Another Drug Bust
My latest narcotic-seeking patient had a dozen or so ER visits in the last 6 months, all but one of which culminated in both Vicodin ES and SOMA prescriptions. Only one doc stood his ground; most chose the easy way out.
There was no objective evidence of injury, of course. There was a reported fall in a grocery store somewhere along the line, and a reportedly abnormal MRI which was reportedly done elsewhere. There were 4 ER visits to our facility in the past month, and the patient's Orthopedist who practiced at another hospital was reportedly out of town until next week. Of course the patient was out of pain medications. Again.
Yawn. Are you starting to see a pattern here?
The patient really didn't want to elaborate on his medical history because he was in "too much pain." Well, that's one of the reasons to see only one physician for your chronic pain problem, I suggested helpfully. That way you don't need to go through the entire history over and over.
Nor did the patient really want to be examined. Too much pain, once again. Well, that's one of the reasons to see only one physician for your chronic pain problem. That way the examination can be more focused.
"Are you going to give me my medications or not?" he finally asked.
I'd like to talk to your Orthopedist to make sure we treat your condition appropriately. I'm concerned about the number of ER visits you have had, and I'd like to see if we can come up with a better solution for you.
"I told you already....he's out of town until next week."
Well, I can probably get in touch with one of his partners to expedite an earlier appointment at least. I'll be back in a couple of minutes.
Of course, the Orthopedist did not exist. There was no physician with that name or with any similar names. And when I returned to the patient's room to make sure I got the doctor's name correct, he was gone.
Of course, the patient will still receive a bill for my services, even though the disposition was incomplete. But I don't really care if he actually pays the bill. That was the most emotionally fulfilling 15 minutes I spent all day.
Queen - Another One Bites The Dust
There was no objective evidence of injury, of course. There was a reported fall in a grocery store somewhere along the line, and a reportedly abnormal MRI which was reportedly done elsewhere. There were 4 ER visits to our facility in the past month, and the patient's Orthopedist who practiced at another hospital was reportedly out of town until next week. Of course the patient was out of pain medications. Again.
Yawn. Are you starting to see a pattern here?
The patient really didn't want to elaborate on his medical history because he was in "too much pain." Well, that's one of the reasons to see only one physician for your chronic pain problem, I suggested helpfully. That way you don't need to go through the entire history over and over.
Nor did the patient really want to be examined. Too much pain, once again. Well, that's one of the reasons to see only one physician for your chronic pain problem. That way the examination can be more focused.
"Are you going to give me my medications or not?" he finally asked.
I'd like to talk to your Orthopedist to make sure we treat your condition appropriately. I'm concerned about the number of ER visits you have had, and I'd like to see if we can come up with a better solution for you.
"I told you already....he's out of town until next week."
Well, I can probably get in touch with one of his partners to expedite an earlier appointment at least. I'll be back in a couple of minutes.
Of course, the Orthopedist did not exist. There was no physician with that name or with any similar names. And when I returned to the patient's room to make sure I got the doctor's name correct, he was gone.
Of course, the patient will still receive a bill for my services, even though the disposition was incomplete. But I don't really care if he actually pays the bill. That was the most emotionally fulfilling 15 minutes I spent all day.
Queen - Another One Bites The Dust
Labels: drug-seekers, patients, scammers
posted by scalpel at 2:06 PM
12 Comments:
Why did he come 4 times to the same ER? Wouldn't he be harder to trace if he were "rotating" the local hospitals. He is not too smart, is he?
He probably WAS rotating.
I had a guy who had 10 or so dictations in the last two years where he kept coming in saying he just needed X number of days of T3s for his chronic pain because he had an appointment with his PMD in X days and just needed to make it till then. He usually got the scripts with that story. I got the PMD name, called the office, and they hadn't seen him in 2 years. So I took the liberty of making him an appointment, and explained to him that there must have been some mistake because they didn't have his appointment in the calender, and in fact had not seen him for two years, but I had made one for him, and he could have some Ibuprofen until he saw his doctor in two days. We had an understanding in that moment. It was worth 10K in therapy, I swear. I might have cried a little.
You suck.
He deserved those pain meds, he hurt.
You're an ass hole.
Hahahahahahaha, I'm kidding.
Another one bites the dust...
I looove Queen!
Another One Bites the Dust - too perfect!
hey scalpel - why don't more doctors do this?
"Why don't more do it?"
It takes time, it involves the risk of angering the patient and the small outside risk that they really have something new going on - you have to be sure about your diagnosis. In short, you have to have cajones to do this.
I never denied him narcotics or confronted him about lying. I just performed a very detailed history and physical exam, and then made it clear that I was going to call his doctor to coordinate his treatment. That's just good medicine, right there.
But in doing so, I made it subtly (or maybe not so subtly) clear that I wasn't going to play the game to which he had become accustomed.
Another tactic is to have the patient sign a release so that prior records and studies can be obtained from the other facilities he has visited. Drug-seekers don't want you to see their records from other facilities, normal patients wouldn't care.
Again, that's not being a mean heartless burnt-out physician who needs to leave medicine and work at Burger King. That's what good doctors do.
You're officially my hero.
*swoon*
Scalpel, you rock.
Is it possible to have these patients arrested?
You can't have them arrested, but you can have some fun with them....
Post a Comment
<< Home