tag:blogger.com,1999:blog-7323692122514281455.post1995135958433067784..comments2024-03-22T17:05:55.267-04:00Comments on MD Whistleblower: Why I Don't Prescribe Pain MedicinesMichael Kirsch, M.D.http://www.blogger.com/profile/07555280388086931097noreply@blogger.comBlogger6125tag:blogger.com,1999:blog-7323692122514281455.post-11026547355364326352018-02-18T18:57:20.105-05:002018-02-18T18:57:20.105-05:00@Tim, congratualations and best wishes on your acc...@Tim, congratualations and best wishes on your accopmplishment. I'm sure you can inspire others.Michael Kirsch, M.D.https://www.blogger.com/profile/07555280388086931097noreply@blogger.comtag:blogger.com,1999:blog-7323692122514281455.post-83025754534807239212017-07-19T22:53:35.151-04:002017-07-19T22:53:35.151-04:00As a person with Ankelosing Spondilytus for 17 yea...As a person with Ankelosing Spondilytus for 17 years I have had every opiod on the market. Recently I was able to get off of them. On my best old day my minimum pain score was a 2.. now with no pain opiods, i have no pain and my pain score is 0. That tells me that opiods keep your brain hightened to pain.<br />These ruined my finances and broke my spirit.. However, now I am getting stronger each day and have hope.Anonymoushttps://www.blogger.com/profile/11404037149846713915noreply@blogger.comtag:blogger.com,1999:blog-7323692122514281455.post-52606134390673714062017-07-19T10:11:24.451-04:002017-07-19T10:11:24.451-04:00I have changed my practice over the years to follo...I have changed my practice over the years to follow the same opioid prescribing practice that you describe. My life has become much easier. As a consultant, when a chronic opioid user comes to me I consult on the use during pregnancy, but all refills are referred back to the original prescriber with recommendations. I have the additional advantage of nine month limited consultation. <br /><br /> There are certainly acute events that I take care of and prescribe short course therapy but that is when I am the attending hospitalist or in a limited procedure mode. I have the additional advantage of an HMO with a single silo for pharmacy and outpatient and inpatient care provider EMR. Patients shopping outside of the HMO for pain meds are identified by a Statewidow non-HMO opioid registry for all pharmacies. The interface between the two EMR for drugs should improve with time. Regulatory fears of the State do not allow for ease of use at this time.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-7323692122514281455.post-53546594827938007002017-07-11T16:39:47.321-04:002017-07-11T16:39:47.321-04:00Dr. Kirsch,
As a survivor of necrotizing pancreat...Dr. Kirsch,<br /><br />As a survivor of necrotizing pancreatitis, and speaking of life outside the hospital, I find the lack of connection between the gastroenterologists and the chronic pain doctors frightening. I suffer from severe episodic pain every time I eat, yet the chronic pain doctors seem disinterested in the root cause of my pain and look only to create more long-term, systemic pain relief. I personally don't think the gastroenterologists should abdicate their role in patient pain control, but rather insist that patients on long-term opioid treatment also be enrolled in chronic pain programs. I believe in the efficacy of the chronic pain physicians and psychologists, but their lack of knowledge in abdominal issues cripples their ability to be effective for their patients. I trust my gastroenterologists with my life. <br /><br />Thank you for the opportunity to comment. Keep up the great work on the blog.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-7323692122514281455.post-16137381431823966092017-06-25T14:19:32.861-04:002017-06-25T14:19:32.861-04:00@Joan, thanks for your thoughtful points on this ...@Joan, thanks for your thoughtful points on this issue. I agree with you that a consultant physician who is being asked for more pain medicines should either get in touch with the attending physician, or direct the nurse to do so. In my experience, the treating nurse has already contacted the attending doctor before I come to see the patient. This issue is often further complicated in that there are patients in the hospital who are addicted to pain medications and complain of pain despite high levels of narcotic medications. In my view, these circumstances call for a pain management specialist to provide necessary guidance. I also agree with your underlying premise that communication among medical practitioners can be improved. Michael Kirsch, M.D.https://www.blogger.com/profile/07555280388086931097noreply@blogger.comtag:blogger.com,1999:blog-7323692122514281455.post-37455798405775127482017-06-25T08:41:57.385-04:002017-06-25T08:41:57.385-04:00as a patient my only concern with your approach is...as a patient my only concern with your approach is that you are counseling the pt to ask the attending. the biggest problem i have with my own health is that my docs do not talk to one another. Imagine being in a lot of pain. You may or may not be awake when the attending drops by. Imagine being 85 and not having all your abilities. Why can't you pick up the phone and talk to the attending and let him or her know that the pt is in a lot of pain and that you are deferring to the attending on this issue? thanks for the oppty to express my thoughts!Joan Bhttps://www.blogger.com/profile/06377295989258923610noreply@blogger.com