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I Was Dismissed From My Doctor For Breaking A Pain Contract.
I have IC which is a very chronic painful bladder disorder. I have been going to the same uroligist for 10 years now. About 2 yrs ago he told me I needed to see a pain doctor. I went to one for 2 months and was not fimilar at all with all the policys. In the 2nd month of going there they dimissed me for going to another dr. that gave me mephredine because I had my wisdom teeth taken out. Now, 2 yrs.later my urologist will not prescribe me any lorcet for pain and says i need to find a pain doctor because he says I am always going to have pain for the rest of my life. I live in SC and the DEA is so strict on doctors here. Has anyone got any suggestions on finding a pain doctor that will take me on after being dismissed?
Hi Krissy: Welcome to the boards. I think we need some more info about the situation before we can try and help. Please post again and give us the details...thanks, cmpgirl
Hi Krissy,

Welcome to the board! I am sorry to hear of the IC. That does stand for Interstitial Cystitis or am I wrong about that.

I am with cmpgirl. Could you provide just a bit more info about the chain of events that took place.

Correct me if I am misunderstanding...you were in pain management and got prescribed narcotic pain meds from your dentist and then the PM said you broke the contract?

Anyway help us to help you by providing a bit more in detail account of what has happened. In the mean time try to hang in there.

Chrissy
Welcome and so sorry to hear about your situation! I understand where your PM Doc is coming from in principle, but for pete's sake, you had minor surgery. Did you take the meds? Were you drug tested? Did you not tell the PM Doc? How did they find out?

Here's what I would do....I'd go see my Urologist and tell him/her what happened and since he/she medically supports you as being in pain and has indicated that you'll need meds for the rest of your life, have him/her "refer" you to a new PM Doc. Even better, ask him/her if he'll write a letter or call the new PM Doc and explain what's going on. Surely, the Uro would do this (I would hope!).

It's stories like this that just make my heart break.

Good luck.
I can't see your contract being broken if another doctor gave you pain meds for another medical condition. If the other dr. did not give you the pain meds then you would have had to take extra from the pain managment dr. You would run out early and be screwed. Makes no sense. Could your Dentist call the pain managment dr. and explain to them. I know, probably not. They don't want to extend themselves like that. If you went to another dr. seeking drugs for the same reason you go to PM then I can see you being let go. But not for a new pain. I just go an anti-spasm pain med for my stomach from the Gastro. Can they kick me out too? It does not sound fair.
Hessie,
Does your PM know about the meds from your gastro? If he/she does, then I would say that you are not at risk for being dismissed. JMHO.

My PM chose [B]NOT [/B]to treat my Migraine Headaches which are Chronic and I've had since I was 7 years old. Have had extensive testing done, and participated in a study at Emery. Because my GP has treated me since 1982, forwarded all records to my PM, which included MRI/CTs of the brain, EEG's etc., the PM was comfortable with having my GP continue in treatment of my Migraines. He asks me about it every visit and documents my medication regime which includes Topamax 25mg in the morning and 75mg at bedtime, 20 mg of Paxil in the morning and 26mg of Tenormin both in the am and at bedtime. For rescue meds I take Fiornal with Codine as needed when a Migrane gets out of hand. But my PM is well aware of all of this, including how many times per month I have to take my rescue meds. I keep a journal and bring with me to my appointment.

I assumed going in to PM, that the doc would take over ALL of my prescribing of my medications, but he did not. His choice I guess. Maybe it has something to do with the laws here in my state. I don't know. Maybe someone else will chime in who knows an answer.

Krissy:
I'm so sorry you were dismissed from your PM. Some clinics have an exception for Dental Work, and (as I understand) some do not. The major thing I think is whether or not the PM doc was informed of the visit to the dentist, and the prescription. Not trying to be harsh here, but we have to be proactive in our care, and "not being familiar with all policys" is something that would never hold water with MOST PM clinics. We are responsible to understand the contracts we sign, and have to understand that with the DEA laws and crackdowns, the PM docs are just trying to protect their practices, as well as us as patients of their practice.

As far as advice, I would say ask your urologist for a referral to a good PM Clinic, and go in with the full story, being upfront and honest. I would clarify with my next PM clinic what their regulations are regarding dental appointments/prescriptions. You may also want to (as another poster suggested, get your urologist to write you a letter of recommendation to the PM doc).

Good luck to you. I hope you find some relief soon.

Blessings,
The key here is for any PM Doc to know EXACTLY what you are taking and why. Every time I go in, and the nurse takes me back to weigh me and take my BP, the first thing she asks is "lets go over your list of meds....Are you still taking A, B, C, D & so on.....Any Rx and non-Rx. There is even OTC allergy med on the list.

I agree with Hessie in that if you didn't take your dentist script, you'd have to take your other meds which not only would you run out early, but technically speaking, taking it for something it wasn't scripted for.

Sounds like this PM Doc has a very tough, zero tolerance policy and you got caught in the middle. There has to be some room for reason. I'd be willing to bet the Doc doesn't have all the information. You probably won't be able to make an appt because you'll be blocked....I'd send a detailed fax addressed to the Doc explaining the situation and practically begging to explain yourself. I'd also attach a letter from your Uro about the situation and just maybe, the PM Doc will see the reasoning and call you in. It can't hurt and will show that your are very serious and maybe they made a mistake. You'll have to be persistent though. If you just "go away", they'll assume you either weren't in pain, or got busted and knew it. I've got to believe that your Uro has to be of some help here and not just pass the buck. If I got hung out to dry on this one, I'd be tempted to go to the AMA board.

Spinal- I'm guessing your PM Doc isn't treating your migraines because you have such a detailed history and things are going fine with your other Doc....Probably doesn't want to "rock the boat" as they say. Additionally, migraines can be one of the most complex things to treat, thus, another reason to stay away from it if all is going well. Your story is a good one though because it reinforces the cooperation of Docs and how everything is on the table. Your journal is a good sound strategy as well.

Ex
the big key here to any med Rxing by any other doc other than your PM is communication,period.as long as you are notifying your PM along the way of what is going on,that would make it okay or at least let your PM know so they can have some input BEFORE accepting an RX you know goes against your contract.i have had meds Rxed by my dentist and my surgeons BUT with every sinlge one,either i called my PM or my dentist did before he even wrote that Rx.that is just what has to be done when under any PM contract where it actually states that you will not go to other docs for any narcotics.these situations arise with all of us from time to time,but like i said,getting everyone on the very same page with everything done out in the open is what you just have to do in PM.simple communication so everyones aware.otherwise,it can look like something its not or was never ment to be.your PM just does have the ultimate control when it comes to our narcotic intake and any Rxes that are written for them for us by anyone.one phone call giving your PM a heads up would really have helped alot.sorry you had to learn this the hard way.since you were new to PM i am kind of suprised they just didn't give you a little warning about how to go about doing this if it ever happened again and given you the benefit of the doubt.but some places have been burned too often and we pay that price.i think just being completly honest with any new PM about what actually happened would really be in your best inteset now.also,make certain to actually ask the new PM if they could please go over your contract with you so you know what to do in certain situations.that would help.you just simply made a mistake becasue you were not fully informed being new,that will also help your situation.hopefully your doc can help you with this and get you to a brand new PM.just remember for the future,follow that contract and communicate with your PM when it comes to needing any type of narcotic from anyone other than your PM.this has worked out really well for me with my surgeries and dental work crap with absolutely no problems.i do wish you luck.please let us know how things are going.marcia
Hi, my name is Karen and I am new to the board.

The same thing happened to me, I was fired by my PM after being under his care for 18 months; I had dental work done, had a very bad abscess and then as soon as that was cleared up, I had two teeth pulled and accepted pain medicine from the dentist. I have followed the PM's contract to the letter and never thought about it being a violation but apparently it was. I got a letter in the mail informing me I had been fired as a patient. It was over the weekend when I got the letter so on Monday I called and tried to explain, spoke with the office manager, then spoke with the patient case manager and I cried, begged, pleaded, everything to be re-instated but nadda, zip, they had no room for anything outstanding except for what I was being treated for.

My PM doc did refill my meds for 30 days and then I had to find another PM doctor on my own. My husband had been urging me to find another PM doctor because I was not getting any better; I have been steadily going down hill over the past 18 months; hubby said try another PM doctor if just for a second opinion.

I found another PM doctor and when I went to get an appointment I was straight up as to why I needed a new PM doctor, they lady at the new place told me she had heard Dr. XYZ was famous for dumping patients......So all of this may have been a blessing in disguise. I will know more after I see the new doctor on the 13th of this month.

I have several herniated discs, 4 facet joints that are messed up pinching the sciatic nerve in both my legs. I had been getting the epidural block every other month, I have been on the Fentanyl pain patch 100 mcgs, Soma muscle relaxer, Lyrica, and Perocet 10s for break through pain.

I am 51 years old and I am in the process of getting my disability.
I am very glad you found another pm doctor. There are only about 3 where I live and all have said no even after explaining to office personel ( you can never talk directly to the dr. to explain). My urolgist told me to try Charleston,Sc or Florence.He says I am on a list in sc because I was dismissed so he cant do any pain meds. I am in the process now of trying to find a new pm but it is difficult because I feel like I hit dead ends. I just wish my urologist would be the one to talk to someone. All he says until you find a pm go to the er if pain gets unbearable which is always, have my good and bad days, but I hate to do that because then you are marked as drug seeker then and that is the last thing I need to happen. I take elmiron now and that is supposed to rebuild lining in my bladder but that doesnt help for pain ,makes me have no appetite and hair loss and had 7 surgeries to remove benign tumors from my bladder. I wish you good luck with your new pm doctor.:angel:[/FONT]
[FONT="Comic Sans MS"]I would def. tell him especially if it is a controlled substance. Yes,I did try to explain and he did not want to hear it. Good luck and thanks for the reply:angel:[/FONT]
[FONT="Comic Sans MS"][SIZE="3"][COLOR="Red"]I'm just curious...how did your PM doctor know you got the rx from your dentist in the first place?:confused:[/COLOR][/SIZE][/FONT]
I bet she told the doctor. She was being honest and see how they treated her. Each time I go they ask what meds I am taking. I tell them everything. They almost force you to lie. I don't think the pharmacy could tell them without violating HIPPA laws.
The more I read about this situation, the more my heart breaks! This Urologist needs his head examined. I mean for Pete's sake, he says you need pain meds....To find a PM Doc b/c you'll need it forever, but he won't script them or refer you??? What the???? Won't he at least write a letter documenting your situation??? Also, I've never heard of this "I can't write any meds because your on a list"....that sounds made up...May not be, but sounds fishy to me. Anyone else feel the same way?? I'd be tempted to find another urologist and see if they could help or at least refer you/call a PM Doc for you. I'd also be tempted to find a good lawyer...Not suggesting such, but sayting "tempted."

I'll be honest people....I have enjoyed coming to this site to help people, but this kind of stuff just tears me up and makes me wonder if I can emotionally take it and maybe shouldn't come here anymore. I mean.....It's the year 2008....Can't we get people proper medical care????

Sorry to rant............





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