WhiteCoat

One Way to Cure a Drug Seeker’s Back Pain

Back StatueA gentleman in his 40s limped into the emergency department for evaluation of severe back pain.

He had a chronic history of back pain, but had decided to forgo recommended surgeries because he was told that there was a chance his pain could worsen. He reportedly had multiple MRIs in the past … all of which showed “severely” bulging discs. He also just moved to the area the evening prior to his visit. In all of the excitement and heavy lifting, he strained his back, he couldn’t find his pain medications, AND he lost his wallet. That meant he had no ID and he couldn’t remember his address because, of course, he just moved into his apartment last night.

He was in excruciating pain and couldn’t move without pain shooting to his legs. Oh, and his heart stopped after taking aspirin a long time ago and he was specifically told NEVER to take NSAIDs because they could kill him.

His exam didn’t show too much except that he was in a lot of pain. So we ordered a muscle relaxant and a couple of Tylenol with codeine tablets.
After about 15 minutes, he stated that the Tylenol #3 “took the edge off.”

He got a shot of Decadron and we prepared to discharge him. He requested a couple of days of Norco pills until he could find his other prescription amongst all of the moving stuff.
I gave him the benefit of the doubt and wrote him a prescription for a couple of days worth of Norco and Robaxin. However, I wrote on the prescription “DO NOT fill prescription without verifying photo ID. Please fax copy of patient’s photo ID to Metro General Hospital emergency department at 888-555-1212.”

The patient flipped out.
“What … am I some kind of criminal?”
“Sir, you’ve given us no way of verifying your identity for purposes of creating a medical record of or providing you with a bill for the services you’ve received. We need to do this for all our patients.”
Shaking the prescription at me over the desk, he said “Yeah, well I bet you don’t write crap like THIS on the prescriptions for ‘all of your patients.'”
“That’s true. But very few of our patients come into the emergency department with no identification and not knowing their address, either. You received medications to help with your symptoms. We just need to verify your identity. If you’d like, we can call the police to have them verify your identification. In fact, Mary, can you call the police and ask them to send an officer down here?”
“You’re the biggest asshole I’ve ever met in my LIFE!”
And with that, he crumpled up the prescription, threw it on the floor, and stomped out the door with nary a hint of antalgia in his gait.

Just goes to show …
Those steroids really do help back pain.

———————–

This and all posts about patients may be fictional, may be my experiences, may be submitted by readers for publication here, or may be any combination of the above. Factual statements may or may not be accurate. If you would like to have a patient story published on WhiteCoat’s Call Room, please e-mail me.

7 Responses to “One Way to Cure a Drug Seeker’s Back Pain”

  1. hashmd says:

    Another bad Press-Ganey score…You will lose your job WC

  2. TH says:

    It was good of you to give him the benefit of the doubt.

  3. kk says:

    patient satisfaction does NOT equate to being a better doctor . . Let me repeat that. ..

    u did the right thing

  4. Carlo Oller says:

    If you have an electronic prescription writing software you can ‘macro’ the text into ALL narcotic prescriptions. This way ALL your patients are required the same, and no one can claim discrimination.

  5. DrGG says:

    Awwwwww. Poor guy couldn’t get off the street. You gave him an out. Walks well doesn’t he? I swear I might put that on my rx pad: “all controlled rx require state or federal picture ID”

    • Mandy says:

      Wouldn’t requiring a state or federal photo ID for filling a script be “racist”, as similar proposed voter-ID laws are “racist”?

  6. Ken says:

    he can’t fill out a press-ganey if he doesn’t have an address

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