Is failure to treat, malpractice?

[Just Blue]

Perhaps you could find someone like Dr. George Nichopoulos.

If you're not familiar with that name.... Dr. "Nick" was indicted in 1980 on several counts of overprescribing drugs to Elvis Presley, including Demerol, Nembutal, Dilaudid, Halcion, Didrex, Valium, Placidyl, Haldol, Nubain, Percodan, Nembutal, Stadol, Oxycodine, and more, in incomprehensible quantities.

Dr. Nick petitioned the Tennessee Board of Medical Examiners in 1995 for the return of his medical license, but was denied.

Anyone remember what happened to Elvis?

Didn't Elvis die of an overdose while sitting on the toilet?

 

[asil8170]

Here are a few segments of articles concerning the treatment of pain that I thought you might find interesting AND possibly help others who are forced to deal with pain.

http://www.talkbeyondpain.com/aboutphpp.jsp
http://www.medscape.com/viewarticle/433604
Opioid Therapy: Controversies and Considerations
Disclosures

Presented by:
Howard Smith, MD (Moderator)
Scott Fishman, MD
Joseph Audette, MD
Summarized by:
Zahid H. Bajwa, MD, and Charles Ho, MD
Pain management specialists are beginning to use opioid therapy for intractable nonmalignant pain. One example of the growing acceptance of opioids is the development of new opioid medications, such as buprenorphine transdermal system, for the treatment of osteoarthritis.[1] Nonetheless, this is a topic of great controversy among nonspecialist physicians because of fears of patient addiction and drug abuse. The issues of urine screening, opioid contracts, and the use of opioids for headaches and soft tissue pain were examined in a symposium, "Controversial Issues Involving Chronic Opioid Therapy."[2]
The Opioid Contract
Next, Scott Fishman, MD, University of California, Davis (UCD), Medical Center, Sacramento, described the opioid contract, its use and content. Such a contract is an explicit bilateral agreement stating expectations for the physician as well as the patient. An opioid contract helps a patient take a more active role and provides some protection for the prescribing physician.
According to Dr. Fishman, clinical studies have not proved the efficacy of the opioid contracts. However, he noted that most of these studies involved methadone maintenance and not pain patients. A review[3] of contracts from 39 major academic pain centers found such documents to range from 1 to 10 pages in length. The various contracts included 12 different categories -- terms, treatment, behavior, points of termination, patient's responsibilities, issues about education, additional treatments, emergency situations, goals, role, discouraged behaviors, and prescriptions -- but there was substantial diversity among contracts. The basic core contract included patient responsibilities, education, and termination criteria.
The use of opioids for neuropathic pain remains controversial. Those studies
that have taken place have been small, yielded equivocal results and have
not established the long-term risk/benefit ratio of this treatment. Some
intermediate-term studies have demonstrated significant efficacy of opioids
over placebo, which is likely to be clinically important. Reported adverse
events of opioids include nausea and constipation, and ARE COMMON BUT NOT LIFE-THREATENING. Further randomised controlled trials are needed to establish
long-term efficacy, safety (including addiction potential) and EFFECT ON QUALITY OF LIFE. http://www.touchbriefings.com/pdf/2784/Bajwa.pdf

I just want to say one last thing. Does anyone here know what it's like to suffer for 9 years at the mercy of medical professionals, jumping through every hoop they've asked you to jump through and FINALLY find a treatment that gives you your life back, only to have it ripped away, tied to a string and dangled in front of your nose like a carrot in front of a mule? That's exactly what's happened to me. I KNOW that I could go to Boston and have Dr. Bajwa treat me BUT IT IS ABSOLUTELY IMPOSSIBLE FOR ME TO GET THERE AND CONTINUE TO RETURN EVERY 6 MONTHS!!!!!!!!!!!!! I just wish that some doctors cared more about their patient's quality of life than they do about the POSSIBILITY of having their hands slapped for prescribing a controversial medication.

 

[Just Blue]

I just wish that some doctors cared more about their patient's quality of life than they do about the POSSIBILITY of having their hands slapped for prescribing a controversial medication.

It is not a hand slap! They could LOOSE THEIR LICENSE!! If you want the medication go to Boston...take a train there and the cost shouldn't be too much. But to expect a Doctor that has worked for 15 years to BECOME a Doctor to risk everything for you to get your narc's is so unbelievably selfish!! I have read your other post as well, and one can't help but conclude that you think the world should just jump to your needs! It doesn't matter how unreasonable those needs are...if you want it you should have it, huh??

 

[dedlock]

Let's see...what part of, "for 9 years I tried every kind of doctor, (yes, that includes psychiatrists, psychologists, bio-feedback therapists, nutritionists, dieticians, physical therapists, neurologists, endocrinologists, accupuncture specialists, hypnotherapists and many others) every kind of drug and every kind of treatment that my doctors could think of." I've been to Mayo clinic...several times. I've even "detoxed" there once but when the headaches returned with a vengence, my condition scared the rehab staff so much that they transferred me to the ICU, where the doctors once again administered every kind to treatment and drug they could think of and, after 4 days, put me back on benedryl and Nubain. They sent me home 2 days later with discharge orders saying that I would need to find another form of treatment. When I asked what they would suggest, they threw their hands up and said..."wish we could help you more."
So, again, I would like to ask...what is the possibility that my FP could lose her license for prescribing a proven form of treatment, approved by the head of nuerology at Harvard after 9 years of extensive tests and dozens of failed treatment plans?

You are not listening. Hear what people are saying. The FP doctor is NOT going to put you in harm's way by prescribing you injectable medications. PERIOD.

Go to Harvard and see the head of Neurology and get him to provide your 'scripts.

Some of us live with chronic pain every single day and we take NSAIDS, use hot packs, ice packs, get massage therapy, use aroma therapy, exercise daily with weights, take yogo classes, do maturitiy level cardio exercises, lose sleep, throw up, go through divorce, have huge financial losses and raise kids on a nurse's salary and still go back to school for a college degree, have migraine headaches until we get past menopause and still survive without going to the ER for OPIATES or beg a FP physician for injectable narcotics/opiates for headaches.

I don't think you are going to get the answers you are looking for here. Seriously, move on.

Addition to your "research" on intractable pain. Hello? Do you have osteoarthritis??? Do you know anyone who does? Have you ever seen what someone's knuckles, wrists, elbows and shoulders look like when they have irretractable pain with OSTEOARTHRITIS? Do you know they can barely turn over in bed? Do you realize they need assistance to dress, brush their teeth? Cannot open cans or pull off the top of flip top. You are not physically compromised. You are a psychogenic invalid. I didn't say you didn't have migraines, I said you are a self imposed invalid.

 

[Curt581]

I just wish that some doctors cared more about their patient's quality of life than they do about the POSSIBILITY of having their hands slapped for prescribing a controversial medication.

Here's the bottom line, and answer to your question:

No, it is not medical malpractice for a doctor to decline to administer drugs the patient wants... But it can be medical malpractice if they were to do so.

Tell me... how much help to you will that doctor be if he loses his medical license or worse, finds himself indicted on criminal charges?

Loss of a medical license or facing criminal charges hardly qualifies as a "hand-slapping".

 

[las365]

asil8170, you seem very invested in convincing people here that narcotics are the only viable treatment for you, that they are medically necessary and a sound course of treatment, etc., but you don't seem to realize that SO WHAT?

The person you need to convince of that is a doctor. No one here can help you get your drugs. Your legal question has been answered multiple times.

Also, baloney that it is impossible for you to go to Boston for treatment. Per your posts in your alimony thread, you receive $36K a year in alimony regardless of what income you bring in yourself. I tend to think that the doctors you claim are so eager to prescribe narcotics for you... aren't.

 

[asil8170]

I'd like to go back to one of my earlier posts in which I asked if I had the right to know why my FP is not "comfortable" with providing this form of treatment... I was told, several times, that I DO NOT have the right to that information.

WRONG!!!!!!!!!!!!!!!

In the "Patient's Bill of Rights" under #2, it says...
The patient has the right to and is encouraged to obtain from physicians and other direct caregivers relevant, current, and understandable information concerning diagnosis, treatment, and prognosis.
This means that I DO have the right to an explanation of treatment options AND the physician's reasoning behind the choices they make for a certain treatment OR against a certain treatment.

In the last paragraph, it states...
To participate effectively in decision making, patients must be encouraged to take responsibility for requesting additional information or clarification about their health status or treatment when they do not fully understand information and instructions.
That means that, by NOT asking my FP for clarification for her choices of treatment, I would be considered irresponsible.

As for being able to afford to travel to Boston twice a year...would you like to tell me how when my monthly expenses exceed our income EVERY month???????????????? Not only would I have to pay for transportation to Boston, there is food and lodging for at least 2 days/1 night, the actual cost of seeing the doctor (last time it exceeded $1800 and insurance will not pay for this because they BELIEVE that such treatment can be obtained locally...HA!) AND child care for 2 days, since their father refuses to take even his normal visitation, let alone any extra.

 

[justalayman]

I just want to say one last thing. Does anyone here know what it's like to suffer for 9 years at the mercy of medical professionals, jumping through every hoop they've asked you to jump through and FINALLY find a treatment that gives you your life back, only to have it ripped away, tied to a string and dangled in front of your nose like a carrot in front of a mule? That's exactly what's happened to me. I KNOW that I could go to Boston and have Dr. Bajwa treat me BUT IT IS ABSOLUTELY IMPOSSIBLE FOR ME TO GET THERE AND CONTINUE TO RETURN EVERY 6 MONTHS!!!!!!!!!!!!! I just wish that some doctors cared more about their patient's quality of life than they do about the POSSIBILITY of having their hands slapped for prescribing a controversial medication.

Lisa, you can argue all you want. It will not convince anybody here and it will not change what you can get from your doctor. It seems you have no choice but to go to Boston.

It seems that everything anybody suggests to you, you have already attempted. If so, then nobody here can help you.

The only option you seem to have is to go to Boston. If you cannot do this, then you will apparently have to learn to live with things as they are.

Your doctor is not guilty of malpractice. You have no claims against her.

The thing I find so odd is you claim to have returned from Colorado because of the children but you now tell us that yuou have been ostracized from your community and your ex does not choose to exercise his parental rights. What have you gained? Now, the children are living in terrible conditions and with no community support.

Sounds like dumping the house up here and moving back to Colorado may be a better move. You have a doctor there that will treat you as desired. You have a friend there (apparently more than you have here). Speaking of that, how do you expect to have a thriving business in a town that you describe as your ex had turned everyone against you. If it is as small as you say and he has convinced many at all, where will your customers come from?

You can move back into the house there and you won;t have to worry about the devaluation of the property due to the water. As a matter of fact, since it won;t sell at what you believe it to be worth, chances are you can get your taxes reduced since taxes are supposed to be based on actual value. That will be even another savings.

 

[asil8170]

My children are well supported by THEIR friends here in Iowa and have done so well academically, socially and athletically since we moved back that I would never consider returning to Colorado.

As for my business, our little town is the "center" of a dozen smaller towns within a 20 mile radius. When I owned a clothing store here, the majority of my business came from outside of our community. I am hoping that this will be the case with my photography business.

I KNOW that my FP is not guilty of malpractice...you've made your point, I just wish that I could find a feasible way to retain the quality of life that I've enjoyed for the last 6 years...the quality of parenting that my children have enjoyed for the last 6 years. The idea of living in pain does not scare me as much as the thought of my kids having to, once again, deal with a "disabled" parent...this time WITHOUT any support of a second parent.
I just don't want them to suffer anymore than they have already. They've been through so much (yes, mostly because of my choices) and now, when I have very little choice in this matter, they will suffer again.

 

[justalayman]

Well, then your options are becoming very limited very quickly.

I realize you have been to the Mayo Clinic but have you spoken to Doc B in Boston as to your predicament? He may have a solution and/or he may have contact at Mayo you do not realize.

You have been dwelling on your FP not providing what you believe is proper treatment and in doing so, I believe you have failed to continue to seek other remedies for your situation.

You have the solution in basis, now you have to find a way to make it a solution in fact. As with all things, if something bothers a person enough, they WILL find a way to resolve it. If that means hitchhiking to Boston twice a year, then that is what it takes but when you simply say "it isn;t possible" then it becomes impossible.

A round trip flight to Boston from Des Moines is only $250 bucks. I find it difficult that you, in your creativity cannot find $500 bucks a year to make the trip. That is probably less than what he charges for an appointment. If you miss a day or two of production, that would surely cost you more to miss the income than it would to simply take the money and go.

 

[lya]

The doctor in favor, at the moment, the one in the Mayo Clinic--don't (you) think he would have made appropriate arrangements to keep the patient (the original poster) on Nubain daily if that was truly what he wanted?

If going to Boston was the answer to anyone's suffering, don't (you) think that person would be going to Boston instead of posting here?

This posted "question" is nothing more than a search for a legal foot-stomping, temper-tantrum that will yeild endless supplies of Nubain.

The whole thread has given me and the wife a headache!

 

[Just Blue]

The doctor in favor, at the moment, the one in the Mayo Clinic--don't (you) think he would have made appropriate arrangements to keep the patient (the original poster) on Nubain daily if that was truly what he wanted?

If going to Boston was the answer to anyone's suffering, don't (you) think that person would be going to Boston instead of posting here?

This posted "question" is nothing more than a search for a legal foot-stomping, temper-tantrum that will yeild endless supplies of Nubain.

The whole thread has given me and the wife a headache!

For some reason I always thought you were a woman!

 

[asil8170]

Do you believe that it is feasible for me to hitchhike to Boston?

In my many years of dealing with doctors, I have spent many hours in waiting rooms. While I was waiting for an appointment, I think that it may have been in Boston, I picked up a medical journal and read a very interesting article. It was about a young man who, much like me, experienced chronic pain (caused by an accident) that had been successfully controlled by a certain narcotic. I can't remember the name of it now. Anyway, after years of successful treatment, his doctor told him that he would no longer prescribe that medication and that an alternative treatment must be found. Well, this young man DID have the financial ability to research and then travel the world (he went to Mexico and Europe) in order to find a physician who could either provide a NEW successful form of treatment or be willing to prescribe the medication which had already been proven successful. After more than 2 years of searching, he found NO doctor who was willing to prescribe that med. Frustrated and in pain, this youn man resorted to forging his own prescription. He was caught, convicted and sent to jail. While serving his time, the prison doctor, after consulting with several of this man's physicians, prescribed the exact narcotic that he had been seeking for years.

Yes, where there's a will, there's a way****************************..there is ALWAYS a resolution to EVERY problem.

 

[justalayman]

Do you believe that it is feasible for me to hitchhike to Boston?

In my many years of dealing with doctors, I have spent many hours in waiting rooms. While I was waiting for an appointment, I think that it may have been in Boston, I picked up a medical journal and read a very interesting article. It was about a young man who, much like me, experienced chronic pain (caused by an accident) that had been successfully controlled by a certain narcotic. I can't remember the name of it now. Anyway, after years of successful treatment, his doctor told him that he would no longer prescribe that medication and that an alternative treatment must be found. Well, this young man DID have the financial ability to research and then travel the world (he went to Mexico and Europe) in order to find a physician who could either provide a NEW successful form of treatment or be willing to prescribe the medication which had already been proven successful. After more than 2 years of searching, he found NO doctor who was willing to prescribe that med. Frustrated and in pain, this youn man resorted to forging his own prescription. He was caught, convicted and sent to jail. While serving his time, the prison doctor, after consulting with several of this man's physicians, prescribed the exact narcotic that he had been seeking for years.

Yes, where there's a will, there's a way****************************..there is ALWAYS a resolution to EVERY problem.

well, when my dad wanted to go from North Judson Indiana to Key west Florida, he hopped on his bicycle and went. That was before 10 speed bikes and all.


Your story is about a person who could not find a doctor that would presribe the meds. You know where one is. Now all yo uhave to do is get there. $250 buys you a round trip ticket.

 

[asil8170]

And since that was before the time of ten-speeds, it must have been AT LEAST 50 years ago. That was a simpler time....a safer time. My bet is he also DID NOT have 6 kids to consider. My dad, in the early '50's, hitched all the way from California to Iowa when he was on leave from the Navy. If he was the same age now as then, would he do the same thing today? ABSOLUTELY NOT...and he was a Golden Gloves boxer!!!!!!!!!!!!!!! But I, a woman who have had 3 back surgeries and other medical issues to deal with, should just throw on a backpack and hit the road. MAN, YOUR LINE OF REASONING HAS ME QUESTIONING YOUR MENTAL CAPACITIES!!!!!!!!!!!!!!!!!!!!

As for the cost...why are you having such a hard time understanding that it WOULD TAKE MUCH MORE THAN YOUR $250 FLIGHT QUOTE to accomplish what, everyone tells me, is my only option????????? Doctor's fees...room and board...child care...what about those? You make it sound like I should HAVE NO PROBLEM just taking off any time I choose. Maybe YOU could do that to your family, but I can't. Even if I could, I'm sure that I would be accused of child neglect or, better yet..."taking money (I think he meant food) out of my kids' mouths..." So, please, TRY TO WRAP YOUR BRAIN AROUND THIS CONCEPT...I DO NOT HAVE THE MONEY TO GO TO BOSTON!!!!!!!!!!!!!!!!!!!!!!!!! You sit there and tell ME that I haven't been listening to what people here are saying...what about YOU???