Doctor’s Diary: Snippets from the Frontline

| Community | April 19, 2019

Staving off Suffering 

I have patents who are in pain.

Some had catastrophic events like motor vehicle accidents, or major illness resulting in immobility. Many are bedridden, requiring house call visits.

They have been on DEA Schedule II pain medication for years, but because of the opioid crisis, rules have been understandably tightened adversely affecting medical management.

A written narcotic prescription requires high-security pads preventing counterfeit abuse (I am not sophisticated enough to use computerized e-prescriptions). Pharmacists assure all medication is dispensed exactly according to law.


As a frontline physician, I must see patients “face-to-face,” and document the need for narcotics with ongoing beneficial effects. Hoops must be jumped through to protect the public.

There have been consequences in this ongoing battle:

renewal of medication must be done every month;
phone orders are not acceptable, with refill delays common;
drug insurance companies have increased “denials” and “prior authorizations”;
pharmacy phone calls to physicians are more frequent and time-consuming;
“extra doses” are rarely allowed should a patient want to leave town or vacation.

Some of my patients endured life threatening problems. Unfortunately, they are forced to jump through more hoops to stave off suffering.

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