Comments on: Tips for the ED Drug Seeker

By: Gimpy Mumpy

Gimpy Mumpy — Wed, 12 Oct 2005 16:05:33 +0000

I completely agree.

Last time my PCP told me to go to the ER for emergency xrays (I’m a spine patient also) I asked if someone from her office would be calling ahead. She said yes absolutely but no one ever did, so when I starting insisting this at the ER it only made me look like some crazy rather than a patient going on what my doctor had told me.

Frustrating for the patient and for the ER staff.

By: GruntDoc

GruntDoc — Wed, 12 Oct 2005 02:35:19 +0000

Thanks all, so far.

Greg P, I get a lot of calls from PCP’s, and it’s nearly always “work them up and call whoever’s on call for the group’.

There’s very little patient ownership these days.

By: Greg P

Greg P — Wed, 12 Oct 2005 01:22:56 +0000

But this probably illustrates what I think is a lost or fading courtesy. The concerned and helpful PCP can always call ahead and explain to the ED doc that his patient is coming, he is a long-term patient and doesn’t complain about trivial things…instead he didn’t bother to help his own patient.

By: Alice

Alice — Tue, 11 Oct 2005 23:51:08 +0000

To add to the last comment: my preceptor told me the other day about a patient of his with documented spinal pathology who went to the ER for what his PCP considered a real emergency one night, and made the mistake of asking for a specific narcotic – because he was a graduate student in addiction medicine, and was trying to be careful what he took!

By: gimpy mumpy

gimpy mumpy — Tue, 11 Oct 2005 20:00:24 +0000

Have to also play a bit of devils advocate here and just mention that not all folks with who come into the ER with a long ‘current med list’ are not abusers. I find that as a disabled adult with a number of daily prescriptions I am often put through the wringer with ER nurses. I ALWAYS say I am not looking to get ANY more meds, just putting accurate data on my intake form but it’s amazing how terrible legitimate users of medication can be made to feel.
I mean how many times do I have to shout “I’m just here for the gdamn xrays my PCP told me over the phone I should come here and have done?”

Just wanted to give the flip side of the coin…….

By: Kim

Kim — Tue, 11 Oct 2005 12:08:05 +0000

Major LOLOL! Great post. Don’t slur your words and begin to snore during triage. That’s always a major sign. I remember being stunned at how fast I saw “Toradol” as an allergy in our repeat visitors as soon as it came out on the market. Sometimes I wonder if I have the word “Stupid” stamped on my forehead; do they really think I’m so dumb that I don’t see manipulation from a mile away?

By: TheNewGuy

TheNewGuy — Tue, 11 Oct 2005 03:54:40 +0000

The EMR comment is a good one… particularly when it comes to linking pharmacies together.

The military did this a few years back for a group of hospitals in San Antonio… they stopped over a million dollars in prescription fraud the first year alone.

A central database of all schedule 2 narcotic prescriptions would go a long way toward slowing down the doctor-shoppers. Kentucky’s system sounds like a winner…Good for them. They need to be checking that database during patient registration, and attaching a printout to every chart.

By: ds

ds — Tue, 11 Oct 2005 02:53:50 +0000

And don’t sign in while still wearing the hospital bracelet from the ED that kicked you out 1 hour ago.

By: TheNewGuy

TheNewGuy — Mon, 10 Oct 2005 21:52:49 +0000

Yeah… good advice.

And be realistic about your demands… NEVER demand percocet 10′s for a not-even-visibly-swollen ankle sprain. I laughed in a guy’s face one night for doing exactly that… he wasn’t happy.

Having a gentlemens’ agreement among the docs for no-unverified-refills (for scheduled narcotics) is also a big help… word gets around, and it only takes one candyman to bring in people shopping for party supplies. Simply from a self-preservation standpoint, it pays to be careful about prescribing the heavier stuff… the DEA has nailed several docs in my area over the last several years for questionable prescribing. Remember, they can afford more lawyers than you can.

And frankly, you should be careful about large prescriptions of anything. We have no mechanism for follow-up for dosage adjustments, reactions, and other necessary surveilance. I do short-term refills, but long-term stuff they must get from their regular doc.

By: beajerry

beajerry — Mon, 10 Oct 2005 14:59:53 +0000

Very amusing, dude!

You can add listing allergies to tylenol, benadryl, and haldol.