Re: Pain and Human Development/ question of ethics 4 Hawki

On Wed, 02 Nov 2005 05:58:26 -0800, Codeee01@xxxxxxxxxxx wrote:

>On Tue, 01 Nov 2005 18:59:24 GMT, <Hawki63@xxxxxxxxxxxxx> wrote:
>
>
>This is all truly good news for all of us pain patients Hawki. I only
>wish there were a listing of all of the good NPs' state by state.
>
Just out of curiosity who what decide who is "good"?
>
>The question is whether or not a doctor or NP is obligated by law, or
>at the very least some responsibility to their patients to inform them
>that the doctor is leaving, and there is no one whom they can refer
>the patients to. Lacking someone, perhaps they would need to
>supply a tapering script?
>
That is a very good question. Personally, if it isn't law it should
be. No patient of any type should be left in the lurch. If any type
of Dr decides to abandon their practice or even just a patient I would
think at a minimum there is a moral obligation for them to find
another Dr who is willing to continue the established treatment plan.
Again I would like to see this as law.

>In this case I can see why the doctor isn't telling. The head of the
>pain management program in the healthcare system the doc is linked
>with - does not like the fact that my doctor had been treating
>approximately 100 patients, he wants to eliminate any doctor who
>writes for chronic pain. This "honcho" believes that 100 patients is
>the equivalent of the doctor being a pusher, and has said so.
>I find this alone to be rather scary coming from the ONE person in
>the system who is in charge of pain treatment matters.
>
Another good point. Again I think that no one other then the Dr & the
patient should have any say in the establishment of a treatment
program that a fully licensed & certified Dr decides jointly with the
patient that is the best course of action.

>Fortunately, I am not "tied" to this system. I had simply been
>working on the assumption that a new doc would be in place,
>and would at least give me a months' worth if necessary...until I can
>find another doctor who treats chronic pain - which will be a huge
>challenge from the lists of good doctors I've seen so far!
>
Unfortunately, so many people are tied in one way or another to either
a system or a limited selection of Dr's. I can understand having a
sliding scale of payment based on in or out of network Dr's, but the
patient should always be able to select the Dr of his/her choice with
the understanding that exercising that right may cost them additional.
>
>As a result, many of the patients have not been told that the doctor
>will not be here after this week. They only find out when they
>attempt to make another appointment, and the receptionist catches the
>brunt of the frustration and panic.
>
True dat. It really sucks for those folks as well. I had one Dr
close down his personal practice and join a group that I don't
personally care for. I like the Dr. well enough, but hate the way the
clinic he joined is run. Unfortunately he simply could not afford to
continue to maintain his own office.

>As for those who haven't attempted to make their next appointment,
>they will be running out of meds, and will get an enormous surprise
>when they phone the office in a month or so. It certainly sounds as
>if the "head honcho" and pain treatment specialist thinks it is
>preferable for the doctors' patients to go cold turkey than to
>continue their treatment, and feels no obligation to them at all.
>I'm glad my doctor explained this to me yesterday, otherwise I might
>well have looked at this doctors' name in one of the lists, and
>actually gone TO him for treatment!
>
Of course this is total & complete bull*** and we are actually
talking about peoples medical care which the immediate discontinuation
of could be life threatening depending on the medications.

>I have had a doctor move in the past, and a set of tapering scripts
>were provided in case I couldn't locate another doctor right away.
>
Push come to shove I guess that is the only way to do it, but I find
it hard to believe that another Dr could not be found to continue an
established treatment plan. After all we are only talking about
writing a script. Not starting from scratch trying to determine what
is wrong and the correct treatment regimen.

>I'm sorry this is so long winded...but was this just a courtesy on his
>part, or is there a legal obligation?
>
>
>Thanks in advance for any input, suggestions, ideas,
>
>
>codeee
>
>
>
>
>
>
>>
>>As to the two talks I attended on pain management (amongst many others on
>>different topics)......to "save space" in printing up the syllabus..which
>>still ended up 3 inches thick...each speaker was asked to ONLY use 24 slides
>>for the printing..most had twice that many that they used during the
>>talks..so the 24 printed were sorta out of context...I have found that
>>powerpoint presentations in many instances are sorta "summaries" and a good
>>speaker speaks FROM them,,while ad libbing all kinds of extra stuff that
>>makes a talk complete....so simply copying the printed 24 slides takes the
>>whole thing out of context...and doesn't help much...also MOST speakers did
>>NOT include their reference list in the syllabus!! tho most slides had
>>references on the bottom..in tiny tiny print..so searching out a specific
>>fact would be impossible..
>>
>>sorry...
>>
>>what is interesting..and good news I hope...is that I just learned that the
>>credentialling board for NP's has just added a new credential..in Pain
>>Management!!! about 400 np's just sat for the first exam...not a huge
>>number,,,BUT indicates that treating chronic pain has attained the level of
>>say..diabetes,,lipids..etc...
>>
>>when I first started reading this group...I was astounded and appalled ..at
>>how many of my "peers" in practice referred to the "drug seekers"...many of
>>whom were actually chronic pain patients unable to find decent ongoing
>>care(that is NOT to say that there ARE many many that simply are seeking
>>drugs!! ran into quite a few of them myself!!)
>>
>>good luck Lynn...let us know how it turns out
>>> --
>>> Zombywoof
>>>
>>> Si vis Pacem, Para bellum
>>

--
Zombywoof

Si vis Pacem, Para bellum
.

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