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Pain contract



  • dilaurodilauro ConnecticutPosts: 11,638

    This is very strange.

    First, lets put aside the fact that you are hurting and in discomfort......

    When you went to this doctor talking about Spinal Issues, it should have been that doctor's responsibility to state that they are NOT a spinal specialist, ortho, neuro, etc but a Gyno.

    Then for that doctor to prescribe opioids for your condition. Reality speaking, they had no right to do that. If anything, a referral to a spine specialist, pain management doctor, etc would have been the ethical thing to do.

    One of the first things that anyone suffering from spinal problems is to seek the help of the proper doctors. It can always start with your primary doctor, but if there is a problem, they can refer you to the appropriate doctors to handle your situation.

    Ron DiLauro Veritas-Health Forums Manager
    I am not a medical professional. I comment on personal experiences
    You can email me at: [email protected]
  • She is my primary just had an appointment yesterday 2 months after contract and was supposed to pick up refill after appointment. So after vital signs they said need a urine sample so gave them one then when I got back from the bathroom the nurse said I need to resign the pain contract before the doc comes in . I was waiting for 20 min to see her the she comes in and says we're taking you off the oxy and I said the medicine helps but would like to try 5mg twice a day up from 1 every other day and she said no there will never be enough oxy and that she is referring me to a pain specialist and just left the room. When the nurse came back with the after visit report the referral was for a therapist from mental health not an pain doc. I was in a lot of pain and hadn't slept in over 48 hours and fell trick so just went ad cryed in the car. Any on have any advice

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  • L4_L5LL4_L5 Posts: 237
    edited 02/08/2018 - 6:36 PM

    You have to be very careful when communicating a desire to increase dosage. Chose your words carefully or else red flags will fly.

    Asking any doctor to increase you from one pill EVERY OTHER DAY to two pills every 24 hours is asking them to QUADRUPLE your allowance. That’s huge.

    To me it seems beyond bizarre that your PCP (Gyno) would have you sign a pain contract for 15 pills a month.

    When someone goes to the dentist and has an extraction and is prescribed 12 to 18 Vicodin for pain does the dentist make that person sign a pain contract?

    What medical evidence did you supply to your PCP to justify opiods? An EMG/MRI?

    What you are prescribed and how much is largely driven by your diagnoses (present and historical).

    Even though I’m not thrilled with your approach, if you have genuine spinal issues going on then your PCP should afford you the opportunity to consult with a spine expert.

    If not, I would change my PCP or google neurosurgeons in your area and check their rating from several independent sources and book an appmt (you may not even need a referral). I’m surprised how many specialists I’ve seen where no referral was needed.

  • I guess they want to assess whether or not you have addiction issues from the sound of it. I'm also perplexed about your situation..doesn't quite make sense. I do know that some gyn are regarded as primary care docs, but she's obviously not a spine or pain specialist. I have to say that asking for specific med or dose can raise suspicion in this opiophobic environment. I would start over again with a referral to a real spine specialist. Of course, you cannot get pain meds from different docs while you're under contract with this "gyn". They would have to release you on good terms for you to be able to see another doctor for pain management. Also, always take pain meds as prescribed, or else you will be in breach of another contract and discharged. It will be in your records wherever you go, and near impossible to find someone else to treat your pain.

    Ol' Spiney..Micro-D L4-L5, TLIF L4-S1 -post op central HNP L4-S1,stenosis, retrolisthesis, EF, facet arthropathy, lumbar& cervical DDD. FBSS- Medtronic pain pump & SCS
  • but what is the point of having me sign another contract if she took me off the medicine that's the first thing she said before even closing the door behind her that she is taking off it and can't pick up refill which I could of picked up the day before but wanted to talk about regimin Did they lose the first contract? Does she not want me to seek other help just so she doesn't lose a patient? Also I referred to it as medicine she just keep saying oxy like I'm an addict

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  • Sometimes the doctor updates their pain contract with new information. That’s not all that unusual.

    It is indeed medicine. No respectable pain medicine specialist would refer to a medication repeatedly as “oxy” and say phrases like “there will never be enough oxy.”

    She sounds frustrated. You’re not seeing the corrrct type of doctor for spinal issue which is a large part of why you’re experiencing what you’re experiencing.

    I would never expect a PCP/Gyno/Urologist to prescribe pain medicine.

  • She is the doc kieser pernamente gave me and my spine doc is in the same clinic but he refers to her to give me meds same with the nuroligest. They say pcp will give meds. Just feels like they don't want to treat me but don't want to lose a patient . just like she said she is reffering me to a pain specialist and it not it's mental health and called them and they just deal with depression they won't even recommend meds to her and the nurse was rude about my delema

  • Find a new primary doctor than fire the other they work for you not the other way around than go from there

  • K thx dont have much experience with this been in chronic pain sice I was 18 and just started going to the doc in 2016 but with the fentanyl epidemic they want to treat pain patients like drug seekers. My 64 year old auntie has alot of medical problems and on top of it she got a fracture in her spine and they say they can't give her any thing for pain because she might fall it's just BS. Anyway what about the pain contract will I be able to get medicine from another doc?

  • peanut006peanut006 MichiganPosts: 6

    If you are under contract for pain management you can see and "interview" other doctors. Talk to them about what their treatment plan for you would be and if it's a good fit, you can switch. But you cannot take any prescriptions from another doctor until you've canceled the contract you currently have, in writing, otherwise you will definitely be dismissed and "red flagged" for any future treatment. So just make sure that you cancel your current contract before doing anything more than talking!

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