Just saw a 90 yo today whose PCP has had her on Norco 10/325 TID for a long time for polyarthralgia. All I could really find was left knee pain with ROM. The indication for the referral was pretty much "please take over this C-II medication". Lives at home because the two daughters want their mother to spend her last days in her house. Since Mom lives alone and one daughter is in Austin and the other travels a lot they don't want to have to keep bringing her to the office and just want meds called in. If I needed to see her could I just do a house call? I said, "Your personal wishes have set up this scenario but your personal wishes don't obligate me in any way to practice substandard medicine. If she lived in assisted living or a nursing home she'd have supervision and transportation but she doesn't because it's what YOU want. So if that's what YOU want, then YOU have to figure out how to get to and from my office. You want me to prescribe without trying any other treatment. You want a 90 year old who lives alone to take narcotics. You don't want any meaningful followup. I can't do this." I guess that's the end of that guy's referrals.