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Ask Dr. D. Love Your Own Question
Dr. D. Love
Dr. D. Love, Doctor
Category: OB GYN
Satisfied Customers: 17994
Experience:  Family Physician for 10 years; Hospital Medical Director for 10 years.
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I've been on pain mgmt with the same doctor 3 years.

Customer Question

I've been on pain mgmt with the same doctor for over 3 years. I have always done what I was told and stayed on the straight and narrow. I had to cancel an appt and called to make a new one but was told I couldn't be worked in for 10 days because the office would be closed. I called on June 25th, was told the office would be closed the entire next week and they would try to work me in the following week, the week of July 6th. I agreed to that but did indicate that I may have to look for a new doctor if they couldn't get me in because I didn't like being left to run out of the Fentanyl patches that this doctor had pushed me to get on and go through withdrawals. I was talking with the office mgr and she told me that yes, I would probably go through withdrawals and I would just have to take myself to the ER if I had problems. I waited through the week they were supposed to be closed, per the pain mgr, and called the morning of the July 6th, only to find that they had changed their week off to the week of the 6th and no one had called me. I had been wearing each of my Fentanyl patches until I started having withdrawal symptoms and then changing them instead of changing at 48 hours like I was supposed to. I was not feeling my best but I had been surviving. Upon realizing that the office mgr had told me the wrong week they would be closed, I called my rheumatologist and asked if he could possibly prescribe me a box of Fentanyl patches to get me through until they were back. He was kind enough to do that and I was able to hold on until July 13th. I called the office that day and asked to have an appt made and was put through to the office mgr who told me that the doctor won't allow me to make an appt because I said I would be looking for another doctor. I talked with the receptionist and she told me that they had made the decision in mid-June to be closed the week of July 6th, so the office mgr either made a mistake when she told me the earlier week or deliberately lied, but no one called to correct the misinformation, even though I left a message on the office voicemail. Yet I have not received a letter saying that they have dismissed me from their practice. I am looking for another doctor but I am down to just a couple of Fentanyl patches and not very many Cymbalta, both of which I have been taking for a long time. I told the office mgr that I was basically out of meds and that I needed prescriptions but I can't get them unless I am seen and the doctor won't let me make an appt. Doesn't he have to still prescribe meds and treat me for 30 days in order to give me time to find a new doc?
Submitted: 1 year ago.
Category: OB GYN
Expert:  Dr. D. Love replied 1 year ago.
Hello from JustAnswer.
A doctor cannot simply abandon a patient. In most states, that is interpreted as requiring adequate notice before discharging a patient from the practice and continuing to provide care for a reasonable time allowing for the patient to seek another doctor. In most states, the duration for this reasonable time is defined to be 30 days.
However, there is no specific requirement that a doctor provide care other than the care that would be medically appropriate for that situation. For example, a common situation arises when a Pain Management doctor finds that a patient has acquired pain medicines from a different source and decides to discharge them from the practice. Although it is expected that the doctor provide care for the 30 days, it is not expected that they refill controlled substances during that time, because it would be considered appropriate medical care to refuse further controlled substances to a patient that has sought and obtained pain medicines from another source.
In your situation, unfortunately, there is much that can boil down to who said what. Since you obtained the fentanyl patches from another doctor, then this doctor could claim that refusing to provide further prescriptions would be appropriate care, as in the example above. Since you canceled the regular appointment, the manager can claim that you were correctly advised of the options, but were never told that you could acquire the additional fentanyl patches elsewhere.
So, the doctor is required to provide appropriate medical care for the 30 days. And if the doctor accepts that it was OK for you to acquire the fentanyl patches from another source, it would be difficult to justify that refusing to prescribe further patches would be appropriate medical care. But if the doctor is saying that it was inappropriate for you to acquire the fentanyl patches elsewhere, then the doctor would have a strong argument that appropriate medical care would include refusing to provide another prescription for the patches.
If I can provide any clarification, please let me know.