Giving false identifying information may seem like a good idea when you get brought in by ambulance after getting your ass beat in a bar brawl that you started.
After all, there’s no way to track you down if you don’t have any ID, right? Free stitches. Free x-rays. Free pain medications. And all of those dimwits in the ED are required by law to treat you. Dudette, you’re golden.
Unfortunately, there would be a little problem if the ED doc was having a bad day. Let’s just say that he missed a fracture on your neck x-rays … an unstable fracture. One that could pith you if you twist your neck the wrong way. You need further care.
Then let’s assume that the radiologist’s note about the missed fracture got put in front of me with your disconnected “phone number” and your fake address. I would have no way of contacting you to let you know to come back.
Some might call it Darwinism at work.
Then …
When someone lives in a town 40 miles away and just happens to come to your ED for the worst back pain they’ve had in a long time and they just happen to be allergic to NSAIDs, Ultram, and Flexeril, it tends to set off little bells in the back of an ED physician’s head.
But there were no previous visits to our hospital and we called the hospital from the town where the patient lives. No history of any ED visits there, either. I check the online state database for controlled substance prescriptions and there’s no history of any narcotics being prescribed to him.
Those ED nurses have pretty good memories, though. So when one of the ED nurses sees you walking to the bathroom and says “I haven’t seen HIM around here for about a year,” you’re busted. “Oh yeah, that’s Johnny So-and-So. Let me guess – back pain?”
Registering under a fake name. We pull up his real name on the state database and there are pages of narcotics prescriptions from hospitals all over the area.
Looks like you’re getting Tylenol … number three for your back.
I’ve decided that I’m taking pictures of any patients who don’t provide picture identification when they register and including those pictures on the chart.
I’ve also decided that I’m going to get a stamp that goes on every prescription: “NOT TO BE FILLED without state-issued picture identification.”
“I’ve also decided that I’m going to get a stamp that goes on every prescription: “NOT TO BE FILLED without state-issued picture identification.”
That ought to be law anyway. At least for controlled substances
Actually..that *IS* a good idea. (although feels like big brother)
But what if the patient is unable…then could friend or family? I guess take their picture too.
Also…if your medical records can be compromised (they CAN)… would we also want a face to go with the private information.
Maybe there could be that iris identification screening thingy.
It always irked me when people had no form of ID on them…and I’d get this *vibe* they provided false info.
Not for everyone..but sometimes you just have this 6th sense.
only going to slow them down briefly….look how many photo immigration cards that blow thru, obviously tampered w/……
Perhaps the micro-chip in the neck as I do my pets
w/ all their health info….but wait , I think there is another name for that type of thing….
Doesn’t hurt to hope of a better way though…..hope’s about all we got anymore in healthcare.
I put in the prescription “Call” under DEA number so I can talk to the pharmacist about the patient and the prescription. Druggies are getting desperate. There are cases of “prescription washing” just like what they do with checks so even though you prescribed tylenol that can easily be changed to mscontin, etc. Your signature and dea number will still be there. Only the top portion of the RX will be washed.
As a pharmacist, I would love it if more docs do this. We had a joker come to us with a narc under a different name, and we knew who he was. He had gone to an ED clear across town probably 30-40 miles away using an alias. We notified the ED and told them his real name so they can flag his chart and name in the hospital system. What a douche
Taking a photo and attaching it to the chart — or perhaps finding a safer place to store it, while making it available as a cross reference somehow — a wonderful idea. Some pain management clinics take photos of their patients. I was photographed at a Wound Care Clinic (maybe they were expecting my face to start looking as wonky as my wounded foot?). So it is done…
Unfortunately, the requirement of a state-issued i.d. is probably unconstitutional/illegal. I am basing that on the many legal challenges that the movement requiring official i.d. before being allowed to vote encountered. The “call” idea from HyperAl seems like a good one — unless that would eat up too much of your time.
A problem with the photo ID is that some patients are not able to get to the pharmacy themselves. I am assuming that you would not use this stamp for patients being transported home by ambulance or wheel chair van, since their ability to get to the pharmacy is significantly limited.
The guy who stated the bar fight might take care of all of his problems the next time he starts a bar fight, since his ability to defend himself does not appear to be his strong point.
First time caller, please be gentle.
I work in a multidisciplinary pain management clinic (sans photos other than the mandatory driver’s license and/or state issued ID during the intake process) and deal with patients going to the ER after office hours. In my experience, it is the ER doc’s sixth sense of “smell”–usually spot on–that determines whether or not something is rotten in opiateland. You work the trenches long enough, this ain’t that tough. Photos shmotos.
Every once in a while we get a 3am call from a concerned ER physician but it’s rare, very rare.
I’ve long appreciated the boundary stances most ER clinicians maintain with this “population”.
I’d say more but I like my license. And man, could I go on.
Sidebar: nice site. Thanks.
I am very picky when prescribing narc so it does not happen very often, plus busting somebody’s cover is worth the time talking to the pharmacist. If you do that consistently word will go out in the street and the next Joe Blow will think twice before visiting your ED.
They take my picture and make me sign for pseudoephed so why not take a photo for someone claiming back pain and then no other records? Heck. That box of drugs is gone in no time for a family of 6 and they treat me like a criminal when I go back for more.
As someone who used to work in pharmacy for a considerable amount of time, putting “Call” for a DEA number on a narc usually pisses our staff off, as it’s almost impossible to get a MD, let alone the prescriber, on the phone in a timely manner. (Of course, said MD have good reason for not coming to the phone…)
Besides, we probably already have your DEA.
PS. We have the same ‘sixth sense’ you know…