my practice has been narcotic free for >4 years.... lovin' it... i still do "pharmacologic consultations" for local PCPs, so I still see the playa's... i just don't have to play the game.
i am not "narcotic free" but i am narcotic free...meaning virtually nobody is referred to me for narcotic management. What i mean is that, my good referral sources understand I dont prescribe narcs very often, and if i do, its my choice, and often the PCP will actually take over if I see fit. This almost never happens.
So if anyone shows up on my door "im almost out of vicodin" then they should get moving, because the more time they spend in my waiting area, the closer to running out they are. These are patients that are typically self-referral, or referrals from docs I have never hear of...
5 years ago, i came into town and said NO NARCOTICS from me, now its NO NARCOTICs (unless i say so, which isnt often...) and the referrals were sparse at the beginning, but have grown steadily, to the point im pretty happy.
the self referrals are all told "we do not prescribe opiates" and most no show, but some show up and try and convince you. PCPS in my area know I dont take patients just for opiate management, and most are ok with it now... the ones that arent, are typically docs im not in a hurry to do business with. The good PCPs and surgeons understand if they want quality, they can send the patients to me,if they want a lackey to just do ****ty procedures and narc up their patients, there is a long list to choose from that isnt me.
Now i am the busiest, highest volume pain physician in my office suite, hahah. others are busier, but i dont care. not to have to deal with the riff raff, is well worth it to me..