I've talked about Pain Management Clinics before. You can read one of my blog posts here: LINK
A few days ago one of our regular patients brought in some scripts from a pain management clinic. These scripts come on a full page of paper. The top half is the Rx, the bottom half is a "patient agrees to the following" with a list.
One of the items on the list is that the patient agrees not to get narcotics from any other prescriber. In essence, the patient agrees to only see the pain management clinic for scripts for narcotics. That's a great idea, but I wonder if anyone in the clinic discussed this with my patient.
In addition to the prescriptions from the PMC, this lady also handed me a Norco script from another doctor, written on the same day. She saw two doctors that day. The scripts from the PMC didn't have a narcotic. They were just your usual Neurontin and Flexeril regimen. But, I wondered, where is the narcotic script? I imagine she's holding that one and will try to fill it later.
So I faxed copies of everything over to both doctors to see what they'll do in the future. As for this batch of scripts, I filled them. I didn't make the agreement and I'm not the PMC's sheriff. I gave up trying to be the judge and jury over these matters. I'll let the doctors sort it out with each other.
I really have to wonder if these "agreements" are enforced. I've encountered this situation with other patients before, who come in month after month with PMC scripts and ones from other doctors. Are the PMCs checking the DEA website to see what the patient is getting every month, or as I suspect, are they relying on the pharmacies to enforce their agreements with the patients?
And if that's true, why is it my job?