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Law Educator, Esq.
Law Educator, Esq., Attorney
Category: Legal
Satisfied Customers: 116707
Experience:  JA Mentor -Attorney Labor/employment, corporate, sports law, admiralty/maritime and civil rights law
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I live in PA and went to a new doctor in my area because my

Customer Question

I live in PA and went to a new doctor in my area because my general physician said that there was not much more he could do for my chronic back pain. I wanted to find a physician to get a new/fresh perspective on my medical history. I am currently prescribed opiates for pain by my general physician and ADHD medication from my Psychiatrist that I have been taking for at least 5 years. I started the narcotic pain medication after my daughter was born at the end of 2012/beginning 2013 and have been taking it ever since. When I went to the new doctor's office, I brought my entire medical history file as well as the medications I have been prescribed. The doctor spent almost an hour with me asking me questions about my medical history and making copays of the documents I had brought with me, but when she asked me about my medication history, I sensed the interest in my case and finding a cause for what was going on, disappear as soon as I said “narcotic”. She shut my file and said that she would continue the prescriptions I was currently on and discussed alternative medication with me. I said I would try anything if she thought it would help my pain more than what I was taking now. I was told that in order to receive the prescriptions however, I had to sign a pain contract and submit to a urine test. They gave me the pain contract and the doctor stood over me while I tried to read and understand the 3 page document. I felt rushed, and they made me feel like I was a problematic patient all of a sudden or bad person so, I just signed the contract without really reading it. I never had to submit to a urine test with my current doctor so this was new to me and I thought they were checking for street drugs. My situation is much more detailed, but I’m going to try and summarize the outcome and my issue as much as possible. I ended up submitting two urine tests in exchange for medication prescriptions in the month I was a patient. The first test being on the first day I came to the office and the second was for 3 days worth of medication because I had to reschedule my appointment due to a personal matter. When I went to my rescheduled appointment, I had to wait an hour and when I asked if I was going to be seen, I was told I was marked as a “no show” by mistake. When I was finally called back to see the doctor, the nurse said that they hired several new employees and that a lot of things were “messed up” asked for my patience and understanding. I said it was fine. When the nurse left and doctor came in, the doctor said that my urine tests came back and she feels the results are inconsistent so, she would not write me any more prescriptions and would not see me anymore. I was completely confused and just asked why. She said that my original urine screen showed an additional drug which I did not tell her about and my last urine test didn't show the medication prescribed in my system, so she would not see me anymore. I offered to submit another urine test to show that I am taking the medication, but she said it wouldn't matter because she has no tolerance for patients who lie to her. I was completely shocked. She gave me no warning, no chance to explain, no time to find a new doctor. I was out of my medication and needed refills but, I was afraid to say anything because I was made to feel like a criminal. Plus, she obviously knew my refills were due because she immediately started the conversation by saying she wouldn’t prescribe me the medication.I did some research and found some information on “Patient Abandonment” and that 5 elements must be present for a patient to have a proper civil cause of action for the tort of abandonment:1. Health care treatment was unreasonably discontinued.2. The termination of health care was contrary to the patient's will or without the patient's knowledge.3. The health care provider failed to arrange for care by another appropriate skilled health care provider.4. The health care provider should have reasonably foreseen that harm to the patient would arise from the termination of the care (proximate cause).5. The patient actually suffered harm or loss as a result of the discontinuance of care.My question is, do I meet all 5 elements and would it even be worth pursuing an action against the physician if I could? I am extremely upset by this and feel I was discounted as a patient and a human for that matter. I was made to feel like I did something wrong and I was left without medication which caused major symptoms of withdraw. I was really very sick and I’m so angry at this doctor and every other doctor who treats patients with chronic pain like animals and drug addicts. I don't know how this will affect me in the future. Will this incident follow me when looking for a new doctor? Does it get entered into some database for other doctors to see? I would appreciate legal advice on this matter. Thank you.
Submitted: 2 years ago.
Category: Legal
Expert:  Law Educator, Esq. replied 2 years ago.
Thank you for your question. I look forward to working with you to provide you the information you are seeking for educational purposes only.
This is something many patients are going through with their doctors since the passage of the new laws regulating doctors and trying to control patients from abusing prescription narcotics.
The new laws make doctors liable for issuing narcotic prescriptions to patients if patients do not follow their narcotic contracts, even if the patient may not be a true abuser. It is up to the patient to read these contracts closely before signing them I am afraid, so you cannot use the excuse you did not read it as an excuse.
Legally, if the doctor shows the test results with a medication that was not listed or disclosed by you, that would be their defense and would be grounds to protect the doctor for them terminating you as a patient.
I am sorry, but because of the new laws trying to stop prescription drug abuse, if the test did come back with an undisclosed medication, the doctor would not be guilty of patient abandonment as it would not be deemed as "unreasonably discontinued" because the law is now forcing doctors to do these tests and be more accountable for narcotics prescriptions they issue.
Customer: replied 2 years ago.
Thank you for your reply. I am aware of new laws being passed reclassifying certain medications, like Tramadol & Vicodin as Schedule II narcotics making these prescriptions more difficult to obtain and more burdensome for a doctor to prescribe, but I am unable to find a specific law requiring physicians to use pain contracts in order to prescribe pain medication. I thought physicians did this to cover their bases because the DEA is targeting more and more doctors who prescribe pain medicine accusing them of prescribing too much medication too often, etc. I am also aware that doctors can only prescribe a certain quanity of medication each month in order to not be classified as a pain management specialist which requires additional certifications and such. If pain managemanet contracts were required by law, I would have had to sign one with my previous doctor. I'm just trying to understand this law so this never happens again. I also read that doctors could fire patients for non compliance if they signed a pain contract, but that they must give written notice of the termination, give at least 30 days to allow the patient to find a new physician, recommend a new physician and fill the monthly prescription in the 30 day cut off period while the patient is looking for a new physician. Is this not true?
Customer: replied 2 years ago.
Also, what happens after the relationship is terminated? Am I now "flagged" in some central database for supposed non compliance of pain management contract? Do they notify my insurance who in turn sends letters to any active physicians or new physicians I am seeing or will no longer approve pain medication prescriptions? I know nothing about this, can't find any clear answers online and I'm becoming more and more upset, stressed, angry, depressed as the days go on. I can't sleep, can't eat. I'm going through withdrawal which is affecting my personal & work life & I'm scared a doctor will never see me again and my medical condition(s) will never be diagnosed this living in chronic severe pain for the rest of my life. Would this situation be considered a quality of life issue by law? It certainly is to me. Thank you.
Customer: replied 2 years ago.
I'm sorry, I want to add one more thing to just give a greater understanding where I am coming from. The doctor who dismissed me without warning was a family practitioner, not a pain management specialist and not only did I transfer myself over to that practice, I transferred my daughter as well. The doctor didn't say she was also terminating my 2 year old daughter, but obviously, I would never allow a physician (or any practice that allowed their physicians to refuse to see a patient without at least fulfilling an obligation to not cause the patient harm and give at least some notice to find a new doctor) to treat my daughter after the way she treated me. I was given no choice but to try and find an immediate alternative for her as well as myself, which I still have been unable to do and it's been 1 week & 2 days since my dismissal. Additionally, I had at least 6 blood tests taken to check my thyroid levels (which I have been insisting is off), Lyme disease (apparently I had a positive indication for at least one of the anti-bodies when I took a blood test 4 years ago, which I just found out about when I requested to view all of my diagnostic tests online through Quest prior to my first appointment with the new doctor - I was never told this at the time), and several other important tests that might explain some of my pain or would definitely present a new condition that needed to be treated. I was told that they would call me with the results which they never did and went I went to my appointment she terminated me and never went over any of my blood test results. I do have access online to view them myself now (I don't know if they are aware of this or not) and already paid my deductible for my 2 office visits and the patient responsibility amount charged by Quest for these tests. I saw that it looks like I have hyperthyroidism which I've long suspected, but I'm not a doctor so I obviously can't confirm the findings. Doesn't the doctor have a moral responsibility to have at least share the results with me so that I could seek appropriate treatment? I just don't see how legally & professionally this is ok. I also think the tests were tampered with by the nurse who flat out lied to the physician and told her I begged for medication when she was out of the office when in fact she was the one to offer to ask another doctor to write the script in the doctor's absence. Not sure if her job was on the line, but something happened here. I was told "drug tests don't lie". Well, I certainly know people do & there is no proof they can show that my urine sample wasn't tampered with. This is all here say in my opinion. I just don't understand how this practice can get away with this.
Expert:  Law Educator, Esq. replied 2 years ago.
Thank you for your reply.
The laws do not mandate the use of contracts per se, but the PA law and federal law passed stricter monitoring of doctors writing controlled substances and there is a central database and the doctors now are under scrutiny as far as what they are writing and can have their license pulled for improper writing and the state and DEA is doing so with regularity lately. Thus, doctors have begun protecting themselves to be able to defend themselves by proving the patients they are writing are not just drug seeking.
The exception to the 30 day notice of termination of a patient is violation of narcotic agreements I am afraid.
After the relationship is terminated, the patient has to find a new doctor and it is difficult because while there is no database, the information is contained in their patient records. Most patients we find are going to emergency rooms or going to other states for treatment. Some are going to alternative medicine clinics. The problem is that there are no laws, including malpractice laws, that mandate a doctor to write any narcotic prescription for any patient.
This new process indeed angers many chronic pain patients who are not drug abusers, but must have something to ease their pain from their condition. However, the doctors are allowed to determine how they deal with their chronic pain patients and what prescriptions they write or not write (again many doctors are afraid of losing their license if it is claimed they are over prescribing, hence, testing and strict requirement that all medications must be disclosed by the patient).
The doctor has the obligation to share all of your files and test results with you and must provide you your records. So all of your test results must be in there.
This severe type of action by doctors may not be right on a moral basis, but legally I am afraid it is not against the law and is not considered abandonment and it has become the standard practice in the medical community thanks to the state and federal governments tightening the requirements on doctors