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Pain Meds & New "Rules"
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An_223003 posted:
I suffered a ruptured cerebral aneurysm- (genetically prevalent in the maternal side of my family) a few years back. Went through meningitis post op- coma for a week- drains , etc. Coiling performed but insufficient- had a re-ballooning of aneurysm and recoiling 5 months later. My left pupil is permanently dialated at about 5 mm- some vision, but the muscles of that eye were permanently impaired so that the eye will not move exactly in conjunction with the right eye. This causes me daily blinding headaches and eyestrain on the good eye- so I am prescribed narcotics, which help. I visit my physician once a month. I do not call in for refills, ever. My question is this: during my last doctor visit, the office staff were handing out pre-printed letters to all patients taking prescribed narcotics. This letter outlined new "rules". Most were very understandable & appropriate (ie: UA drug screens, NO narcotics if street drugs found in your UA- no doctor shopping, no receiving RX from other providers). I have no problem with those guidelines. BUT- the one thing I did not appreciate was the insert of a paragraph stating that once a year I have to bring in a family member so that my doctor can ask them questions about me. I was always under the distinct impression that I still had a small bit of patient privacy left to me. Can I be required to bring my school age children or ex-husband (what about co-workers!) into my doctors office so that my PRIVATE medical treatment can be discussed? This has me extremely irritated. Is there no doctor/patient privilege or privacy left? Is this legal? I live in AZ. As previously stated, all patients received this letter. Thanks for the input.

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If you are prescribed narcotics by your family physician, should he/she be able to require you to bring a family member or friend into your doctors office once a year so that they may privately be asked questions about you? (regarding patients without senile dementia, etc.)
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Weathergirl21 responded:
Sorry to hear about your pain issues...

Did you end up signing this particular contract? Or was it only a sheet of paper that they handed you?

Under HIPPA laws...a Dr./Insurance company, anyone with access to your medical history may NOT distribute or discuss this with anyone without your written consent.

So..they can legally ask for this as a Dr. can decide who and how he wants to treat his patients... but you have the right to refuse by not signing this contract or agreeing to bring someone in stating HIPPA laws...

But, I think with this particular Dr. it seems that is one of their conditions and you might get discharged from their practice...which again..they can do legally..just like for any reason they could decide to stop practicing and close their doors tomorrow...or refuse to see certain patients based on their guidlines..
 
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transcriber52 responded:
Anon_22687, I also live in Az. and we still do have HIPPA laws here as stated above. I went to a pain center here in Phoenix and they had the similar rules, UA, no outside meds that kind of stuff is pretty much normal around here at the pain clinics. But I would not sign about having to bring some family member with me to discuss my issues. I still have the right to privacy in that sense at least. It should be my choice if I want to include someone else in that part of my life, not theirs. And in no way do I want them to be able to discuss with the Dr my life issues, who knows where it will go. I don't have anything to hide but I don't want it to be pushed on me that I have to do this. The one pain center I went to I even had to sign that I would not receive pain meds even from an ER no matter what. I don't go to a pain clinic anymore but the anesthesiologist I go to has similar rules but I sure don't have to bring any family member with me ever. You have a good day and good luck with this issue
 
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BrenBren30813 responded:
Hey there Anon226...
First, I want to welcom you to the board. I like your poll and thought back to the other day where I went in for imaging and filled out a piece of paper stating the HIPPA laws. I was to fill out those people (relatives, friends, doc's, etc) that could have access to my imaging results or ANY other records attained at that facility.
My question to you, did you sign a form like this when you first started to go to this pain doc?? Most of them do make you sign the form. Before raising hell (which I would want to do) simply call and get a copy of your "medical records" and don't state anything you are looking for specifically (though you would be searching for that Hippa form). Get EVERYTHING that you have filled out, prescription records, doc visits etc. I think there is a loophole here to work with if you have signed that form, and if it is still in your file. You are screwed because you sound like a single mom who doesn't have a spouse to come in and vouch for you...and your children will not count. Try to get around it by getting a hold of your records (I hope they haven't trashed this portion of your records already). If that doesn't work, could you explain to them there is not another adult who lives in your household to vouch for your responsible behavior surrounding the narcotic prescriptions? I was given advice recently to not share any info. with friends, co-workers, or family in regards to the med's I take, so I would not want them to allowed ANY personal time with my physician. When is your next appt.?? Maybe if enough hell is raised, and you can put some things off for a while (don't react to them yet, unless you have to sign that form, then let me know before you do - because that could nullify the former HIPPA contract you signed)...then you can say that you will bring someone in with you this fall or something --- just to put it off and see if they altar the policy at all.
Do you attend church?? This is really a tough situation and you have been through so much already. If he is a good doc to you and has helped you settle into a comfortable regime involving your med's, then if I were you, I would do everything in my power to try and follow the rules to the fullest.

I'm worried because I went to the ER the other night for an injury that was closely related to the one I am being treated for, yet NOT...so I received 2 days of pain meds after I discussed with the ER physician that I was under contract with my pain doc -- he said he was trying to get me out of pain, wrote in his notes that I explained to him everything that I told him I was prescribed...I called the doc's office 2 times Mon to let them know that I received the 2 day supply of pain pills...I left 2 messages for the doc or nurse to call me. Today I went to the ortho to get my images reviewed from ER and told him I was under contract with the pain doc - so he wouldn't touch that (helping me manage my pain) So I called AGAIN and finally got the nurse on the phone...they will see me first thing in the morning, I'm going, no doubt, but I'm afraid he will fire me...I HATE THE ANXIETY and crap we have to go through to get treatment.

Please let us know what comes of this, I'm glad you posted here today - have a better day, Bren
 
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peeking2 replied to BrenBren30813's response:
Thanks for the input everyone. Firstly, I did not sign a pain contract when I first started seeing this doc- about 3 1/2 years ago. This letter given us (and I loved the way the receptionist loudly announced "everyone has to sign these new rules!") was not privately discussed with each patient- more an en mass "sign it or else" situation. No signing, no meds. I do NOT mind the other requirements at all. I agree that people should not make end-runs around their physicians. Following those rules is reasonable and prudent. But I would think that it has to be illegal to open up your private medical treatments/records to another individual against your will. "With my consent" truly means "I had no other choice". This is the very reality of what is going on with medicine these days. No patient privacy. It's gone folks.
 
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BrenBren30813 replied to peeking2's response:
I'm sorry to hear this. You will just have to go with the flow on this one if this is an otherwise great doc for you. Maybe you could search out another one, but if you are adequately medicated, and he's not pushing too many expensife therapies on you, then I would try to hang on to him. Whe you do make the plans for that "special visit" ask the purpose of it - like does it have to be someone you live with, or just a friend, or just someone who sees you taking responsibility, etc.
You did "have no other choice" but docs who implement these policies will do it for EVERY patient, even the good, reliable ones who it's not even fair to, you know?

Keep us updated if you can! Have a low level of pain day, or pain-free it you can manage, take cre, B
 
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Weathergirl21 replied to peeking2's response:
Hey Peeking,

Unfortunately...If you signed this particular agreement, then you are giving your consent and it's not against your will...Your choice would be to say no and go to another Dr...So, while I agree that it is a very strange request by this particular Dr. it is not illegal of them to decide how they want to run their practice and dispense narcotics with certain restrictions..

Just like they can say..if someone refuses to do a UA..then no meds...

You can decide if you feel that you do not want to keep seeing this Dr., then I agree with Bren Bren...you can start making some phone calls or appt with someone else..which you are free to do as a consultation..not accepting meds from them until you decide to start seeing them and terminate your business with this other Dr..

This is unfortunately the world of being a chronic pain patient...the Dr.s have rules/regulations by the DEA to follow, they also have drug addicts trying to scam them everyday which they have to watch out for...So some Dr.s are much more strict about certain things than others...My Dr. has us sign a contract as well...but in all my years going there, I have never had to do a UA or pill count, etc...

I guess you will just have to make a choice if you are happy with everything else about this Dr. and his treatment of you as a patient, then stay...or decide to start looking elsewhere...Please don't feel helpless..you do have a choice!
 
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annette030 responded:
OOPS, I wrote a reply and also voted in your poll, the reply disappeared. I will try and re-write my post.

Before you get all upset, you did say that the doctor would ask the family member about you, not that he would share any of your information with them. If so, this goes along with the HIPAA privacy rules as I have read them, and the other confidentiality rules that I am used to doctors having pre-HIPAA.

Family members can currently call your doctor and tell him whatever they wish to about you, and he can listen, he just cannot tell them anything about you.

HIPAA is a federal set of rules, so it is valid all across the country, not just in one state.

I suspect your doctor just wants to know you are functional and managing correctly with your meds, but I would just discuss this with him in person at your next appt. Ask him what type of questions he would ask, and if you are allowed to be present.

If you are a single person and have no other adults in your home, you would not be the first person he has had as a patient like that. Of course, he is not going to have a talk with your school age kids, your ex, or your co-workers. Ask him who he would like to talk to in your case, and see what he says.

Even if you have signed the agreement already, you can change your mind anytime you wish, just write him a letter and keep a copy. If you mail it, make sure you have someone sign for it. He may decide he does not want you as a patient, or that he will not write prescriptions for controlled substances anymore. You need to get that information from him and decide for yourself what you will do.

As a married person, I would not mind taking my husband with me once a year to talk to my doctor. If I were single, I would have to ask the doctor who she would want to talk to, and then decide.

I suspect if you changed doctors you may find more and more of them have these types of documents for their patients to sign.

Take care, Annette
 
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AprilshowersbringMayflowers replied to peeking2's response:
perhaps you could cross that portion out on the form and then sign. just hand it to them and see what they say. if they do say something tell them your situation ie; no close relative in the area, no close friend you would trust, etc. maybe they will let you slide on that part of it. you have been seeing the doctor for quite awhile so maybe that will be taken into account.

good luck!
 
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pkrwd responded:
This is a great idea for us pain management patients on strong narcotics!!! For us patients with diminished capacity, I have brain damage a severe short term memory loss .
How in the hell can 78% of you think this is not a great idea?
I think it should be mandatory for patients like me. This makes no sense at all.
I do need help with my strong drugs! and I do take a family member at least once a year with me, Not required but these drugs can kill if not taken as directed!
 
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pkrwd replied to pkrwd's response:
Had a Craniotomy. now my memory is gone
 
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pkrwd replied to pkrwd's response:
Disregard... I read it wrong!!! Then I reneg on my comment and agree with the 78%...
 
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pkrwd replied to pkrwd's response:
Disregard. I read it wrong! I now agree with the 78%
 
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missietl19 responded:
That totally sounds like couldn't be able to push that because of the "HIPPA" form that everyone has to sign now.
 
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BayArea408 replied to missietl19's response:
I have RA and other medical issues and I often bring my husband to Dr appointments in case he remember things I might have missed and/or can be a second set of ears to take notes/ask questions.

That said, I would NEVER sign a "contract" telling me I have to bring someone to my appointment, that I can't be prescribed drugs if I'm in the emergency room etc.

The contracts, while probably in place for lawsuit-scared doctors, are demeaning. Remember -you are paying. The doctor works for YOU and they can be fired.


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