talking to referring provider about sending patients on opioids

[AndyDufrane]

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so soon I will make the rounds and talk to the local community primary care providers, and one of the questions I think they will ask is if I take over opioids prescription, in my brain I am saying "If you are trying to dump your problem chronic pain opioid dependent patients, then no, since I am medical spine specialist and no a chronic pain specialist", but what should I say in a diplomatic way so as not to shock

 

[lobelsteve]

Just be honest and be pleasant.

Inform them of the laws from your state and the DEA policy.

You are happy to evaluate and treat appropriately.

Give them the rules of your clinic, the same one you give patients. Give them the ICAT, risk tools you use.

Rx for no one at consult.
UDS for anyone who is a candidate.
Get pharmacy records before prescribing.
Outside records. Imaging reports and actual films.

It's all very matter of fact. Your rules are inflexible or you will get burned.
You are on their side (the PCP).

 

[RUOkie]

, then no, since I am medical spine specialist and no a chronic pain specialist",

That is exactly what I say. I am clear to all referral sources, that I am NOT a "chronic pain doctor". I take care of biomechanical issues that contribute to painful conditions of the musculoskeletal system.

By March of next year (2013) I will have no more chronic opioid patients.

 

[101N]

so soon I will make the rounds and talk to the local community primary care providers, and one of the questions I think they will ask is if I take over opioids prescription, in my brain I am saying "If you are trying to dump your problem chronic pain opioid dependent patients, then no, since I am medical spine specialist and no a chronic pain specialist", but what should I say in a diplomatic way so as not to shock

Talk about what you WANT to see, not what you don't want to see. Then see what you get down the road. Do not mention: FMS, chronic pelvic pain, narcotics, TMJ, migraines, chronic abdominal pain, TOS, or other BS. If you talk about it, you are the expert in it, ergo you own it.

Also, take personal responsibility for getting your consult notes back to your referring docs. I pick up my own transcriptions electronically, save them as pdfs, and e-fax them back to my referring docs the next day. If a bunch of druggies start being referred I attach the following pdf to my notes and fax it as well:

http://www.supportprop.org/educational/PROP_OpioidPrescribing.pdf