Q: what to do if pain dr fires you and you go to er and the dr also refuses to treat you
It's not uncommon for the ER to refuse treatment if you have an implanted intrathecal pump or are taking oral narcotic medications prescribed by the pain physician for the treatment of chronic pain.
While most ER doctors are well trained in treating the many different conditions that they may encounter in their routines, chronic pain management is a specialty area in which they may have little exposure. However, they are well trained in the use of narcotic medications for the treatment of acute pain resulting from injuries and certain medical conditions. Also, they may refuse to perform certain diagnostic tests that might cause damage to an implanted pain pump or its catheter delivery system.
More important, however, is why the pain physician "fired" you. It would appear that this may be the result of your taking more than the prescribed dosage of oral narcotic medications or you are obtaining pain medicine prescriptions from multiple physicians.
Rather than going to the ER, you should consider consulting with a physician specializing in internal medicine and explaining why the pain doctor refuses further treatment for you. He or she may intercede for you to continue your treatment or, at least, get details of your medical condition and the currently prescribed medications.
If you are taking oral narcotic medications and running low, it's important that you not suddenly discontinue their use. This will result in unpleasant and sometimes dangerous withdrawal symptoms. To stop using narcotics, you should gradually taper down from the normal dosage.
If you have an implanted pain pump, you must be aware of the refill date, probably given to you by the pain doctor, so that it doesn't run out of medication and result in withdrawal problems.
I totally agree with your sentiments regarding pain management physicians who abandon their specialty and leave their patients to fend for themselves. However, I must agree with some of them about the increasing government rules and regulations for the purpose of controlling illegitimate narcotic drug use at the expense of effective treatment of chronic pain patients.
If a physician no longer wishes to prescribe narcotic medications, the patients should not be accused of “doctor shopping” when they seek an alternate source for such medicines. Also, no conscientious physician would suddenly refuse to refill narcotic medications for his or her patients knowing that in addition to suffering with more pain, they would eventually go through the most unpleasant withdrawal effects without first tapering down their dosages.
I don’t see a simple solution for this problem but, on the bright side, there are some new non-narcotic medications that can effectively control some forms of chronic pain. Lyrica and Cymbalta are examples. Also, implanted pumps that place a small amount of narcotic medication directly into the spinal cord can provide sufficient relief for some types of pain thus obviating the need for oral narcotics. The storage tanks for these pumps can only be filled by qualified specialists using specially formulated narcotic drugs.
I agree it is a difficult area. However, a doctor that sees his patients that try to deal with chronic pain on a daily basis and he becomes immune to it is just a real shame.
Anyone who depends on these medications to make it thru the day are more than willing to follow any protocol that is required. The problem is that it all takes too much time. And time is money .... everything these days is decided on money ... we no longer see individuals.
As far as Lyrica and Cymbalta ... not everyone can tolerate them ... and not everyone finds relief with them. I tried both. Lyrica caused too much dizziness and leg aches. Cymbalta was an absolute horror.
Also, with certain conditions, any procedure can cause a severe flare-up and having anything implanted can cause a continued flare-up.
So there are no easy answers. But it is important that everyone involved realized that the person experiencing the pain would give anything to have it eased. We settle for the any relief no matter how minor it might be.
It would be nice to have the medical community be more supportive. I wish the powers that be ... would talk to us little people that live with these conditions and our own difficulties with having to take these medications on a daily basis, before making there blanket decisions!
Sorry for the typos ... 
Have you tried finding a Family Care doctor that treats chronic pain? Whoever it is, they are required by law to closely monitor your meds, and cannot prescribe more than the month dosage. I would reccommend going to another doctor and make a promise to him that you will work with him and keep your pain contract. Doctors are afraid of losing their license and get nervous easily if they feel we are showing signs of abuse. I know my own doctor almost lost his license because one of his patients overdosed on the meds he prescribed. Now he is overly cautious, and only takes patients that are super cooperative. So if you need your pain treated, this is really the only way. Good Luck!
Important:
We hope you find this general health information helpful. Please note however, that this Q&A is meant to support not replace the professional medical advice you receive from your doctor. No information in the Answers above is intended to diagnose or treat any condition. The views expressed in the Answers above belong to the individuals who posted them and do not necessarily reflect the views of Remedy Health Media. Remedy Health Media does not review or edit content posted by our community members, but reserves the right to remove any material it deems inappropriate.
Featuring Content From:
By using this service, you accept our Terms of Use. Please read them. The consumer health information on is for informational purposes only and is not a substitute for medical advice or treatment for any medical conditions. You should promptly seek professional medical care if you have any concern about your health, and you should always consult your physician before starting a fitness regimen. Copyright © 2012 Remedy Health Media, LLC. All Rights Reserved.
My Pain Management doctor decided to change his focus ... he no longer wishes to treat those with chronic pain that can only be helped with narcotics. He will only treat those that require narcotic treatment for short terms or chronic pain sufferers who will allow the placement of stimulation implants or nerve blocks.
So after 5 1/2 years of treatment he decided he would wean me off of the only medications that gave me any relief (not total relief) and send me on my way. Not even a recommendation to another doctor.
I offered to take drug screening tests every month or whatever he required to feel comfortable prescribing for me. There had never been any problems with my adhering to his rules.
I don't understand how he can continue to call himself a Pain Management Specialist as he no longer helps us manage our pain.
I was lucky and my neurologist took over my treatment.
I have since heard from my primary doctor that many patients have been fired by their pain management specialists for the same reason (fear of the rules and regulations surrounding narcotics). She said she has some patients that have to travel 40 plus miles to find someone willing to treat them.
Many were accused of doctor shopping when they tried to find a new doctor.
I find this very irresponsible!
The Pain Management field has become a farce. It started with the right intentions and the doctors spending time with their patients and understanding what we go thru on a daily basis. It has since become like all other areas of medicine today - an assembly line treatment center. Which defeats the purpose of the specialty!