Shirah Vollmer MD

The Musings of Dr. Vollmer

Doctor Rant

Posted by Dr. Vollmer on March 4, 2014

OxyContin

 

 

http://www.latimes.com/local/la-me-rx-source-20140304,0,3275352.story#axzz2v38ABubS

 

Doctors give pain pills to relieve suffering, avoid phone calls and to be liked by their patients. Many, as described in today’s LA Times article, do not seem to think about the public health hazard of prescription opiates, given to patients who might be abusing them. Oral surgery is a prime example. Many young adults get their wisdom teeth removed, followed by a prescription for 30 opiates, most of which are not necessary for pain relief. Most teenagers can use a Non-steroidal anti-inflammatory agent.Those who need stronger pain relief need one or two pills, not thirty. Then why are  there massive amounts of opiates being prescribed? Lot of  pain medications means the doctor won’t get called for more medication. This is a bad reason. Worse yet, are those doctors not considering that the patient is drug-seeking? Even before today’s environment where patient satisfaction is seen as a key indicator of physician quality, many doctors get a narcissistic high when patients are grateful, even if they are grateful for medication which they can use to hurt themselves. Gratitude is a seducer and as such, many physicians are vulnerable to losing good judgment in exchange for feeling important. Now that it is exposed that doctors are a key part of the prescription drug abuse problem, there will be better monitoring of a physician’s prescribing practice, and as such, there will be a better tracking system of the great offenders. This might help, but my suggestion is more training in medical school and residencies about how the power to prescribe, means the responsibility to say no, and in so doing, physicians need to learn to tolerate the ensuing rage associated with limit setting. This rage, in today’s world, often means scalding reports on social media sites, and again, physicians need to accept that drug addicts, incensed that they cannot get what they want, can then cause internet distress. This is the world we now live in. Doctors need to rise above. This begins with good training. We have a long way to go.

2 Responses to “Doctor Rant”

  1. Shelly said

    I salute you in recognizing that some of the problems stem from the prescriber, however not everyone seeking prescription pain pills are drug addicts. Some are simply consumers who are being given OTC anti-inflammatories which do not work. For example, my husband had a root canal recently followed almost immediately by gum surgery. He was in excruciating pain and was not given anything for pain. When he called the office, the secretary told him to take Tylenol. The dentist refused to give him anything stronger and he was in terrible, terrible pain for several days. Was this due to the fear of the dentist to prescribe anything stronger? Why should people suffer needlessly?

    • Yes, there is a sweet spot between being sensitive to pain control and over-prescribing. Both extremes are bad. My suggestion is that doctors learn to prescribe medications in limited quantities and then be available for phone consultations to decide whether more pain pills are necessary. Thanks.

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