When a pain management practitioner – really could care less about really trying to manage a pt’s pain

I had a interesting conversation with a chronic pain pt yesterday. This pt shared with me a 18 minute recording of a office visit with a mid-level practitioner. This is suppose to be a pain practice and this pt has a torturous level of pain in each shoulder from two separate accidents.  The pain is so intense that the pt has very little use of both of their arms.   Just imagine the difficulty a person would have in doing personal care and/or simple chores around one’s house. Especially since the pt lived alone.

This mid-level did not ask what the pt’s level of pain was, but told the pt that they were at the max dose by the CDC of opiates and that she was on Xanax (Alprazolam) and he referenced the Beers Criteria https://www.aafp.org/afp/2020/0101/p56.html and the risk that Beers stated was hazardous to cause falls and other MAYBE SIDE EFFECTS.  But Beers is specifically directed towards those 65+ y/o and this pt was 61 y/o.

What the pt told me that they were prescribed was NO WHERE NEAR the CDC guidelines of 90 MME/day and this was a pain practice, so those limits do not apply to pain specialists.

The pt point out to the mid-level that the CDC were only guidelines – which the mid-level acknowledged, but the managing MD over the practice had implement max daily MME levels that what he consider “safe”.  That OLD ONE SIZE FITS ALL.

The pt is going to try to find a new pain management practice and I suggested once they have left this practice to file a complaint with the Quality Improvement Organization (QIO) and when they get reviewer’s report back. If the reviewer believes that the pt was not properly treated. Take that report and file a complaint with the state AG’s office on the MD and the mid-level in the practice and file a complaint with CMS about the pt’s Medicare’s Advantage Prgm

3 Responses

  1. This is very common. I have and had a similar issue. I have a few spinal nerve problems and damage in both lumbar and cervical. Then there’s my Trigeminal Neuralgia. All Proven and in my file! All the Drs around my area Refuse to do Anything to help control my pain! They’re all afraid to prescribe because Nothing else (non opioid) has worked and they are in fear of loosing their license. A few were outright honest with me and most just give me BS excuses to why they are “not able to help me”! It seems Obvious that NObody in the medical field could Care LESS about us patients or our Pain!

  2. Geez,,i don’t have to imagen simply using ones arms hurts,,w/ a thoracic lamectomy that never stood a chance in healing,,as the wrongfull attachment of my ligaments on the left side,,frozen shoulders are no fun,,,Point is,,the conversation above sounded like my last appointment,,,only there was a lot more yelling back on my behalf,,not as much as usual,,for yelling even hurst sometimes w/out proper amounts ,ie effective dose of medicine,,,Also to your point,,they don’t care,,I stood Infront of my pain doc,,buckle over from a pancreatits attack,,all he cared about was that false positve on a otc drug test,,that was subsequently sent to gas spectro proving my innocents,,,but the whole time im grabbing my left side,,,he’s yellen about this drug test,,,didn’t give a dam about pancreatits,,yea,,my pain doc,,is also more concerned about the corporation rules,,,not his patient’s anymore,,,maryw

  3. How about, instead of jumping from doctor to doctor, as more get squeezed out of prescribing opioids, that they join the work that will end the attacks–Doctorsofcourage.org and learning that no drug causes addiction, and how to get the CSA repealed.

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