Dismissal from Pain Management Doctor

[Jain1]

Hello, this is the first time on this forum. I am hoping to get answers.  My husband has been seeing a pain management doctor since 2011 for chronic back pain that radiates pain down into his leg.  His doctor is always amazed how he can walk because of the nerves and discs in his back are extremely severe.  In July of 2013 my husband, John, fell and broke his femur. His femur was repaired by an orthopedic surgeon and upon release from the hospital the orthopedic surgeon prescribed pain medicines that I had filled for John before he went into a skilled nursing facility to rehab his leg.  Then in December of 2013 John broke the rod in his femur. An orthopedic surgeon removed the rod, put in a new rod and also replaced his hip. While they were tweaking his hip in and out to get range of motion, the surgeon broke his femur again in a different place.  After discharge from the hospital and into a skilled nursing facility, I was given a prescription for Valium by the hospital physician and pain meds from his orthopedic surgeon.  Those were filled by the rehab facility.  Then in May of 2014 John's 10-year-old prosthetic knee developed a staph infection.  He had the knee removed and in it's place a cement knee was put in.  After discharge from the hospital the orthopedic surgeon gave me a prescription for pain meds to be filled.  I went to the pharmacy and had it filled for John.  Then in August of 2014 the orthopedic surgeon removed the cement knee and put in a real knee.  At discharge from the hospital the orthopedic surgeon gave me a prescription for pain meds for John which I had filled at the pharmacy.  

Now, we have received notice from this pain management doctor that John has been dismissed from his care stating that they received a DPS report stating that John has been getting narcotic prescriptions from other providers and that he broke the contract. I looked at a document in the patient forms that states that "doctor shopping" for additional pain medications from other physicians is discouraged.

We had given each hospital, each orthopedic surgeon and each skilled nursing facility a complete list of all medications John was taking on a daily basis, which also included the narcotic pain meds.  I did not know there was a contract between John and his PMP. I simply accepted the pain med prescriptions that were given to me on the dismissal from each hospital stay and had them filled.

So once we get through all this leg and knee issues, he will not have any pain medications for his chronic back pain.
What do we do now? What is the best approach to finding another pain management doctor? What obstacles will we face?  Please help, I feel like this is all my fault for accepting these prescriptions for my husband.

[philnoir]

If, during all this time with the hospital, broken leg, etc, your husband was also receiving pain medications from the pain doctor, then he is in violation of his controlled substance agreement.

However, if your husband has been receiving medications from only one doctor at a time, then there is no conflict.

You see, the contract was with your husband, not with the skilled nursing facilities.

This is a big problem with pain contracts when care is uncoordinated. I would like to see them outlawed.

Certainly this is not how their use was intended, but because of pressure from regulatory agencies like the DEA, doctors are forced into making their patients follow these rigid rules.

Blame your government. Since the DEA was unsuccessful in fighting street crime, they chose to take the politically expedient route of fighting a very small problem -- prescription drug "abuse",

Write your congressman, write your senator. Our government is interfering with the doctor/patient relationship and no one is happy execept for a well-funded and incompetent bureaucracy.

But enter in a conversation with your pain doctor. Explain your misunderstanding, and perhaps you will receive another chance.

[aMKR]

DITTO, Outlaw these contracts and ********. Funny how pain clinics are so strict but (if your addict) they hand you methadone and/or suboxone, for life... makes NO sense. Free lifetime supply of opioids, for “former addicts” as maintenance but you need pain medicine and have never abused a drug ever, nor been in trouble with the law, nor addicted... yet you make me sign away my rights, and make life a living hell in the process. It’s abhorrent.

[77hank]

You need to contact your Pain MD (in person) and explain what you did and etc. And yes, Pain Management clinics and MD's have contracts-We all sign them when we seek relief and will be using narcotic based drugs.

Your pharmacies must have had agreements with the Pain MD to notify him/her when you (your husband) was getting narcotic pain meds outside the schedule you and the clinic had. They interpreted the behavior as "drug seeking" which is manifest by MD shopping.

Make the appointment and explain and maybe they will re-enroll your husband. Good luck.

[aMKR]

Why? You’re not doctor shopping if you’re at the HOSPITAL! Jeez, it should be in those antiquated contracts that getting medicine filled after an ER visit or surgery does not constitute in anyway shape or form, “Doctor Shopping” (honestly, that’s youre health insurances call, even if not under contract, you go doctor shopping having multiple scripts from multiple doctors, NOT going to the Hospital scumbags

[backhurtz]

The problem is those that were obtaining prescriptions from primary cares, urgent cares, ERs, dentists, and any other prescriber they could, bypassing their PM docs. That's why they put into contracts all opiates must be written by your PM doctor and you must notify PM doc before filling any other opiate/benzo , including from surgeons, ERs, etc.

[092656]

I failed 2 urine tests for marijuana and was dismissed. ...what can i do now...I've been to this clinic 3 times. The one before this one I went to for over 2 years and never failed.at least they never said I did anyway

[remar]

Your husband in no way was Dr shopping. He had surgeries and needed the pain medication. I'm so sorry both of you are going through this.
I was thinking of going to a pain management clinic myself for chronic pain since my GP will no longer prescribe pain meds for me but after hearing these stories I don't think I will be doing that.
I really hope they give your husband another chance. I have to wonder how many of these Drs deal with severe pain? If they did they would not let their patients suffer.

[Jain1]

Thank you everyone for your advice. I have tried contacting John's pain management doctor by calling as well as sending an email to his doctor's private email. I have used the private email before because he's told me that he personally checks it.  I explained to him the course of events that led to this. John's dismissal letter indicated breaking of a contract.  The only thing I could find in the paitient forms paperwork was a document entitled "Guidelines For Chronic Narcotic Administration." It's probably a matter of symantics, but I believe there's a difference between a contract and guidelines. The guidelines indicate "doctor shopping" is prohibited. I asked his PM doctor in my email if he really thought John was doctor shopping, given the fact that we gave all other doctors a complete list of his medications which included the narcotics. If these femur and knee surgeries had not occurred we wouldn't be in this predictament.

Thank you Steph for your encouragement. I feel your pain from all the spine problems you are experiencing.  I've seen my husband suffer from constant pain.  I've listened to him cry out in pain every morning from his back issues. It affects the entire family.  It's always there.  I've seen my husband go from a vibrant hard working man to a man that's been on a walker for the past year. It's so sad.

I will keep everyone informed as this progresses. If we don't hear back from his PM doctor, we will go to his primary care doctor to explain the situation and get a referral. He's had a long relationship with his PCP and he'd been seeing his PM doctor since early 2011 without any incidents.

[Life360_Dave]

Hi, dosent make any sense for them to dismiss John for this. I dont think his doctor is aware this happened as the letter may have originated from his staff  as a procedural ruling. Many of the front desk staff do things without the doctor knowing it. I would do a walk in to the factility telling them exactly what you posted here as something is not right. Or simply get another doctor.
These doctor shopping laws are intended to make red flags for drug abusers not for people like John

[Steph_SCO]

Firstly it is not your fault, when a specialist hands you a prescription for medication you should not need to question whether or not it is in breach of any contract.

I suffer from lower nerve damage, T6 and T7 crushed vertebrae and the rest of my Thoracic vertebrae are fractured. I have seen several specialists, across seven different hospitals. Each one has prescribed me with medication ranging from anti-depressants, Diazepam, Gabapentin, Tramadol, Morphine MST, Venlafaxine, Oral Morphine. I am in the UK so if you are overseas then I cannot comment on the rules and regulations, but my pain management team all know the medication I have been prescribed over the past three years.

I would seek advice from a lawyer, or an independent company that can advise you on the rules. At the end of the day you were merely carrying out the instructions given to you by someone who should know these rules, and certainly someone you should be able to place your trust and life in their hands.

I hope things start to get better for you and your husband, you both deserve a happy resolution to all of this.

I have checked the Watch list so I will keep an eye out for any updates, I pray things get better for you both real soon, and as I said earlier, none of this is your fault.