Wayfaring MD

I am a family medicine resident who likes to highlight the hilarious in medicine as I write about patients, medical school, residency, medical missions, and whatever else strikes my fancy.



Disclaimer:
HIPAA is for reals, folks. All of my "patient stories" have been changed to protect patient privacy. I will change any or all identifiers, including age, location, race/ethnicity, sex, medical history, and quotes. Also, I am an anonymous internet person. Why should you trust an anonymous internet person to give you medical advice? Don't ask me, ask your doctor!
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A word of advice to all you future doctors out there: 

Don’t prescribe controlled substances to a patient who isn’t yours, especially for a chronic problem.

Ok, if it’s an acute problem, sure, I’ll let it slide. But let’s say you see a middle aged lady for chronic knee pain, for which her doctor has already tried multiple NSAIDs and physical therapy. The answer to her problem is not “well let’s just try a lil Lortab and see how that works”. Doncha think her doctor thought about that? Maybe there’s a reason why her doctor has avoided those medicines. Is there any other option for treating her pain adequately without using addictive substances?

Seriously though. Recently I’ve seen 2 of my patients who have been started on opiates by other providers who had only seen them once. It’s easy to give people what they want (but maybe isn’t the best for them) when you don’t have to deal with the consequences and aftermath. 

Both patients were people who had addiction in their pasts. Both had multiple options available to them for treating their pain before turning to opiates. But both came in specifically asking for opiates. And interns gave them to ‘em. 

So now it will take me months to get them off of these drugs which we most likely could have avoided and still treated their pain adequately. Ugh.

On the flip side, if you have a patient who you are trying to avoid starting on chronic opiates or benzos, put a note to that effect in an obvious place in their chart so if other providers see them, they can be on board with the plan.