Reddit PCP forum - derogatory remarks about pain

[Ducttape]

---

Members don't see this ad.

some of the comments above it are still at pain medicine.



if i posted on reddit, with respect to the pain medicine comment, i would throw it back at them - someone fails UDS. the patient has a problem. how is increased monitoring going to fix addiction? i am not an addictionologist and continuing opioids to an addicted patient is not appropriate medical care. you wont do it. why should anyone else?

 

[jwheezy]

some of the comments above it are still at pain medicine.



if i posted on reddit, with respect to the pain medicine comment, i would throw it back at them - someone fails UDS. the patient has a problem. how is increased monitoring going to fix addiction? i am not an addictionologist and continuing opioids to an addicted patient is not appropriate medical care. you wont do it. why should anyone else?

Yeah I’ve been so tempted to reply but we all know it’ll fall on deaf ears

 

[VA Hopeful Dr]

some of the comments above it are still at pain medicine.



if i posted on reddit, with respect to the pain medicine comment, i would throw it back at them - someone fails UDS. the patient has a problem. how is increased monitoring going to fix addiction? i am not an addictionologist and continuing opioids to an addicted patient is not appropriate medical care. you wont do it. why should anyone else?

I'll be the first to admit that if someone fails a drug test and I tell them I won't write anymore of whatever, they immediately want a referral to the specialty involved (you for pain meds, psych for benzos/stimulants). I will usually oblige, see my previous comment about patient satisfaction scores, but I have no expectations for you to actually take over writing the medication and I will usually warn patients about that.

 

[Ducttape]

yes VADoc but you are one of the understanding PCPs. you dont make comments like "the whole point of the referral is that you can do closer monitoring"

(we do give alternatives, but these doctors are objecting that we give alternatives but dont continue meds)

 

[VA Hopeful Dr]

yes VADoc but you are one of the understanding PCPs. you dont make comments like "the whole point of the referral is that you can do closer monitoring"

(we do give alternatives, but these doctors are objecting that we give alternatives but dont continue meds)

Not looking for accolades, more pointing out that we're definitely not all this way and in fact in my experience (which is limited to what I've seen) this reddit thread seems a minority like most of reddit.

 

[Agast]

You have to remember PCPs are not as empowered to fire abusive patients as specialists are. I see so many posts online where they’re asking what to do with someone who has actually physically threatened them and they’re like “Do I have to keep treating them?”

 

[lobelsteve]

Same nonsense here. PCP sent patient to me to get Tramadol. I'm like no one cares about Tramadol. His notes detail several ER visits with combined BZD and tarmadol overuse leading to falls. She was sent to a different pain clinic first who offered Butrans and prcocedures. Too expensive. Comes to see me to try and get Tramadol. No F'in way. It's documented in the chart the problems she already had. Tell patient about non controlled substances and PT/procedures. Crickets. "I just want my tramadol." Bye. So PCP calls the next day and asks me to reconsider. They left a message. Told them if they think it's right thing to do they can Rx. But recommend against it as she is better hurting than dying from OD or falling down under the influence of an Rx.

I did my job and proviuded appropriate treatment recommendations. Rest is on the patient and PCP.

 

[Agast]

Sometimes not giving someone pain pills is the treatment plan. If I say “this condition is not appropriate for pain medication” I’m not asking the PCP to prescribe, I’m saying as the expert that No one should be prescribing. It’s like begging a cardiologist to write HTN meds to someone with no cardiac issues because they like the feeling of hypotension.

 

[Ferrismonk]

View attachment 388057
Forums back at it again, now shots fired at psych!

I'm happy to see and help patients with inconsistent UDS. They're just not getting opioids.

 

[pain101]

I've had a patient with with convicted DUI from controlled substances that PCP sent to me. They immediately walked out when I led with saying I would not prescribe opioids and they did not want to hear about what else I had to offer

 

[Laryngospasm]

I'm happy to see and help patients with inconsistent UDS. They're just not getting opioids.

My pet peeve is when we tell them ahead of time they won’t get opioids and only offer other treatments for them and they agree and then come and beg for opioids and say we never told them. GTFO