Recently, there was an LA Times interview that focused on the number of prescription overdose deaths in Southern California. The primary focus of this article was to call attention to a disproportionate number of prescription overdose deaths that primarily occurred with the pain management physicians.
Unfortunately, the article had a negative slant which appeared to infer that it was seen as the responsibility of doctors that prescribe these powerful medications to better police their patients (before they offer these medications) and the state medical boards to better police the doctors that prescribe these medications.
It also seemed to infer a causal link between prescription overdose deaths, the coroner’s reports of the deceased and the prescription writing of the doctor whose name was on the bottle of the person that overdosed. Unfortunately, this takes a simplistic view on the management of these chronic pain patients.
On many occasions, the pain management physician is stuck between a rock and a hard place trying to determine if the patient is an appropriate candidate for medication usage. The patient may have had a previous doctor that had written a prescription for pain medications that would more than likely produce a dependency condition on these medications.
That is not to say that the patient was an addict.
If for some reason the doctor stopped writing medications, or if the patient did not follow the rules of the clinic, he would then likely get referred to a pain management physician. The pain management physician will thus inherit this problem of patient management. Unfortunately, the pain management physicians are also often “dumped on” by other medical specialists to solve their problems.
There is no benefit, credit or accolades that occur when the pain management physician makes an accurate diagnosis and proper treatment is initiated. But ff a mistake is made or complication occurs regarding the patient’s understanding of how to properly take medications, or if there is a miscommunication between the patient and the doctor, there is too often a rush to judgment to blame the pain management physician who prescribes these very powerful medications and performs these very life-changing procedures.
I deliberately wrote The Great Pain Jack to outline the problems with pain management through real-life examples. The book characterize these problems with patients that are sometimes very difficult to treat.
What do you think? Why do doctors get painted as villainous? Is there a better way to diagnose prescription drugs and protect the patient?
Please see the LA Times article and feel free to post your comment on this blog or the writers twitter feed @JohnfPetraglia or like him on Facebook.