Remember… healthcare is a FOR PROFIT BUSINESS… influences decision on pt care ?

Well I’ve been going to the same PM Dr for the past 8 years.

Always had a good relationship.

I’ve used only the same pharmacy for well over 15 years.

Always took my meds as prescribed.

2 oxycodone 5/325 per day.

Never had them lost or stolen.

No matter how unbearable at times, I’ve never called in between appts.

Just one of the most honest/compliant patients she’s had IMO.

Anyway the bottom line is she alleged me to be negative on my urine 3 times so she cut me off last month.

She said I’m still a patient for now and can go back for injections if I wish.

I have access to my records via the Patient Portal and for every accused negative it shows positive and I know I was positive because I certainly took them.

I’m assuming this positive is from the cup.

They then send the urine to a lab.

Because the lab shows negative, I guess that’s all that matters to her.

I could see if I was negative on the cup AND the lab I wouldn’t have much of an argument, even though I took them as prescribed. But I’m positive and negative which makes no sense to me.

At my last appt, I called her out on this and told her to “stop trying to convince me that I was negative, it’s like me trying to tell you that you didn’t wear shoes to work this morning, sounds silly doesn’t it?”

She said she believes me but can no longer prescribe because of the lab results.

She printed out the lab results and gave me copies.

As you’ll see, it was collected the day of my appt. 

The lab receives it 3 days later and possibly didn’t test it for yet another week.

I do believe I have a fast metabolism because I’m 56 and weigh the same as I did in high school. I’ve never been able to gain weight.

So my questions are:

1) did the time it took for the lab to process the urine have any effect on the outcome?

2) do you feel she should have based her decision on the fact that the cup was positive for every one?

I will leave it as this for now although as you can imagine I have a ton of questions.

I feel completely blindsided and this couldn’t have happened at a worse time as on top of my chronic pain I’m also in a bad flare of diverticulitis and scheduled for a colectomy on July 10.

Thank you very much for your input and time!

It seems strange to me that a physician would send out a urine sample to a outside lab when the office’s testing shows the medication that the pt is prescribed shows up in the test…

I am not very knowledgeable on urine testing procedures, but common sense would suggest that tests on a sample that is not stored properly or mishandled.. could allow the medication being tested for to deteriorate until it was at such a level that it could not be detected.

I found this website that discusses mishandling and other issues effecting false urine test outcomes http://www.brighthub.com/science/medical/articles/71492.aspx

I also find it strange that the physician is willing to continue treating the pt with ESI’s… it is common knowledge that ESI’s are MUCH MORE PROFITABLE for a practice than getting a office visit charge for writing a prescription.

For a pt to have their pain managed on such a low dose of Oxycodone  – a total of 10 mg/day – seems so benign. Could this physician have figured out how to improperly store or mishandle urine samples being sent to outside labs so that the sample will deteriorate to a point that it will test negative for the medication that the pt is on .. so that there is “proof” of a negative test ?

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