There have been reports that some practices have a zero tolerance for certain behaviors that cause concern. Lost prescriptions may be seen as a “red flag” and treated as a breach of the “physician/patient” relationship. This may be considered an infraction of your pain care agreement or “opioid contract”; you might have been expected to sign such a document before an opioid pain medications was recommended as part of your pain treatment plan. There have been several instances reported to the American Pain Foundation of patients “being fired” by the pain medical provider.
If you were to intentionally try to deceive your provider in order to obtain more medication - no matter the reason - this action breaks the patient/physician (provider) relationship. This means that no relationship continues to exist and therefore the provider has no obligation to continue your care. Truth-telling is essential. Do not try to hide from the reason why your opioid medication supply has come up short–even if you are attempting to protect a loved one who is engaged in criminal behavior.
Common ways that “firings” are handled include:
- A final prescription of your current opioid with a thirty (30) day supply may be provided.
- You may be told to start weaning off your opioids without further instructions.
- You may be told to find another provider and perhaps given a list of pain specialists in the area to contact for an appointment. Note: Often it is not known whether those on the list are accepting new patients, will accept your insurance or are willing to continue your care after the “firing.” Often, if you can get an appointment, it may be in 2-3 months or more.
- You may simply be sent a certified letter to notify you that you will no longer be cared for by that provider.
Needless to say, no matter the scenario, it is best to avoid if at all possible.
What is particularly harmful is what happens if you are fired without just cause. Again, if there is ever a problem with your medication supply, it is imperative that you talk to your provider directly. You must get past the office staff at times, but meeting face to face and asking for understanding and help is essential.
If you have not been given a fair hearing and the provider fails to address behaviors that cause them concern in order to correct the problem from happening again, then the provider is in essence abandoning the patient. This is not considered ethical behavior. Abandonment can be reported to the State Board of Medicine. Some explain that the action of firing a patient without due process is passing off the problem and compounding a public health dilemma–overloading the emergency departments and health department clinics already stretched beyond capacity. Others name this as yet another form of discrimination, as this does not happen when other medications (not classed as a controlled substance) are prescribed. If you have been fired and you feel that you were treated unfairly:
- Report your case to the State Board of Medicine
- Report your treatment to Hospital Administration where your provider has admitting privileges
- Report your experience to your insurance carrier
- Report your care experience to your local media and tell your story
- Contact your local, state and federal legislators about your inability to access quality pain care in your community
- Seek legal advice. You may need to review your medical chart for accuracy of the events and watch for unfair labeling that may interfere with future referrals.