is at dispensing these types of drugs so he prefers that you see them. He isn't concerned about addiction. He just thinks there those thart know more than he does. (I know about the addiction thing because he wouldn't even prescribe my Abilify for bipolar on a regular basis. He wanted me to see the psychiatrist for that!) :D LOL

Good luck to you,
Luanne

[Mark N]

Steve, I really do know that addiction is the big concern for PCPs, it is just frustrating that they aren't willing to find out more for their patients. I also know many of them are overloaded but once in a while I just have to let off some steam about the system.

[BrokenBladder]

Curious I remembered a long time ago that I had a PCP who was scared of prescribing narcotics. So I made a deal with him.
It was a pain in the butt for me but he did agree. I told him that I would faithfully come to him every two weeks so that he could monitor me if he would prescribe the needed medications. He agreed and I did that for about 6 months until I was able to find a doctor (specialist) who felt more comfortable. Maybe this would work for you at least on a short term basis.