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kimbell1
Enthusiast
Reged: 08/20/03
Posts: 280
Loc: Route 666, Painville, Texas 6...
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I am currently recieving social security disability (on my first try-no appeals) and also am recieving early retirement disability pension from the state because of chronic lower back pain. I have had all the tests, a lot of 'alternative treatments' and nothing works but pain killers to eliminate the pain in my back.
A lot of states have laws that supposedly protect doctors from problems if they prescribe for patients in liegitimate pain. There is even a federal law regarding pain issues but I don't have the link.
While each state is different, the state that I live in (Texas) is clear that my doctor is protected since I have documented proof.
I don't beleive that social security would give me early disability (I am 46) because they liked me when I applied for benefits. I assume that my records convinced the powers that be. Same way with my early disability pension from the state where I worked.
Yet I like so many others, am under-medicated. When I have mentioned that I would like to try another pain killer that doesn't damage a liver like Lortab does, my doctor freaks.
I read so many post on these 'pain forums' about no doctor willing to help people in legitimate paine that I begin to wonder how these doctors ever got passed the screening process to get into medical school.
Guess that just knew how to suck up at the interview.
I predict that soon that there will be some type of national health care like Clinton wanted. Too many don't have any insurance.
I can't wait for these over-paid doctors to start having to take what the government will pay them or go out of business. There will never be enough patients with cash to pay out of their pockets for every doctor to continue to inflate his fees.
Maybe then we will get people going into medicine that want to be doctors to help people-not become instantly rich.
I guess at that point, I will the doctors' pain. LOL!
I can't wait for pay-back time.
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Paranoia is just hightened awareness.
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roxeanne
Member
Reged: 02/24/02
Posts: 197
Loc: I Come From Mars!
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I recently watched a medical video on pain management. It was a video designed for Dr's to watch that counted as part of their recurrent annual training.
It was very interesting. It had a group of pain specialist, lawyers specializing in medical law, and one person from a state medical board. They all agreed that the undertreatment of pain was a serious problem in the U.S.
They even brought up an interesting point which I was unaware of. They said that a Dr who undertreats chronic pain could face legal liability from their patients for malpractice.
I can think of several Dr who could face some liability for
undertreating or not treating at all my pain.
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IMSUSCOT1
Threadhead
Reged: 10/23/02
Posts: 884
Loc: usa
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I fly from arizona to texas to see a pm spec who scripts oxycontin for me...pm me if you want more info
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kimbell1
Enthusiast
Reged: 08/20/03
Posts: 280
Loc: Route 666, Painville, Texas 6...
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I hadn't thought about UNDER MEDICATING a person with legitimate, documented pain being under-prescribed as a basis for a lawsuit for mal practice but it does make a lot of sense.
As a matter of fact, I received a letter from my attorney who handled my social security disability application and they listed that they take these types of cases.
PM me privately if you want their nem. It's a Dallas legal firm and they are good. Remember-I got my social security on my first try with no appeals. My former wife's sister who also had an attorney from another town had to jump though the process for 3 years and she had been a nurse that developed Lupus.
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Paranoia is just hightened awareness.
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yawkaw3
Pooh-Bah
Reged: 03/22/03
Posts: 1193
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kimbell,
People get to be doctors by working their Best if kept off the board off in college to get into a decent medical school, spending 4 years there, taking a series of exhausting licensing exams, then doing their residency (which is generally from 3 to 10 years- pain management can be done in 5).
The laws protecting doctors from the DEA are laughable at best, vaguely written, and rarely have precedents. Since you didn't do research on this yourself, I happen to have a bookmark, as I'm a medical school student who plans to go into pain management or psychiatry: http://www.painandthelaw.org/statutes/painpolicy_regulations.php There is a wealth of information on painandthelaw.org, which is definitely worth a read for anyone involved in chronic pain.
Let me just clear this out of the way:
-I believe everyone is entitled to pain relief.
-I have an infinite amount of sympathy for chronic pain sufferers, under-medicated or not.
-When I become a doctor (if I go into pain management), if I write prescriptions for 100 patients (just for the sake of conversation), it is more important to me to take care of the legitimate chronic pain needs of 95 patients, than to worry about the 5 addicts who scammed me into a script. A lot of doctors don't think like that. I'm different.
- Other doctors would rather deny legit pain patients in order to make sure they don't prescribe to an addict (heaven forbid, it's not like they won't get it somewhere else). Personally, I think the stuff should be available over-the-counter, but that's another conversation for another thread.
-Doctors are scared of the DEA. Some doctors are assholes. Most aren't, and their prescribing practices are a function of abrasive drug laws. They would genuinely like to help people, but they don't want to lose their license, as that spells the end of a long, difficult career. I hope by the time I enter medicine, it's different.
But if you have SSDI, then you should be getting adequate pain relief. If you're not, you need to keep trying doctors (that's just the way it goes sometimes, regardless of what you feel entitled to, and that can be hard to accept as it is often unfair). Or maybe work on your approach/attitude. Here's something you said in another post:
Quote:
I don't use OP's but I am about to run out of a pain killer at the end of this month. My doctor has always been good in the past about giving me a prescription well in advance before I fun out...
Your post goes on to discuss the incompetency of your doctor's office staff, and how your pharmacy didn't have authorization for a refill. To me, it seems like your pain was treated fine, just the office staff bungled up giving him the message, and you are pissed because you ran out of meds. That is perfectly understable, but if your pain is being adequately treated, why insult the medical profession over a mistake made by the office staff? You are not the only patient your doctor sees; I really doubt he purposely didn't give you your refill on time, if he had always been good about it in the past.
You also say:
Quote:
I predict that soon that there will be some type of national health care like Clinton wanted. Too many don't have any insurance.
First of all, I think everyone is entitled to quality healthcare at a price they can afford.
But I'm not sure what your "prediction" is based on. Are you predicted massive American insurance companies will sit idly by as they watch their fortunes evaporate? Do you think doctors via AMA's PAC will one day decide they make too much money? Do you think America, capitalist center of the world, will suddenly decide that socialism is a great idea after all? The answer is no, though there are many good arguments on both sides of the socialist health care issue.
Btw, medicine isn't the lucrative profession it once was, now that HMO's have entered the scene. I agree that doctors were abusing the medical pricing system for some time, and some things they do are way overpriced. Don't get me wrong, you can still make a very nice living, but unless you go into plastic surgery or a field that doesn't require insurance, you are making far less money than you would have not very long ago. And did I mention malpractice insurance? Actually, you did in a post where you wondered if it were possible to sue a doctor for not giving you narcotics. So, doctors can be sued for both underprescribing (though that's very rare at this moment) or "turning you into an addict." Tough situation, huh? Did I mention the incredibly high cost of malpractice insurance in states who don't have caps on settlements? That costs several hundred thousand dollars in some specialities because of the sue-happy society we live in. Most of the people I'm friends with in med school are there because they find it fascinating, they want to help people, and yes, once you factor in all the risks and expenses and insurance company scams, you can make a good living for yourself. I believe that is warranted after all the hard work you put in and dedicating your life to the betterment of others.
Quote:
I can't wait for these over-paid doctors to start having to take what the government will pay them or go out of business. There will never be enough patients with cash to pay out of their pockets for every doctor to continue to inflate his fees.
These "overpaid" doctors take what insurance companies give them, which is often not enough, and leads to more and more doctors merging into larger practices for at least some financial leverage.
If you want a nationalized health system, feel free to move to Canada. Expect hefty waiting lists , busy doctors' offices, and a less individual attention paid to patients. It might very well be possible to make an effective national health plan, but how often do bureaucracies ever make something that's effective and as tidy as promised?
Quote:
Maybe then we will get people going into medicine that want to be doctors to help people-not become instantly rich.
No, the standards of getting into medical school will relax, and ambitious, educated people are going to go into law or business or any other much-quicker-path-to-more-money sort of profession.
What is my solution? Allow health insurance companies to have a semi-private division dedicated to providing low cost medical care. They would get government subsidies so they can afford to give decent care without compromising our current situation. Doctors who want to accept higher volume, but lower office fee patients will do so. This way, people with insurance will not see the quality of their care dramatically plummet. People without insurance can purchase (or receive somehow from an employer) the new program, which would let you see doctors who accept it (much the way an HMO only lets you see certain doctors with just a copay). The disabled should receive free care, IMO. The government couldn't force any doctor to take the new program, but they could offer tax incentives or something to make it enticing, and the large volume of patients would attract doctors, too. The DEA also needs to give doctors way more room to do their jobs. And on top of that, America shouldn't have to finance the world's prescription drugs, so foreign drugs that pass quality-control inspection and are cheaper should be allowed into the country (in largers amounts than the bill they recently passed about Canadian drugs).
Wow, that was quite a rant.
-yawkaw
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zorg
Veteran
Reged: 04/29/02
Posts: 559
Loc: Midwest
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The problem is largely the DEA They tell doctors what to do, and don't have licenses themselves. Thanks to the war on drugs, an entire nation of people are suffering from chronic annoying pain to debilitating pain leading to suicide. We have the DEA to thank for presenting to a doctor's office in clinically documented agony, and being shooed away; to the ER if necessary. Bad news
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myrrine
Member
Reged: 08/10/03
Posts: 163
Loc: Western PA
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You get an award for that post yakwaw!!! You are so right, as frustrated as I get with the medical system, I can at least understand why it is that way. My mother was involved with the hosppital community both as a nurse and a patient, so I've seen it from both perspectives. And there are really greta doctors and bad ones, they're just like everyone else. I could sit here and blame the doctors for underprescribing me and not really knowing what is wrong with me, but the truth is I don't want anything stronger than hydro 10/500...I'm only 24, what's next after that??? I hate being in pain, but I hate my dependency more. It's a constant struggle to control this and not explode. But I know doctors are only human. We don't want them to control our bodies, yet we expect them to make everything better...it just doesn't work like that.
Anyway, that's my thought for the day. I totally agree with you Yakwaw, and I would just like to add, I'm really happy that there are OPs, because I can get my pain relief from them and go to my doctors for a true diagnosis without looking like a drug seeker. Because once you tell a doctor your on pain medicine they look at you differently. Of course my Primary doc does prescribe pain meds but she's started to lower it to wean me off...even though the pain hasn't been helped...and I've gone to PM, and sent away because it wasn't a back injury that was causing my pain. So I don't ask for pain meds now when I go to see new doctors, I just tell them my primary takes care of it. So unitl I find a compassionate doctor I feel comfortable with, I'm just going to leave it at that. At least with OPs I have my options open...
Ok that was longwinded....pain free wishes for everyone
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They say "time marches on," I just never got used to the beat...
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toe
Pooh-Bah
Reged: 10/09/02
Posts: 1431
Loc: MidWest USA
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Thank you yawkaw!
I wanted to make a similar post last night, because my mother completed her residency the spring before I started college. People seem not to realize the incredible financial, emotional, social sacrifices that graduate and professional students make. Suicide is common enough amongst this population that if you don't have one in your own class, you at least know someone who did. Then you get residency. I think that laws have passed since my mother's residency to make the hours worked by residents superficially more humane, but I remember working out in my brain what my mother's hourly wage would have been for her 100 hour weeks at the time and it was less than federal minimum wage.
Doctors in private practice have to pay their staff. They have to pay rent. They also have to pay the rising costs of malpractice insurance, which is not optional. Many doctors are being driven out of their profession because cannot afford to pay malpractice insurance . Consider this when you throw around the thought of taking a doctor to court for undertreating pain. Every suit drives the cost of malpractice insurance up and puts another doctor out of business. Next time you read about a malpractice suit, consider the fact that this suit may be putting the very doctor that you might eventually find who will treat you properly out of business.
The way this topic started makes me feel like the original poster feels like she's owed something. (I apologize for the 3rd person, I just don't recall the name). I say you've already gotten quite a break. I'm not even eligible for SSDI because I was considered a "temporary worker" at a university, where Social Security is not withheld from the checks, and my "temporary" status made me ineligible for disability insurance. I'm living on state disability assistance ($115) and Medicaid and waiting for my first SSI application to be completed.
However, I AM able to receive C-II meds and this has nothing to do with luck, shopping around, or the fact that I "really deserve it." I have had the same primary care doctor for over 2 years. We went through flexeril, PT, more flexeril, more PT, darvocet, more PT. In January of this year he finally ordered an MRI, which resultedin a referral to a Back Specialist, who prescribed skelaxin (shortly replaced by methocarbamol, due to an intolerance) more agrressive PT, a TNS unit, and a back brace. I injured my back before my follow up and it took an exceptionally long time to heal. At that point he reccomended discontinuation of the PT and use of long-acting opiates. I went back to my regular doctor, who put me on MS Contin.
This took two years. Of course I was frustrated in the interim and I am still frustrated. Opiates just don't relieve all of your pain. When I am going through one of my "spells" no amount of any medication rouches the pain in my knees. I've got an auto-immune disease that leaves me eternally exhausted and unable to get by on 8 hours sleep. And I am still fighting for my SSI.
You've got your SSDI, so gather your evidence, go to your doctor, ask for a referral to specialist or blood tests, x-rays, whatever it takes. If I managed to get a prescription for 180mg of MSContin a day from a doctor at the university clinic, then anything is possible.
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"It's the end of the World as We Know it. . ."
-REM "and I'm seeking asylum in Canada"-toe
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yawkaw3
Pooh-Bah
Reged: 03/22/03
Posts: 1193
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I'm glad to see people agree that it's not totally doctors' faults when they are underprescribed, and they have a lot to deal with themselves. But I still believe we're all entitled to proper health care (which includes management of chronic pain).
BTW, toe, did you get my PM? Haven't heard back from you in a few days...
-yawkaw
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Opie_Yates
Old Hand
Reged: 08/11/03
Posts: 476
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By the way, if you're in Texas, vote YES on Prop 12.
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I'm not a doctor, I just play one on a message forum!
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alphaman
Member
Reged: 06/07/03
Posts: 157
Loc: pittsburgh
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I just wanted to say i completely agree with you all, and i think that the DEA and the politicians should not make the laws about what to perscribe. In my opinion it should be the doctors that have the majority on how medical laws should be written they are the ones that go to school for this so there for they should make the laws for this thats JMHO........heath
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Never Be so Open-Minded that your Brains Fall Out
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samisu
Member
Reged: 02/08/03
Posts: 158
Loc: Tennessee
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Yakaw, Thank you for your great post. You put into words so eloquently what I feel. Sometimes I think it is just so difficult for us to see the forest for the trees. Maybe some day this great nation in which we live will come to the realization that there are truly people out there who seek medications for the relief of chronic pain just the same as for the relief of an antibiotic to treat an infection and not just the so called "addicts" who are seeking pain relievers. Until then, I am glad that the OPs exist and that I am able to use them. I know that there are so many out there who truly suffer and do not have the resources to utilize the means necessary to alleviate any of their suffering. Even though I must admit that I get frustrated at my PCP for being hesitant to prescribe the meds I need for adequate pain relief, I certainly understand the position that our powers that be have put him in. Let's all hope that the future of medicine will see a relaxation in the protocol for the treatment of pain relief for CP sufferers. 
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