No more Purdue Pharma

[ccmdfd]

Government made dope is supposed to be an improvement?

Yeah I can just see the upcoming lawsuits.

Government killed my baby!!!!

[Sensei]

A presumption of innocence, for starters? Not implying that they are a bunch of druggies? Maybe taking the time to get to know what's going on with their patients, instead of a nearly drive-by visit and "here's a script for 90 Oxys"?

My recollection of a dozen or so years ago was that it was pretty common knowledge which doctor one needed to go see if one wanted a shitload of oxy. If the lay population knew, surely the pharmacists knew who were the candymen. So, likely, did the other doctors.

Funny thing: Don't we see this over and over? Some people abuse something and then everyone else's use of that thing gets restricted.

A few thoughts. First, if you or anyone you know is receiving 90 oxy after a drive-by visit now, then they’ve got a great case for malpractice. Yes, that happened a decade or 2 ago, but times have changed along with standards for prescribing that require physicians to document their history, physical, as well as discussions about opioid alternatives. Anyone who feels like their opioid prescriber is not getting to know them is free to go get another doctor who will provide them with better outcomes by being more than a glorified drug dealer.

Second, drug screens are monitored for patient safety. There is no criminal penalty for a failed drug screen just like there are no fines or imprisonment for having an A1c of 14 or a supratherapeutic INR.

Third, concepts like presumption of innocence and freedom of speech are great when applied to a legal system or how the government treats you. However, your doctor doesn’t work for the government - yet. Thus, I don’t understood why you are applying these concepts to such an interpersonal relationship. Do you enjoy freedom of speech with your boss? I bet there is no presumption of innocence with you spouse if your marriage is anything like mine. Yet, opioids hold such a sway over the American public - there is such a need for them (despite all the scientific evidence to the contrary), that Americans go all Johnny Cochran by invoking the legal system whenever there is a perceived barrier to them.

Finally, my experience has been that people who feel victimized and criminalized by controlled substance monitoring rarely do well with opioids. If it is someone you care about -watch them closely.

[Baldanders]

A few thoughts. First, if you or anyone you know is receiving 90 oxy after a drive-by visit now, then they’ve got a great case for malpractice. Yes, that happened a decade or 2 ago, but times have changed along with standards for prescribing that require physicians to document their history, physical, as well as discussions about opioid alternatives. Anyone who feels like their opioid prescriber is not getting to know them is free to go get another doctor who will provide them with better outcomes by being more than a glorified drug dealer.

Second, drug screens are monitored for patient safety. There is no criminal penalty for a failed drug screen just like there are no fines or imprisonment for having an A1c of 14 or a supratherapeutic INR.

Third, concepts like presumption of innocence and freedom of speech are great when applied to a legal system or how the government treats you. However, your doctor doesn’t work for the government - yet. Thus, I don’t understood why you are applying these concepts to such an interpersonal relationship. Do you enjoy freedom of speech with your boss? I bet there is no presumption of innocence with you spouse if your marriage is anything like mine. Yet, opioids hold such a sway over the American public - there is such a need for them (despite all the scientific evidence to the contrary), that Americans go all Johnny Cochran by invoking the legal system whenever there is a perceived barrier to them.

Finally, my experience has been that people who feel victimized and criminalized by controlled substance monitoring rarely do well with opioids. If it is someone you care about -watch them closely.

I am sure you are correct in the majority of cases, and I imagine you see a lot of opiate-seeking folks. But my mom, who is fairly opposed to regular opiate use (she used to have bottles of 5mg straight oxy that would go past the expiration date, despite chronic pain) is now undermedicated after major surgery while still in the hospital. At least that was her last experience.

Admittedly, she's at the "having trouble finding a surgeon who's willing to do anymore cutting" phase of her back/neck problems, despite having increasing curvature/collapse in her lower spine and the recent discovery that the last surgery to hold her upper vertebra together hasn't held up well and the bone isn't fused to the hardware like it should be.

[Sensei]

I don't see the process/program as being a problem.

What's likely the problem from my experience as a patient and also working is healthcare, is probably "bed-side manners" on the end of the doctors. No offense to our good doctors here, but that community generally has the human social skills of Patrick Bateman, and can turn what should be pleasant experiences into needlessly miserable, condescending, insulting, and confrontational ones. I, as well as most of my (former) coworkers are genuinely convinced that most doctors are on the autism spectrum (which makes sense given their intelligence and razor-sharp focus for 24 hour shifts), but that comes with the price of human interaction skills and being able to detect the impact that their tenor/speech and actions have on people.

Hence, my generally positive fervor for NPs and PAs. It's always good to have a people person who can take the specs from the customers and translate between the engineers and customers. (brownie points if anyone gets the reference)

No offense taken on my end. After all, the majority of my co-workers in academic medicine wear BLM/Black Fist lapel pins, think that most cops have the mentality of Buford T. Justice or Archie Bunker, and armed police on our campus are a threat to minority patients. We literally have faculty and residents who think that the new K-9 security dog was brought on board to intimidate black patients.

I look forward to the day when more Americans can stop judging entire professions based on their interactions with a few...you know, discern the forests from the trees.