sadia301 Posted January 9, 2012 Share Posted January 9, 2012 Hello, I started a new job for Pain Management. The doctor I work for does pain management/general medicine. Sometimes i am questioning how this doctor runs his Pain Management clinic. He has all documents including MRI, CT scans, xrays and other doctors consultations. He will first evaluate the pt and create a treatment plan which after i see the pt. Everything is electronic. At every visit he will have pts fill out a consultation/agreement/contract form. He only prescribes medications. My question is weather or not this doctor is prescribing in an ethical way. The following is how he prescribes: Oxycodone 30 mg q 6 hours. The most he will prescribe of oxycodone is 30 mg disp #180. He does not prescribe oxycodone 15 mg at all. Norco 10/325 q 6 hours. The most he will prescribe of Norco is #180. Prometh/Cod is another drug he will prescribe. Most of these pt will come in and say they have a chronic cough at night and in the am. They actually have COPD i think and need to follow up with their PCP. Ive been trying to explain this to pts... some of which have listened to me and started treatment. Others do not want to listen and want Promth/Cod along with the pain meds. (This is the medication i feel strongly against, do pts really need it? I think not.) He will also prescribe Soma 350 mg, and xanax 2 mg tid. On all of my charts i write pt needs to be followed up by PCP, regular exercise, blood work, and psych referral. In some cases i will even document Ortho/Neuro referral. Does this seem to be with the norm of other Pain Management clinics? I have read the other posts on this site and have gained some insight but would like further advice :) Thanks in advance! Link to comment Share on other sites More sharing options...
wilso2ar Posted January 9, 2012 Share Posted January 9, 2012 At first glance this looks suspicious. I have been doing this for 3 1/2 years and have never treated anybody for chronic cough. Other worrisome thing is large amount of shortacting meds and high doses of them. Is there any use of longacting meds? Are there any referrals to an interventionalist for injections or therapy? Also, this a personal preference, but I don't prescribe chronic soma or xanax. both highly abusable and for what I do not much value. I would start reviewing American Pain Society guidelines and see if the practice at least follows it somewhat.www.ampainsoc.org/press/2009/downloads/20090210.pdf Also pain management should be multi-dimensional. meds, therapy injections, surgery and referral to psychologist if needed. Link to comment Share on other sites More sharing options...
sadia301 Posted January 9, 2012 Author Share Posted January 9, 2012 The only main medication he prescribes are Oxycodone, Norco and xanax. There are no referrals. I advise the pt to see their follow up doc and if i think they need more referrals i do mention it to the pt. Thanks for your post. I think ive concluded that this job is more harm than good. Link to comment Share on other sites More sharing options...
Cideous Posted January 10, 2012 Share Posted January 10, 2012 Does the phrase, "Run for your life!" mean anything to you? Seriously, unless you want to be answering questions in the DA's office I would bolt. Link to comment Share on other sites More sharing options...
sadia301 Posted January 10, 2012 Author Share Posted January 10, 2012 Quit 2 day ago...and it feels so good!! Link to comment Share on other sites More sharing options...
shnor77 Posted January 10, 2012 Share Posted January 10, 2012 Now I see why at all my PA school interviews they ask how I would respond in the face of unethical medical practice. Link to comment Share on other sites More sharing options...
Stjprn Posted January 11, 2012 Share Posted January 11, 2012 Good decision, Sadia! Glad you were able to see what was going on, decide quickly, and act on your decision quickly! Good luck on your next gig. Link to comment Share on other sites More sharing options...
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