RehabEdge Physical Therapy Forum

Forums  Register  Login  Forgot Login?
  My Profile 
My Subscription
  My Forums 
Search
  FAQ  Log Out
Follow @RehabEdge

You simply can't trust ALL of your patients

 
Logged in as: Guest
Users viewing this topic: none
  Printable Version
All Forums >> [RehabEdge Forum] >> Medical Complexity >> You simply can't trust ALL of your patients Page: [1]
Login
Message << Older Topic   Newer Topic >>
You simply can't trust ALL of your patients - April 23, 2007 10:44:00 PM   
Dr.Wagner


Posts: 1242
Joined: January 25, 2003
From: Indianapolis
Status: offline
So I had a patient come to the ER to FIND ME...ooooohhh she was unhappy.

I changed her Vicodin prescription from 20 to 4.

Here is what happened.

Our Physician Assistant evaluated a patient for Dental Pain. Apparently she had a chipped tooth with "exposed nerve".

Ok ok, I will break my fundamental rule regarding narcotics and I will trust the PA on this one.

He gave her 20 Vicodin (in retrospect, just way too much, but she was crying and appeared to be in acute pain.).

I receive a call from a Pharmacist the next day that she had JUST FILLED the prescription. Knowing it had been 24 hours later , I smelled a rat.

I changed the script from 20 to 4.


THE PATIENT WENT BALLISTIC!

She called the hospital wanting to talk to me and everyone else.

Then she came to the hospital and was escorted out by security.

I suspect she had already secured buyers for the Vicodin and then I ruined her plans and now she was in a bind.


OOOOh the loving and trust worthy patient.


Patients lie to your face.

_____________________________

Dr. Wagner DO
Moderator of Medical Complexity Forum
Post #: 1
Re: You simply can't trust ALL of your patients - April 26, 2007 5:17:00 PM   
3.5fig

 

Posts: 105
Joined: July 14, 2005
Status: offline
I am a Chiropractor that works in a interdisciplinary occupational medical clinic and I do not evny what you guys(DOs,MDs) have to go through regarding patients and their meds. I have seen so many fishy stories...."I left my meds on the bus" to the ever so often used "it was stolen"...to which our office response is, "fine, just bring in the police report and we can re-fill it for you". Medication seeking patients is one part of health care that I am glad that I don't have to deal with....

(in reply to Dr.Wagner)
Post #: 2
Re: You simply can't trust ALL of your patients - May 2, 2007 5:55:00 PM   
VagusX

 

Posts: 340
Joined: March 27, 2003
From: Savannah, GA, USA
Status: offline
I can be pretty sure that she is not making much of a business with 20 pill orders of 5/500 Vicodin. I have never worked in an ER, so I have not been in direct contact with "seekers," but I don't know anybody who would spend a $100 co-pay at the hospital to get 20 Vicodin to sell at $5 a pop on the street.

She is likely just a user and it sounds like she needs some help. Flag her and give her some Ultram next time.

(in reply to Dr.Wagner)
Post #: 3
Re: You simply can't trust ALL of your patients - May 2, 2007 8:27:00 PM   
Dr.Wagner


Posts: 1242
Joined: January 25, 2003
From: Indianapolis
Status: offline
Ha!

vagus...these type of people don't have insurance and don't pay "co pays".

Many times, they leave false phone numbers...I called once to tell a patient she had Chlamydia and it was a Bar B Q place.

Drug seekers are pretty interesting...they never pay but they are ALWAYS allergic to NSAIDS and Ultram...it is pretty humorous. My PA felt bad that he had been "duped".

_____________________________

Dr. Wagner DO
Moderator of Medical Complexity Forum

(in reply to Dr.Wagner)
Post #: 4
Re: You simply can't trust ALL of your patients - May 3, 2007 5:07:00 PM   
VagusX

 

Posts: 340
Joined: March 27, 2003
From: Savannah, GA, USA
Status: offline
LOL

I probobly couldn't visit that BBQ place any longer.

Just out of curiosity, if the same person came in and had payed $100 to see you for "dental pain" would you have a different opinion about prescribing 20 Vicodin?

(in reply to Dr.Wagner)
Post #: 5
Re: You simply can't trust ALL of your patients - May 3, 2007 7:09:00 PM   
Dr.Wagner


Posts: 1242
Joined: January 25, 2003
From: Indianapolis
Status: offline
I have no idea who has insurance or who doesn't...generally until they are gone, primarily as I don't have any paperwork...but it doesn't matter because I get paid hourly and not per patient or based upon insurance. I get paid the same if I see 30 patients pershift or 10.

"Co pays" are not collected on sight in my hospital. ...

Sometimes at discharge I ask if they have insurance in an attempt to write for cheaper/generic medications.

_____________________________

Dr. Wagner DO
Moderator of Medical Complexity Forum

(in reply to Dr.Wagner)
Post #: 6
Re: You simply can't trust ALL of your patients - June 23, 2007 2:49:00 AM   
cej7

 

Posts: 33
Joined: August 23, 2004
Status: offline
My husband sent me the following link today (apparently he's been listening to me venting). The 'editorial' seems to sum up what many ED staff are thinking on this topic..

Link: http://www.craigslist.org/about/best/sfo/301345524.html

(in reply to Dr.Wagner)
Post #: 7
Page:   [1]
All Forums >> [RehabEdge Forum] >> Medical Complexity >> You simply can't trust ALL of your patients Page: [1]
Jump to:





New Messages No New Messages
Hot Topic w/ New Messages Hot Topic w/o New Messages
Locked w/ New Messages Locked w/o New Messages
 Post New Thread
 Reply to Message
 Post New Poll
 Submit Vote
 Delete My Own Post
 Delete My Own Thread
 Rate Posts



Google Custom Search
Forum Software © ASPPlayground.NET Advanced Edition 2.5.5 Unicode

0.109