Legal for PAIN CLINIC to verbally discharge you and refuse Rxs?

Posted by treziesmom @treziesmom, Sep 9, 2020

I have been a patient at a pain clinic for 4 years, getting prescriptions from them for Oxycodone/Acetaminophen 10/325 mg. and 12 hour Morphine 15 mg. each month. I am elderly and ill and have had numerous surgeries. I have never used any drugs socially, and all of my drug tests have been ok. The clinic verbally discharged me about two weeks ago and refuses to give me an appointment to get my Rxs which are due in a few days. I did verbally behave inappropriately at last appointment due to extenuating circumstances and mental health issues. I am terrified and don't know what to do. I can't just quit these meds. Any suggestions?

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@treziesmom

What I did for me and later my mom was to ask our family doctor if he would take over my pain medication and later my mom's. The pain clinic I went to could do no more than to prescribe the medication and my mom's pain medication was through an orthopedic group... and same with her only the pain meds is all they could do. These specialist required a higher co-pay and they also had to do urine test more frequently than our family doctor. My mom could not give them a sample and they had to do some other test so they knew she was taking it. They require blood work too. Our family doctor had no problem with taking it over. He has a lab in his office building. Test is every six months.. which I have missed one because of covid and my mom's passing. I had to ask my doctor to increase the number of pills for me a few months ago when I went through thumb surgery. After I did not need the extra I asked him to reduce the amount back down. They like it when you ask to reduce it back down. I don't want a huge extra supply in my home.

Zee Gee

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I would call the clinic you were at and ask them if they have heard of Patient Abandonment! They cannot just kick you out...unless of course you broke one of their rules. Good luck and let us know how it works out!

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@suzanne2

@ellens Do you need a referral? I am able to call a specialist directly and get an appointment if needed.

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Not right now, thanks. I do live in Duluth and so far have enough pain meds but will definitely keep you in mind and will keep your message.

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@treziesmom I was wondering what the outcome to your problem of no pain management doctor? I do hope you have found someone to prescribe what you need.

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I was discharged from a pain management clinic and that's been about 2 years ago. I sought out another pain management clinic and Dr and I found one tht I adore. Well guess what? He's leaving this office and guess where he's going? He's going to the previous office that I got discharged from. I had called there to get registered and they told me tht since I'd been discharged before tht she would have to discuss it with it them to see what they say before proceeding any further. I'm pretty sure they are going to deny me but how is that even fair?

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If you have a good relationship with the current physician, could you ask him to advocate for you in regard to his new clinic?

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The Doc should be able to bring you in. Unless you broke one of the big rules you should be fine. Let us know!

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@garnetafisher

I was discharged from a pain management clinic and that's been about 2 years ago. I sought out another pain management clinic and Dr and I found one tht I adore. Well guess what? He's leaving this office and guess where he's going? He's going to the previous office that I got discharged from. I had called there to get registered and they told me tht since I'd been discharged before tht she would have to discuss it with it them to see what they say before proceeding any further. I'm pretty sure they are going to deny me but how is that even fair?

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I'm so sorry you're having to face this issue. I, too, experienced a similar situation & had the same fears. You're not alone - unfortunately. I'll weigh in from 3 different (yet connected) perspectives.

1. The Dr Dilemma:
Although you were discharged from the clinic your Dr is joining, that does not mean your discharge from there is imminent. The fact that the office is stating your future there as a patient is possible pending a discussion is very encouraging.

Typically, when providers join a clinic, they have a significant (if not the only) say in who they bring in as THEIR patient. If your connection is strong with your provider & especially if you've maintained compliance to all requirements like we must, I would see no reason for the clinic to turn you away.

In this regard, I highly recommend reaching out to your provider to have an open, candid conversation about your concerns & the resistance you faced when you tried to register. This is likely very good information for your Dr to know. I have a feeling he will be concerned with his new office's approach. I feel like all predictable situations (this being a very common situation with pain clinics) would have been negotiated in the provider's agreement when joining the practice.

Communication is a necessity. Not only will you ease your anxiety, but knowing what your next steps are will allow you to continue to move forward. I completely get that you do not want to search for another provider, re-establish the trust that easily can be destroyed not to mention it's mentally, emotionally & physically draining to tell our stories from the beginning once again. But, if you have to find another clinic, time is important.

2. Discharge & The Responsibility of a Provider:
Abrupt discharge without a plan is not only irresponsible & negligent on the doctor's part, but it can be very dangerous to you. Our bodies are opioid dependent & withdrawal is a huge concern. Withdrawal impacts our overall health in many ways. Not only are we experiencing the physical aspects, but there are repercussions to our mental health. Pain & our desire to ease it can take us to scary places.

There are guidelines in place for a safe withdrawal by tapering. The taper is usually rapid so there's at the very least some withdrawal felt for a while. Gradual tapers are ideal because it's the belief that when done correctly, the body adjusts & the physical withdrawal is mitigated.

The Oregon Pain Guidance Group has compiled info & resources to guide providers everywhere on appropriate dose reduction, tapering guidelines & protocols. Note: This info is not specific to Oregon.

I recommend checking out the resources they've gathered: https://www.oregonpainguidance.org/guideline/tapering/

CMS Guidelines: https://www.cms.gov/about-cms/story-page/cdcs-tapering-guidance.pdf

When a reasonable plan for continued care & /or when sufficient time is not allowed by a provider, there could potentially be a case for "Patient Abandonment". Patient abandonment is a type of medical negligence that occurs when a healthcare provider improperly terminates the doctor/patient relationship.

3. Alternative Medication Options:
There are alternative medications that can give you different ways of approaching opiates & discontinuing opiates (eg: Suboxone or any buprenorphine). If the goal is to be off opiates, looking into these options could be a viable, successful way of accomplishing this.

Regardless of the primary concerns, in the end it is crucial to be your own advocate - I've learned that I'm the only one who is truly the most qualified for that job. It's hard when there is a feeling of shame, even outright allegations of our misconduct. Frankly, it does not matter. We all are worthy of dignity & respect. Never let anyone convince you otherwise.

I wish you the very best & hope you can come to a mutually beneficial solution to move forward. Feel free to reach out - I'm happy to help in any way I can.

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