Top 10 signs you are working in a pill mill.

[FitDoc]

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[emd123]

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1. You accept only (or mostly) cash pay.

2. You have lines of patients snaking out your door. (I don't care if you're Marcus Welby himself, or the #1 doctor at the Mayo Clinic: none of us are good enough to justify a line out the door.)

3. You have multiple clinics and have unsupervised extenders in each who could care less, each cranking large numbers patients per day through, daily, all getting opiates.

4. You routinely write opiates on the first visit before a send-out drug screen is resulted, don't check PMP reports ever, or public online criminal records (if available), old records, and don't review imaging or work your patient up in any way other than "treating the pain."

5. You ignore aberrant UDSs and routinely give people 2nd, 3rd or fourth chances including routinely accepting opiate patients who were discharged from other practices.

6. You have to have "security" to control the people waiting in the line snaking out your door.

7. Your office is in a strip mall, with the word "laser" in the title.

8. You have to have guns, nunchucks, pit bills or some other ridiculous weapons/means of self defense in your office that other specialties don't need, or loads of cash stashed anywhere.

9. You have cars swirling around your parking lot, people loitering in your parking lot, and have people trading pills in your parking lot.

10- Pharm reps and stim reps leave your office, and go to other doctors offices and routinely say, "Holy crap, that guy's waiting room was full of people nodding off, left and right. I felt like I was in the land of the walking dead. I never want to go back there. I just felt dirty even being in there. Ick."

 

[PainDrain]

11. You have a pharmacy on site and dispense scripts in-office.

 

[Ligament]

Midlevel to physician ratio greater than 2:1

 

[HoboCommander]

Can you get in trouble if you prescribe pain meds and your patient becomes addicted?

 

[Promethean]

Can you get in trouble if you prescribe pain meds and your patient becomes addicted?

That is going to happen sometimes. How you handle that issue is what matters. Do you support them to wean off the drug, provide referrals to behavioral health, etc? Or just keep writing scripts and being glad to have a loyal repeat customer. The first is the behavior of a doctor. The latter is a dealer.

 

[knoxdoc]

The name of your clinic is "Pain Clinic", and located in a strip mall in Florida.

 

[SpineBound]

If you have a slot machine in the waiting room that pays out in percocet.

 

[jsaul]

if you write for vicodin soma xanax , same doses same quantatity for every patient that walks in the door

 

[pastafan]

If your yearly income has 6 zeros at the end....

 

[lobelsteve]

If your yearly income has 6 zeros at the end....

Nope. Owners make millions. Going rate for md to sell soul and license is 350k cash.

 

[doctorperez]

1. You accept only (or mostly) cash pay.

I think this appreciation is unfortunate. Some of us don't like dealing with insurances but it doesn't mean we run our clinics as pill mills.

 

[Ducttape]

I think this appreciation is unfortunate. Some of us don't like dealing with insurances but it doesn't mean we run our clinics as pill mills.

I'm sorry.... No.
Dealing with insurance is an integral part of this business. If a clinic takes self pay only, it has something to hide or is proposing a treatment plan many are willing to shell out $$ - it is most likely a pill mill (or out of business).

 

[emd123]

I think this appreciation is unfortunate. Some of us don't like dealing with insurances but it doesn't mean we run our clinics as pill mills.

Do you practice Pain? If so, how often do your self-pays gladly pay cash for MRIs, injections, LC/MS drug screens, PT, and non-opiate adjuvant meds?

If they don't, what do they most commonly and happily pay cash for? I don't know, I'm just asking...

 

[doctorperez]

I'm sorry.... No.
Dealing with insurance is an integral part of this business. If a clinic takes self pay only, it has something to hide or is proposing a treatment plan many are willing to shell out $$ - it is most likely a pill mill (or out of business).

Says who it is an integral part of this business? This is America, you're free to choose getting paid for your services with insurance, cash, chickens, burritos, or whatever you wish.

Being paid in one form or another doesn't imply anything about hiding something. Your claim has no basis other than conjecture and speculation.

Do you practice Pain? If so, how often do your self-pays gladly pay cash for MRIs, injections, LC/MS drug screens, PT, and non-opiate adjuvant meds?

If they don't, what do they most commonly and happily pay cash for? I don't know, I'm just asking...

Why, yes I do.

My self pays pay for their imaging, PT, drug screens, and all expenses for involved with their individually appropriate care the same amount of times they can afford their pharmacotherapy - 100% of the time

 

[lobelsteve]

I think this appreciation is unfortunate. Some of us don't like dealing with insurances but it doesn't mean we run our clinics as pill mills.

You have a target on your practice from the DEA and your medical board.

 

[doctorperez]

You have a target on your practice from the DEA and your medical board.

We get inspected every year and pass with flying colors. I practice in what could easily be the most regulated state for pain medicine. My clinic complies fully with all requirements and standards of care, year after year. The DEA/medical board/department of health for all my years of practice, have never even bothered with my reimbursement model.

By the way, pharmacies charge my self-pays 5-8 times what my clinic fee is and neither them, nor the DEA/all other bureaucrats could mind that they pay in cash...as it should be in a country that calls itself free.

 

[emd123]

My self pays pay for their imaging, PT, drug screens, and all expenses for involved with their individually appropriate care the same amount of times they can afford their pharmacotherapy - 100% of the time

Just curious: Where are you finding all these über well-off people, who are also too cash strapped to afford medical insurance but well-off enough to drop cash for MRIs, drug screens, PT sessions, and the like?

 

[Ducttape]

your clinic passes out medications? it gets inspected every year? that speaks volumes in and of itself.



no offense. if you are prescribing opioids and directly recieving cash payments, there is grounds for concern. there is no way around that.

 

[Jigsaw]

i currently work at a place(yes I am looking to leave) that accepts cash for Medicaid patients. They are only interested in one thing and even though they may pretend to want injections PT etc.

 

[Jigsaw]

If there is a sign near the bathroom stating to reschedule if they rhink their UTOX will be abnormal.

Oh and no insurance and it is $240/ month

(This from a patient who went to one in Virginia)