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May 27, 2010
Confidential Doctor-patient relationship? Or suspect criminal conspiracy?
In the Drug War front, the situation in Mexico may have become completely uncontrollable, but not to worry! Our drug enforcement agents are continuing to launch raids on doctors in this country and charge them with overprescribing pain meds. The legal system being the way it is, a charge of overprescribing now translates into racketeering, conspiracy, money-laundering, etc. In other words (in a clear message to other dorctors), if you write a prescription that the DEA thinks you should not have written, you could go to prison for life! Currently, there's quite a ruckus over a Kansas physician who does not hesitate to treat large numbers of pain patients, some of whom allegedly resold the drugs on the street. So the doctor is being prosecuted. HAYSVILLE, Kan. -- The Schneider Medical Clinic was once open seven days a week for as many as 11 hours a day. Patients, scheduled 10 minutes apart, often waited hours for an appointment.OK, right there I see a problem. With that kind of high-volume practice (which will most likely increase under Pelosicare), it would be nearly impossible for doctors to get into the kind of detailed patient policing that the DEA seems to be pushing for by way of these high-profile prosecutions. Today, its doors are shuttered and the couple who ran the clinic are in jail, charged with allegedly operating a "pill mill" linked to 56 overdose deaths.Fortunately, there is still a jury system, so the DEA can't imprison doctors merely on their say-so. But regardless of whether Dr. Schneider is convicted, a message is clearly being sent. Even some of the chief state prosecutors are alarmed. ...experts say high-profile prosecutions of pain management specialists has since spooked medical providers from writing pain medication.Freedom to be pain free? Tell it to the judge! The prosecutor in this case, Tanya Treadway, has a long history of antagonism towards pain activists, and she actually tried to charge Siobhan Reynolds with "obstruction of justice" for putting up a billboard defending Schneider and a PRN video about the conflict between drug control and pain control -- activities which constitute free speech. So eating away at a patient's right to medicate pain and the right of a doctor to treat a patient as he sees fit may in fact be the whole idea. A patient's need for pain meds has to be balanced against what is considered in the best interests of the "Drug War." Patients who need pain meds must necessarily become suspects. If you think I am exaggerating, just read what one of the prosecution's experts says: Dr. Doug Jorgensen, a Massachusetts pain management specialist, testified that the number of patients was "beyond excessive," and the sheer volume would make it difficult to monitor patients. He also said prescription refills were given to patients whose urinary screening tests showed they were not taking their pills, a sign the drugs were being sold.I'm sorry but patients are not suspects. Testing the urine of patients to monitor whether they are taking their pills is downright Orwellian, and I would not go to a doctor who did that. Nor, I suspect, would most people. Which means that the drug war bureaucrats probably have a plan in mind to make patient urine testing mandatory. For all I know, such a provision might even be buried somewhere in the thousands of pages of the Pelosicare "law." (In any event, you can be sure that in the near future, dissenters who behave like, say, Joe The Plumber can expect to see their once-confidential prescription records leaked to the media by common bureaucrats.) posted by Eric on 05.27.10 at 11:30 AM
Comments
"refills were given to patients whose urinary screening tests showed they were not taking their pills, a sign the drugs were being sold" Is it? Non-compliance with the treatment regime is a well-known phenomenon, even for patients with chronic and/or fatal diseases. I think that much more likely than drug trafficing. Bob Smith · May 27, 2010 05:34 PM As a general rule, pain management patients include a non-trivial percentage who are abusing and/or selling drugs. I know nothing about this case but I treat many patients with chronic pain and I can assure you that a 10 minute appointment once a month without any ancillary services for monitoring purposes is borderline malpractice. All patients deserve to have as much pain medication as they need, but the potential for abuse is very significant and the treatment of patients with chronic pain needs to be conducted very carefully. ShrinkWrapped · May 27, 2010 09:23 PM I'm not thrilled with the government taking on policing of doctors, but this does sound like a Dr. Feelgood operation. Even ignoring the question of whether patients were reselling their pills, this sounds like a doctor who has abandoned his responsibility to his patients. Clayton E. Cramer · May 28, 2010 02:02 PM " Testing the urine of patients to monitor whether they are taking their pills is downright Orwellian" While you are certainly entitled to your opinion, if you wish to set standards of practice you might want to become a member of the profession. Since it is not being done by the State soes it still qualify as Orwellian? Is it onerous? Yes. Is it undignified? Yes. "Non-compliance with the treatment regime is a well-known phenomenon, even for patients with chronic and/or fatal diseases. I think that much more likely than drug trafficing." Look, these too cute by half arguments do not win over anyone. If the patient is non-compliant that is their choice. But if they haven't been taking any of the last prescription then they really shouldn't need another refill now should they? Let's stop pretending. Some people seek drugs for non-medicinal purposes. Some of these people attempt to obtain them from medical practitioners through fraud or deception. Whether you agree or disagree with their motives is immaterial. The reality is they exist and it is not appropriate for them to be obtaining these medications from practitioners - that's not what medicine is about. It is sad and unfortuante that our society has decided to restricts access to such substances, but that is the way it is (at least for now.) By these same laws medical practitioners are allowed legal access to these substances solely for the purpose of treating bona fide medical conditions. That means - whether they agree or disagree with the underlying law - they have a professional obligation to ensure that they only use these substances when medically appropriate. Nobody likes to deal with a client or customer they don't trust, but we all know that these are human beings and trust but verify is not exactly a new concept on the face of the Earth. That some practitioners chase easy money by servicing the illicit drug seeker is also nothing new under the Sun. Don't insult anyone's intelligence by pretending they don't exist. Chicken Little claims that the sky is falling might be taken a little more seriously if they didn't involve such an obvious Doctor Feelgood situation. "this sounds like a doctor who has abandoned his responsibility to his patients." And his responsibility to his profession. MountainMain · May 30, 2010 10:14 AM Ah. Yes. Doctor FeelGood. Except that medicine is supposed to make the patient comfortable if treatment is not available. People in chronic pain chronically take drugs. Which is why the drug market beyond a point is inelastic. After you chase away the casual users those in chronic pain will pay a lot for pain relief. It doesn't matter if the pain is from a broken bone or rape memories. M. Simon · June 2, 2010 12:32 PM Bonjour, Ladylike to unify you, I am Nancy nansyeartho · June 10, 2010 12:33 AM Post a comment
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