In the ER at which I volunteer, we no longer answer the question about whether nurse ‘X’ is on duty tonight. Nurses have been stalked by irate patients and/or ex-boy friends. We do not tell which doctors are on duty. It could be a vengeful drug seeker calling. Nurses are taping over their last names on their hospital badges. Hospital security staff is never more than a few seconds away. The local police have been utilized to defuse overly confrontational patients and visitors. (The PD is almost omni-present in the ER these days with prisoners, psych evaluations for OPC, and accident investigations.)

I suppose that at most ERs these things are now Standard Operating Procedure. Despite that, no security measures are totally protective, especially if a wacko decides to run you down in her car outside the building.

Completely off-topic, but I don’t know how else to ask this question here…

I was using another computer to look over some blogs and I ran across a blog by a doctor with a ME/Coroner’s office. Had some fascinating stuff about autopsies. Now I can’t narrow the keywords enough to get a reasonable hit from Google. Do any of you med-blog fans know which blog I’m referring to?

I’ve been threatened by drug seekers. Drug addicts tend to be an anti-social and uninhibited group of folks; they’re not particularly known either for their self-control or their respect for what constitutes good medicine/appropriate prescribing. Their manipulative machinations are the stuff of legend.

The DEA has come down on several physicians in my area for being “candymen” (among other offenses). Some were prescribing completely unreasonable quantities, lack of appropriate follow-up, lack of appropriate documentation, etc. When such physicians get dragged out of their offices by the police, their patients are left high and dry, so they come to the ER. When I tell such patients that I can’t refill their Oxycontin/methadone/etc, they’ll occasionally snap back “you could, but you won’t.”

They’re right, and I tell them so. I then explain that I can theoretically do anything I want with my license… at least until the DEA or the State Medical Board catches up with me. Drug seekers seem surprised to learn that the government has far better lawyers than I could ever afford, and that I cannot help my patients if I’m in jail or stripped of my license.

It’s inappropriate to manage chronic pain from the ER. Patients don’t always understand all the contraints on our practice, but I find that most are at least somewhat mollified when they understand that we have standards of practice to follow, and we are not simply refusing to prescribe out of sheer meanness.

That said, I wholeheartedly endorse un-published phone numbers, and being zealous about your privacy. Even if you’re an individual who can handle yourself, what about your wife and kids?

Most cops choose not to live in the same neighborhoods they patrol… I completely understand why.