(Snippets from the frontline)
He was an opera coach with a deep melodious voice. Now in his 80’s, my patient uses a walker and suffers from lumbar spinal stenosis causing persistent pain, yet controlled by medication allowing him to remain independent.
I had seen him the week before, so his narcotic prescription (acetominophen with codeine) was routine and had not changed in years.
But during my phone call renewal, the pharmacist asked if other pain relievers had been used and politely I said “no.” His response, “why not?” I told him the patient was stable; not overusing the medication; it was effective without side effects; and there were no signs of addiction. “Denied.” Questioning his rationale, he “did not feel comfortable with it.”
I queried “Have you ever met this patient? Have you asked him about his pain? Did you ever perform a physical exam, or see his CT scan results?” Still denied.
Even complaints to the national office were to no avail, as they supported decisions made by their pharmacists.
We have an opioid crisis and prescription misuse exists, but a denial like this is practicing medicine without a license.
Doctors must be the decision-maker.
Gene Uzawa Dorio, M.D.