Narcotic contract question

[Caldestin]

I am seeing a PM on Monday; hopefully to get a second opinion about everything concerning my knees and back. The only thing I am worrying about right now is that I signed a Narcotic Contract with my PCP 2 years ago. When I looked up the forms on the PM's website; he had one as well. If I see this PM on Monday; wouldnt I be breaking the contract with my PCP?? I mean, I am really worried about this. Would I get into alot of trouble, or do people break Narcotic Contracts daily because their doctor isnt treating them the right way?? It states on my PCP's contract that if I get medication somewhere else; I will not be seen again...FOR ANYTHING!! Any advise would be great.

[namnam46]

Hi Caldestin,

In your OTHER post you didn't say that you had signed the contract with your PCP.  IF you had the information would have been very different.  :{

You WILL be in a LOT of trouble if you do this WITHOUT the consent of your PCP!!!  Your PCP WILL kick you out and you will be Red Flagged as a Doctor shopper.  

Tomorrow you need to get in touch with your NEW PM Doctor and CANCEL the appointment UNTIL you talk with your PCP UNLESS you don't mind being kicked out.  The OTHER problem that you MIGHT incur is that the NEW PM Doctor will find out that you have ALREADY signed a Pain Contract and will REFUSE to see you UNTIL you have been released from your PCP.  

IF you can get that release from your PCP then you will be OK BUT you REALLY need to do some work BEFORE you see the PM Doctor so that you WON'T be in trouble with EITHER Doctor.  

I would HATE to see you LOSE EITHER one of your Doctor's as it is VERY difficult for you to get REALLY good Pain Management at your age - as Ashelen has told you.

PLEASE decide which Doctor you WANT to see and then proceed from that point BUT DON'T get yourself into a difficult situation that you CAN'T get out of without being "Red Flagged" and NOT be able ot get ANY Doctor.  

Let us know what you decide and how you are handling it as we worry about our Members here on MH.  :)..............Sherry

[Caldestin]

Thank you,
I want to see the PM DR. I was just reading up about this kind of stuff. Hell no I'm not a Dr shopper; I may be in pain, but I'm not that stupid. Tomarrow is Friday, I'll call and tell the receptionist to cancel the appt with the PM doctor. Then I will go to my PCP either next week, or at the end of the month when I get my refills. The thing is, I really don't know how to tell my PCP that I want him to release me; because the thing is, up until 4 months ago, he was actually listening to me. I definatly dont want to be red flagged, but I definatly dont want to be in this much pain because of a knee problem. The funny thing is that one of my cousins had to sign a pain contract with his past doctor, about a month ago, he started seeing a PM and apparently their were no occurances. Would they Red Flag for breaking contract all because the patient got frusterated with the original doctor in the first place?

[Caldestin]

And my cousin never notified the original doctor, just stopped going to him and signed the contract with the new PM doctor he is seeing.

[atonicat]

An easier way would be to ask your doctor for a referral to this PM doctor. That way he knows about it and you wouldn't have to break any ties with him. It's always good to be upfront and honest. I'm sure he would understand that you want a doctor who's trained in pain.

[Caldestin]

One other question. If I contact my insurance company to notify them about this; along with the contract I signed; as well as being unsatisfied with the treatment my PCP was doing, wouldn't the insurance company be able to do something as well? I mean, when I go on Monday I will be taking my current medication with me so the PM doctor knows what I am taking, I am also going for a second opinion. I guess it wouldnt be so stressful if there wasnt a contract to begin with; because then I could just walk away with no incursions. What if tomarrow; I walked into my PCP and asked for my records and informed them I was going to see a pain management specialist on Monday; would that be a way of getting released from the contract?? Or would I actually have to inform the doctor himself?

[Caldestin]

@atonicat I have already tried that; he told me no.

[atonicat]

I would say if you told his office and said you were going to a PM doctor and requested your records than you should go to the PM appointment. Tell your PM what is going on though. Basically if you get red flagged and then try to go to another doctor it would be very hard. But since you have not been flagged yet, and informed your PCP, you should be fine. As long as your PM knows why you went to them, everything should be fine. It's not like you're going behind anyone's back.

[Caldestin]

Yeah exactly; that way I wont be going behind my PCP's back about this issue. I'm going there tomarrow, and asking for my records from the receptionist, although I dont know if the doctor will want to talk to me without paying; and if not I'll tell her to let the doctor know that I am going to see a PM doctor on Monday. Hopefully I'll be able to see him without paying. I really dont want to go back to my PCP after this experiance though.

[geminigirl1963]

One concern I have is that since you said you've already asked your PCP for a referral to pain managmenet and he refused your request - if you go into his office tomorrow asking for your records and tell them you are going to PM on Monday, you may still be jeopardizing your relationship with your PCP.  I'm not sure why he has refused to give you a referral to pain management, but since he has, going into his office and telling them that you've decided to go may not go over too well (although I honestly believe that all patients have the right to see a doctor who will listen to them and treat them appropriately).

I suggest calling the PM doctor's office and telling them you wanted to come in for a second opinion and ask if there is any way that you can keep the appointment, but NOT sign any contracts or receive meds - simply get that second opinion.  I may be wrong here (and someone please let me know if I am), but I don't think that if you did that and didn't sign any contracts OR receive any meds, then you wouldn't be breaking any contracts with your PCP.  

Whatever you decide, you certainly don't want to jeopardize your relationship with your PCP - it's not just pain control that we're talking about here - it's ALL health issues, so it's important to have a "regular" doctor that you can go to.

[namnam46]

Yes, if you did that tomorrow and get your records that would DEFINITELY get you released - Here's what I would do and that is to go in and ask for your records BUT don't tell them it's for another Doctor!!  Just tell them it's for YOU!!  They CANNOT refuse you as it's the LAW that you can have access to your Medical records.  The reason for this is that your PCP has ALREADY told you that he/she won't refer you to a PM Doctor, therefore, if your PCP knows WHY you want them they MIGHT STALL in getting them ready for you.  It will take - NORMALLY - a few days for them to be able ot get them ready for you.

Why don't you ASK your PCP to give you the MRI again?  THEN if he says "NO", you have an even MORE LEGITIMATE reason to leave him, that you can tell the NEW PM Doctor!!  That way they WILL understand and NOT question you in ANY way at all.

IF you do this carefully then EVERYTHING will work out GREAT for you. You can of course do it ANY way that you want - I JUST don't want you to take ANY unnecessary chances where you Pain Medication is concerned.  It's the Grandmother in me!!  :)  I ALWAYS try to protect the younger people on here that are having problems getting the meds that they need and are entitled to!!  I don't want you to take ANY chances - as I said earlier.  

I DON'T understand why you PCP won't send you to an Orthopedic Surgeon to check out your knee for surgery? Did you EVER ask him/her about the surgery?

I hope that this helps you a little. PLEASE let us know what you decide and how it goes. As I said earlier - I REALLY worry about you all.  :)

I'll be looking for MORE updates from you...........Sherry :)

[Caldestin]

@geminigirl1963 your reply is below
"One concern I have is that since you said you've already asked your PCP for a referral to pain managmenet and he refused your request - if you go into his office tomorrow asking for your records and tell them you are going to PM on Monday, you may still be jeopardizing your relationship with your PCP.  I'm not sure why he has refused to give you a referral to pain management, but since he has, going into his office and telling them that you've decided to go may not go over too well (although I honestly believe that all patients have the right to see a doctor who will listen to them and treat them appropriately)."

I'm fully aware of the fact that I need a GP; my PCP is a Internist; but he doesnt listen. Back in 2008, I think he had another practice that closed for some reason or another, I dont know why. If by doing this tomarrow it severs all ties with my PCP, I'll be fine with it due to the fact that both of my parents doctor is covered by UHC; plus on top of that, she is one of the highest rated doctors in my state. I asked him for a referral 4  months ago; and recieved basically a STFU; not in that context, but he became I wouldnt say angry, just tempermental since then, like I offended him or something, which had me thinking for the next couple months that all he wanted was the money I was paying to see (co pay is $30.)

@namnam46 your comment is below
"Yes, if you did that tomorrow and get your records that would DEFINITELY get you released - Here's what I would do and that is to go in and ask for your records BUT don't tell them it's for another Doctor!!  Just tell them it's for YOU!!  They CANNOT refuse you as it's the LAW that you can have access to your Medical records.  The reason for this is that your PCP has ALREADY told you that he/she won't refer you to a PM Doctor, therefore, if your PCP knows WHY you want them they MIGHT STALL in getting them ready for you.  It will take - NORMALLY - a few days for them to be able ot get them ready for you.
Why don't you ASK your PCP to give you the MRI again?  THEN if he says "NO", you have an even MORE LEGITIMATE reason to leave him, that you can tell the NEW PM Doctor!!  That way they WILL understand and NOT question you in ANY way at all.
IF you do this carefully then EVERYTHING will work out GREAT for you. You can of course do it ANY way that you want - I JUST don't want you to take ANY unnecessary chances where you Pain Medication is concerned.  It's the Grandmother in me!!  :)  I ALWAYS try to protect the younger people on here that are having problems getting the meds that they need and are entitled to!!  I don't want you to take ANY chances - as I said earlier.  
I DON'T understand why you PCP won't send you to an Orthopedic Surgeon to check out your knee for surgery? Did you EVER ask him/her about the surgery?"

Thats awesome your a grandmother; I actually lost both of mine 10 years ago due to lung cancer and back cancer. When I go (I was actually thinking about phoning them to release the records to me) tomarrow for the records; it will for sure release me from my narcotic contract with my PCP and not red flag me?? Heres the thing; once I recieve the records from the office, I will not longer be seeing him. Also, what if the receptionist asks me why do I want them? I mean, should I talk to the doctor himself for these?? Or would the receptionist be able to release me form the contract? Or should I request to be released? That way I'll still be on good standing if I ever was compelled to go back.
I never asked my doctor for my MRI's; considering that the place where I got them done already has a copy of them ready for me to pick up.
Hopefully, what will happen; is that tomarrow I can request to pick up my medical records from my PCP, terminate the Narcotic Contract with them without question/without my PCP flipping a **** or yelling at me in the waiting room (I've heard the horror stories of how a woman went to the hospital after a car accident, was basically in a coma for 3 days and during that time got pain medication, went to see him for a refill, and got reemed in the waiting room.) go get my X-rays and MRI's, and see this PM on Monday. Hopefully, everything will go as planned.

[namnam46]

I'm so sorry to hear that you lost BOTH of your Dear Grandmother's and ALMOST at the same time and to the same disease - though different types.  I KNOW that you must miss them. :{

I was talking about your PCP ordering you a NEW MRI so that he can compare the two.  THEN if he REFUSES to order a NEW MRI for you that will DEFINITELY give you a legitimate reason to leave him as he wouldn't order the test for you.  In 3 years your injury could DEFINITELY get MUCH WORSE and that would show him the reason that your meds aren't doing the job that they SHOULD be doing and WHY you need something different.  

Did you EVER ask to be referred to an Orthopedic Surgeon to do the surgery that you need?  IF he won't do that then there's ANOTHER reason to legitimately leave him ALSO!!!  I just want you to be sure that you have ALL your "ducks in a row"!!  LOL

You DON'T have to tell them that you are taking them to another Doctor - you can just tell them that you want them for YOUR RECORDS.  As I said the CAN'T deny them to you.  I doubt that they will be able to get them for you in time for you Doctor's appointment and you sure don't want to PUSH THEM on this as that would raise a BUNCH of signals that you DON'T want raised!!   There SHOULDN'T be ANY reason that you would need to see the Doctor to get your records.  The receptionist OR the Nurse SHOULD be able to do this for you WITHOUT you coming into contact with the Doctor.  HOWEVER, if the Doctor is ALREADY acting weird then I don't know what they will do.  JUST remember that they HAVE to honor your request.  BEFORE you take the records to you NEW Doctor BE SURE that you read them first and BE SURE that there is NOTHING in them that is derogatory in them about you. Nothing that would allude to you being a "drug seeker" etc. that this Doctor MIGHT have written since you asked to go to a PM Doctor.  You said that seemed to "irritate" him and sometimes the Doctor's will go in and write derogatory things that AREN'T true in records and THEN you have to WRITE A LETTER to the Doctor that wrote the derogatory statements disputing what he wrote so that it will be added into your records.  IF you write a letter to your Doctor it HAS to be added to you records - that's the LAW also.  I just don't want you to be SURPRISED by you records.  HOPEFULLY, nothing will be wrong with them and ALL will go SMOOTHLY!!!!  I DON'T want to frighten you BUT you need to be aware of what has happened to NUMEROUS members here on Med Help. IF you know what to look for then you won't be "blindsided".  :}

I'm VERY happy that you have ALREADY contacted the Lab that did the ORIGINAL MRI's and they will be ready for you!!  :}  That's a good move on your part.  

I wish you the BEST of luck tomorrow and hope EVERYTHING will go VERY smoothly for you and you will get the results that you DESERVE!!!  

I'll be looking for a VERY positive update from you tomorrow and AGAIN on Monday. :}

Just know I'm thinking of you..................Sherry

[Caldestin]

Ill update with the findings from my medical records tomarrow. They arent paperless, but I'm pretty sure they have a copy machine. Hopefully they dont charge to make copies. namnam46; I'll shoot you a message when I get them; hopefully youll be willing to point out if there is anything wrong with them. I guess when I get my records it will mean that the contract is over and I'm free from it right?

[namnam46]

No, you won't be out from under it until you TELL them that you DON'T want him for your Doctor anymore OR they dismiss you from him.  I'd just tell them tomorrow that you are changing Doctor's BUT NOT UNTIL you have the records IN YOUR HANDS!!!!  So IF they don't have them ready tomorrow - DON'T tell them ANYTHING!!! When they hand them to you THEN tell them that you are leaving the practice.  REMEMBER that they PROBABLY won't be able to get them ready for you on a "moment's notice".  It COULD take up to 3 or 4 BUSINESS days as they will have to get them together and print them out.  So DON'T be surprised IF they can't do that immediately.  I've NEVER known a Doctor's Office that could do that.  :{  Just so you know, SOME Doctor's Offices DO charge you for making the copies - as much as $2.00 a page - so JUST be prepared.  HOPEFULLY, yours won't.  I HAVE heard of that on MH before though.  I was fortunate as MINE didn't charge me ANYTHING when I moved from Tennessee to Arizona  1- 1/2 years ago.  It would have been VERY expensive for me IF they had, BUT yours shouldn't cost that much as you are so young that you haven't built up YEARS AND YEARS of records, therefore your records shouldn't contain very many pages.  :}

I wish you the BEST of luck...........Sherry

[flower12345]

Hi. I just read through the tread. Sherry gives great advice. Get those records BEFORE you tell him you've found another doctor, so he doesn't write anything that could damage your reputation in the records.

Hugs,

Flower

[geminigirl1963]

I also agree about not saying anything to your doctor BEFORE you have your records in hand.

You may also be required to sign a release form for them to release the copy of your records even to you.

Whenever you DO tell them that you are going to another doctor and won't be seeing this doctor any longer, might I also suggest that you follow this up in writing.  This way you not only have proof for your new PM doc that you are not seeing two docs, but it also is written proof that you have cancelled the narcotic contract by basically "firing" your current doctor.

I'm glad that you have other options for another PCP - it certainly sounds like it's time to move on from this one as he's not only not been listening to you, but sounds like he's also been very "snippy".  The refusing to do testing and send you for other opinions also does not bode well with me - I think you're quite correct in him pretty much only wanting that co-pay you were having to pay him.

Most doctors do charge for copies of records, but it does vary from doctor to doctor as to how much.  It does make sense that they would charge for them, as it does cost them in paper, copier toner and employee time to do the copying.  One way you might be able to reduce the cost to you would be to call up the new PMP office and simply ask them what records they require (i.e., doctor's notes, test results, medication lists, etc.) and how far back they want it from (some only require a  few months' worth and others want EVERYTHING)

Best of luck and let us know what happens.

[Caldestin]

That's exactly what my father said. To contact the pm and see if I could keep the appointment with them and not sign the narcotic contract. But he did say to bring my lortab with me in case the pm did decided to prescribe; because at that time; I could sign the contract and hand them my medication; but it probably doesn't work that way.  Nevertheless I don't want to see my pcp because if my pcp did are about my health, I would be getting regular bloodwork and such done to make sure y liver wasn't failing. Like I said before when I told him that the lortab hasn't worked as well; and that I was concerned about the amount of tylonal I'm ingesting; he said I was going to be fine. Isn't it every patients right to worry about their health? Also it is my right to have a second opinion, it's everyone right. I don't think there's a law saying I can't.

[Caldestin]

Sorry, replied to the end of geminigirls comment. My iPhone is horrible at reading forums. But I definatly will contact them today and request my records and once I get them; I will write a letter to my doctor as well as inform them that I will not e coming back.

[Caldestin]

Sorry, replied to the end of geminigirls comment. My iPhone is horrible at reading forums. But I definatly will contact them today and request my records and once I get them; I will write a letter to my doctor as well as inform them that I will not e coming back.

[Caldestin]

Ok so I just got off the phone with them I'm getting my records (all of them) on tuesday

[namnam46]

EXCELLENT!!!!  Did they ask you ANY questions at all?  Did you have to tell them anything to get the records?

[Caldestin]

No, they didn't ask any questions nor did I jaw to do anything for them

[namnam46]

That's wonderful.  If you don't mind me asking, did they charge you anything for the copies, that you know of?

[Caldestin]

$23 on Tuesday; I moved my appointment to wenesday. When I pick them up, I'm going to notify them I will not be coming back; hopefully my pcp didn't write anything when I requested them today to try and screw me. Namnam I will send you a message with the contents so we can go over it if you don't mind