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New Dr I have concerns me as he refuses to give me any pain meds

Greetings,
I found your web site tonight as I researched information to write my health care facility about my concerns, I have two.
I live in a very poor county in northern Maine. The clinic I use is completely staffed by PA's & I've never met the Dr who is making the decisions about my health care.
This worries me greatly. This is not a small office with one Dr and one PA but rather a lot of PA's employed there and one Dr who never sees the patient.

"The doctor–patient relationship has been and remains a keystone of care: the medium in which data are gathered, diagnoses and plans are made, compliance is accomplished, and healing, patient activation, and support are provided. United States law considers the relationship fiduciary; i.e., physicians are expected and required to act in their patient's interests, even when those interests may conflict with their own."

My PA told me after my reading an article on yahoo news about the opioid crisis which stated the the emergency room visits for over doses are less than 1% for patients legally prescribed the medicine. Seems the over doses are mainly for drug addicts buying the pills illegally. That upon proof of my producing the article she would write me a script but than she informed me she spoke to the Dr who stated I don't qualify for the medicine.

I am elderly at 60 years old, disabled with 50% lung capacity, I've had numerous heart attacks & a stroke too. I have serious lower back problems, where the pain shoots down my left leg and exits thru my ankle. Out of 7 days in a week I'm lucky to have one good day. The rest of the time I wake up and just make it to my couch, which is where I spend the rest of my day, simply waiting for bed time to arrive. That gets depressing, especially being reduced to that little, that powerless of a man in front of my wife. Most nights I'm just lucky to hold her once we get into bed, forget about a romantic love life. My wife and I are madly in love to this day, we still hold hands and we are never apart.

I just recently transferred to this clinic and the 10 mg oxicodone is the script they refuse to write for me, I understand the crisis in this country but I also have a right to a quality of right expectation. I use to get 60 doses or 120 5mg pills but I've offered to reduce that number to only 12 doses of 10mg oxicodone in a month. They still refuse the medicine.

My two questions to you are, and I quoted the US National Library of Medicine in the 2nd paragraph, in the hope that it's true. Do I have a right to get the medicine I need?
My other question is, is it ethical to see a PA and never meet the actual Dr responsible for my care? This concerns me. I look forward to your reply.

Thank You in advance,
5 Responses
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446049 tn?1649005835
If you're anywhere near Presque Isle there are a few good pain management
doctors that you could check out.
Helpful - 0
Avatar universal
Is there a possibility of going back to the doctor that was prescribing the
5 mg Oxycodone until you find another practice your comfortable with?  
PM practices do typically prescribe opiates on subsequent visits like backhurtz mentioned.  Both of the previous pain clinics I went to prescribed my medications on the second visit.   If you provide your medical records to the new clinic they will be able to see the alternative treatments you’ve tried and the medications you’ve tried that have successfully been treating your pain.
I mentioned maybe seeing your GP because your PM records are typically  sent to your referring doctor as a courtesy and in most cases it’s the GP.  He’d already know you have been taking the 5mg Oxycodone and be aware of/monitor your lung capacity issues.  
Helpful - 0
20803600 tn?1546262537
COMMUNITY LEADER
With your only having 50% long capacity, putting you on opiates might cause even more breathing issues. Opiates cause respiratory suppression, and it may very well be given your breathing status that is one big factor in not giving you opiates.
As far as PAs vs MDs go, all PAs are required by Federal law to be supervised by the MD. This doesn't mean they physically have to be in the room, but review decisions made by the PA.
There are other types of meds that treat pain that might help you, so I would consult with a PM practice.
You have to understand, even in ones that do prescribe opiates, they typically do not prescribe on the first or second visit, and they typically want you to try other treatment options first.
Helpful - 0
Avatar universal
The reason given was they do not prescribe opiates anymore.
Helpful - 0
1 Comments
I would look for a pain clinic that does. Maybe you could search the internet for Pain Management doctors in your area and call them before going to the trouble of seeing them. Do you have an internist or General Practicioner? Sometimes they will prescribe them for you. I might actually start there. Tell  your internist or GP what happen and ask if they would be able to write your prescription. They will probably want to see you for a quick visit initially and each month.
I hope you can get some positive answers very soon!
Good luck
Avatar universal
I’m sorry to hear your having trouble getting your medication.  The PA checked with the doctor? You said you didn’t qualify. What reason did the doctor give for not wanting to write a prescription? Did you encounter any problems with the previous doctor that wrote the prescription for you? If it were me I would go to another place. Bring your medical records from your previous doctor with you. You’ll have to provide the old office with a signed written request for the records. The doctor should at least see you for a consultation before the PA starts seeing you. At least that is a pretty standard thing where I live.
Best of luck to you!
Helpful - 0
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