Doctor Leaves Patient with No Medication

[RoRo]

What is the name of your state (only U.S. law)? New Jersey

I had a multi-level fusion, cervical spine, in 2006. Since then, the disc above the fusion has herniated, my neurosurgeon does not want to operate as of yet, but thought sending me to pain managment would be the way to go.

I've been seeing a pain managment doctor since January 2008, I go every 2 weeks and he gives me a script for percocet, which helps me tremendously. I've got an 11 and 13 that need me and if it weren't for the percocet, my life would be spent on the couch.

I had my appointment scheduled for this Wednesday with my pain managment doc. On Tuesday I got a call, he had to cancel the appointment. I asked what would be done about my pain medication and was told to call the office he was at, which I did and spoke to the Office Manager. He assured me he would give the doctor my message. For the last 3 days I have been trying to get in touch with this physician, to no avail. He has no answering service, he's not answering his pages..nothing. I'm going on day 2 with no percocet and I am hurting.

My question is, can a doctor, after having a patient on a pain managment regime just cancel an appointment and not take care of the person who is under his care?

I appreciate any and all advice. Thanking you in advance,

Sincerely,
Rosemary

[barry1817]

Originally Posted by RoRo

What is the name of your state (only U.S. law)? New Jersey

I had a multi-level fusion, cervical spine, in 2006. Since then, the disc above the fusion has herniated, my neurosurgeon does not want to operate as of yet, but thought sending me to pain managment would be the way to go.

I've been seeing a pain managment doctor since January 2008, I go every 2 weeks and he gives me a script for percocet, which helps me tremendously. I've got an 11 and 13 that need me and if it weren't for the percocet, my life would be spent on the couch.

I had my appointment scheduled for this Wednesday with my pain managment doc. On Tuesday I got a call, he had to cancel the appointment. I asked what would be done about my pain medication and was told to call the office he was at, which I did and spoke to the Office Manager. He assured me he would give the doctor my message. For the last 3 days I have been trying to get in touch with this physician, to no avail. He has no answering service, he's not answering his pages..nothing. I'm going on day 2 with no percocet and I am hurting.

My question is, can a doctor, after having a patient on a pain managment regime just cancel an appointment and not take care of the person who is under his care?

I appreciate any and all advice. Thanking you in advance,

Sincerely,
Rosemary

I would be calling the office manager back and seeing what the problem is.

I would also give a call to the state medical board and speak to them about what constitutes abandonment. If the state agrees with you about being abandoned, you might wish to pursue a complaint with the medical board.

It would help if you document a log as to what was going on, so that you can rely on facts and dates to substantiate any possible claim.

[lealea1005]

Your appointment could be cancelled for any number of reasons, including personal (Physicians DO have a life outside their office).

Did you reschedule your appointment? Is the Physician refusing further treatment or to reschedule your appointment? Have you tried calling the office familiar with you again to explain the situation?

[ecmst12]

You may also want to try physically going out to the office where the doctor is and asking for your script, or at least an explanation. Sudden detox from pain meds can be dangerous and if he or you wanted to try weaning off the meds and trying something else, that should have been an agreed-on plan. It's a lot harder to ignore a person standing in your waiting room than a phone call/message.

[RoRo]

I do understand a physician has a life outside their office, I have no problems with his cancelling and yes he did reschedule my appointment to the following week. My problem lies with his being my pain management physician and not making sure I was taken care of prior to his being called away. Most physicians have partners or back up, they don't leave their patients hanging.

The situation is odder, this physician does not have an office, per se, he travels to 4 different offices, the one I see him in is a chiropractor's office, he doesn't get there until after 5PM and you sit for hours waiting for him. There is no one there that can prescribe meds except him, and he's only there on Wednesday. Then he tries to push procedures on you that work in conjunction with the chiropractor. The women that work behind the desk work for the chiropractor. The 2 times I called there I was told, I'm sorry, I'm just giving you the message, I don't work for him. I asked where he was that day and was told he was in the Parsippany office, so I called Parsippany, the people in the Parsippany office don't work for him either, they work for Gastroenterologists. After the 5th phone call to Parsippany, I was told he was in New Brunswick, so I called New Brunswick where I was told he was out for the week and the woman there finally gave me his personal secretary's cell phone number which I've called numerous times left messages, and have not received a call back.

There is so much more about this physician, he has no one to pre-certify tests, i.e. MRI's...he gave me a script for an MRI and I had to get someone I know that works in a totally unrelated doctor's office to pre-cert the MRI. He had me go for bloodwork, he never got the results and he had me going crazy calling the lab to have them send the reports to me. I finally got the reports from my rheumatologist, who had nothing to do with any of this. He never has your personal file in front of him, he writes everything down on a piece of white paper, God only knows where that ends up. There is no system to this physician's office. I started going to him because he was recommended to us by a doctor my husband knows very well.

Bottom line, I'm really suffering right now, I would have to believe I must be going through withdrawals. I have made another appointment with a "real" pain management physician which I will see next Friday, and will be cancelling my Wednesday appointment. I'm going to go see my family physician today and explain this to him, hopefully he can help me until I see the new physician.

I wanted your input as to whether or not a physician is allowed to act in such a manner. I greatly appreciate all of your answers as I know you do this gratis. If I have a legitimate complaint, I will file one with the State Board. I would love to hear what you have to say regarding his practices and if you think this is how a physician should run a practice.

Again, my thanks to all of you.

Rosemary

[lealea1005]

Originally Posted by RoRo

I do understand a physician has a life outside their office, I have no problems with his cancelling and yes he did reschedule my appointment to the following week. My problem lies with his being my pain management physician and not making sure I was taken care of prior to his being called away. Most physicians have partners or back up, they don't leave their patients hanging.

*Not all Physicians have partners or are part of a larger group. Even if he did have call coverage or a partner, many Pain Management Docs will not refill the other's narcotic prescriptions without specific permission.

The situation is odder, this physician does not have an office, per se, he travels to 4 different offices, the one I see him in is a chiropractor's office, he doesn't get there until after 5PM and you sit for hours waiting for him. There is no one there that can prescribe meds except him, and he's only there on Wednesday. Then he tries to push procedures on you that work in conjunction with the chiropractor. The women that work behind the desk work for the chiropractor. The 2 times I called there I was told, I'm sorry, I'm just giving you the message, I don't work for him. I asked where he was that day and was told he was in the Parsippany office, so I called Parsippany, the people in the Parsippany office don't work for him either, they work for Gastroenterologists. After the 5th phone call to Parsippany, I was told he was in New Brunswick, so I called New Brunswick where I was told he was out for the week and the woman there finally gave me his personal secretary's cell phone number which I've called numerous times left messages, and have not received a call back.

*Nothing odd about that. He sub-lets other Physician offices so he can service a larger area (and Parsippany to New Brunswick is quite a large area). It saves on overhead and he is able to service a larger population. He should have a contact # that goes directly to his personal secretary/staff and an emergency after hours number.

There is so much more about this physician, he has no one to pre-certify tests, i.e. MRI's...he gave me a script for an MRI and I had to get someone I know that works in a totally unrelated doctor's office to pre-cert the MRI. He had me go for bloodwork, he never got the results and he had me going crazy calling the lab to have them send the reports to me. I finally got the reports from my rheumatologist, who had nothing to do with any of this. He never has your personal file in front of him, he writes everything down on a piece of white paper, God only knows where that ends up. There is no system to this physician's office. I started going to him because he was recommended to us by a doctor my husband knows very well.

*Well, perhaps he keeps all his patient records computerized for easier access. If he is not contracted by your insurance company, he is under no obligation to authorize anything. How is it that your "friend" from the other Doc's office is privvy to the medical information/exam notes needed to pre-cert the MRI? If she did that in my office, she'd be fired in a New York minute. How did your Rheumatologist get the lab reports if he wasn't the ordering Physician?

Bottom line, I'm really suffering right now, I would have to believe I must be going through withdrawals. I have made another appointment with a "real" pain management physician which I will see next Friday, and will be cancelling my Wednesday appointment. I'm going to go see my family physician today and explain this to him, hopefully he can help me until I see the new physician.

Good luck with that.

I wanted your input as to whether or not a physician is allowed to act in such a manner. I greatly appreciate all of your answers as I know you do this gratis. If I have a legitimate complaint, I will file one with the State Board. I would love to hear what you have to say regarding his practices and if you think this is how a physician should run a practice.

Again, my thanks to all of you.

Rosemary

Physicians are legally able to run their practices as they see fit as long as they practice within the standard of care guidelines. It would seem your Pain Management Doc is doing so. You were offered another appointment within a very reasoable amount of time. Without knowing the medication or prescribed dosage, I cannot comment on whether you could have waited until the rescheduled appointment time.

ETA: If you think you are having symptoms of narcotic withdrawal, go to the Emergency Room for evaluation and treatment. Good luck.

[lya]

If it looks like a duck, walks like a duck, and QUACKS like a duck...

I belive the OP needs to go to the ER for treatment and, hopefully, will be referred to a real doc.

[RoRo]

*Not all Physicians have partners or are part of a larger group. Even if he did have call coverage or a partner, many Pain Management Docs will not refill the other's narcotic prescriptions without specific permission.

I understand that there are doctors that are the one and only in their group, but they must have a way of contacting them in an emergency. I cannot find this doctor PERIOD! To leave 10 messages with different offices, contacting his personal secretary and leaving numerous messages with her, and paging the doctor directly numerous times with no return calls whatsoever over a period of 4 days you believe is normal practice. What happened to the Hypocratic Oath--"Do No Harm" Do you know what it's like to be on narcotic medication for 10 months and then have none, even for a day, the pain I experienced I wouldn't wish on anyone.


*Nothing odd about that. He sub-lets other Physician offices so he can service a larger area (and Parsippany to New Brunswick is quite a large area). It saves on overhead and he is able to service a larger population. He should have a contact # that goes directly to his personal secretary/staff and an emergency after hours number.

I really don't care if he sub-lets or where he runs his practice from, the point is, as I stated above, I've left repeated messages with numerous offices, people, secretaries, and even paged the doctor and have gotten no return call. He does not have a staff and he has no emergency after hours number. This is my point, you cannot get in touch with this physician!


*Well, perhaps he keeps all his patient records computerized for easier access. If he is not contracted by your insurance company, he is under no obligation to authorize anything. How is it that your "friend" from the other Doc's office is privvy to the medical information/exam notes needed to pre-cert the MRI? If she did that in my office, she'd be fired in a New York minute. How did your Rheumatologist get the lab reports if he wasn't the ordering Physician?

No his records are not computerized, he never knows from one week to the next what he did the prior time you were there to see him. I asked him about my records and he told me he keeps all his records at his home. What use is it to have patient records at your home when the patient is coming to see you, there is never a file he can look back at to see what was done and what should be done. He IS contracted by my insurance company and why would you give a patient a script for an MRI that can't be pre-certified, what sense does that make? You don't need medical information/exam notes etc., to pre-certify someone for an MRI. You need the patient's name, address, and insurance information as well as the doctor that is requesting the test. Here's my medical information, The patient had a cervical fusion and I want an MRI, not rocket science and has nothing to do with my medical records and medical history. My "friend" didn't need any of these things to pre-certify my MRI, she was being a friend and did me a favor or I would have never gotten the MRI done. Since he has a supposed personal secretary, why can't she do his pre-certifications? It's amazing you feel my "friend" should have been fired in a New York minute, but think this physician's way of practicing medicine is perfectly ok. I told my rheumatologist he ordered the bloodwork since the bloodwork he ordered had to do with my rheumatoid factor. She called the lab that did it and they faxed the records to her...why is this so hard to believe, she is a physician. This doctor wouldn't even call the lab to get the results of the test he ordered...you honestly believe this is the way a physician should run an office?


I did go to my family physician this afternoon, he did give me my prescription, enough to get me through until I can get to the new pain management doctor next Friday. When I explained the sequence of events that transpired he was appalled. He told me in all his years of practicing medicine, he's never heard of a physician acting so irresponsibly.

Again, I want to thank those of you that have taken the time to respond to me, and I will be filing a complaint with the State Board. No patient should be treated in such a manner.

[ecmst12]

I think it was wise of you to make an appointment at a real pain management clinic. Maybe you can even find a real treatment for your pain so you can eventually stop the drugs....that's not always possible but I think it's worth looking into.

[lealea1005]

first, let me say that, yes, I DO precert diagnostic testing for patients...every day....information that is needed includes the diagnosis, procedure codes, medical history, including current office notes. The person calling in the precert usually answers questions directly from the office notes. The ramifications of one of my employees attempting to precert a test for a person that is not a patient are numerous,and they would be fired immediately, if they were caught.

I was not agreeing with this Doctor's practice style or the fact that he did not have emergency call. I was just trying to tell you that some of the things you described may have had explanations behind them. I am happy you decided to find a new Doc.

[longsally111]

Lya, I am surprised!!! I thought you knew better than that!!!!! the er is not the appropriate place to get refills on narcotics and on regular monthly drugs as well. No ER dr is going to give a pt percocets because their pain management dr won't.

[ecmst12]

But if she's having withdrawal symptoms, that could be a medical emergency.

[lya]

Originally Posted by ecmst12

But if she's having withdrawal symptoms, that could be a medical emergency.

Exactly.

I once did CPR on a man in the waiting room of an ED. He appeared to be fine and talked to me when I walked through the waiting area to deliver a set of documents and was on the floor in full arrest when I came back through the waiting room. He was in the ED because his doctor refused to refill his Valium, a drug he had taken daily for many years. The abrupt withdrawal resulted in sudden cardiac arrest! He survived and the MD was held accountable.

The ED will evaluate the need for pain relief and will evaluate the potential for serious problems due to abrupt cessation of addicting medications and will provide treatment as indicated.

I was not intentionally meaning anything other than for severe pain and/or prevention of untoward events associated with abrupt withdrawal of addicting medications, though I am fully aware of the number of drug seekers that tie up EDs all over this nation.