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Policies and Procedures |
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The following policies are for PAIN
MANAGEMENT patients. Neurology patients may not need to sign a contract of
this type.
The purpose of the contract is to
enhance patient safety and to prevent aberrancy.
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By helping to prevent
aberrancy, we can help ensure that pain management will be there for those
patients in need. |
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At the time of your
appointment, you'll receive a prescription with enough refills to last until
your next appointment. Telephone, mail and fax refills will not be
authorized. Absolutely no weekend, holiday, or evening refills are ever
authorized. |
Prescription medication refills |
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You may use narcotic painkillers when prescribed by a
physician for the treatment of pain. However you must show perfect
responsibility for the medications. You must protect against loss, theft or
damage; you must keep them away from children, animals and other persons. In
order to justify the use of controlled substances, the State of California
believes you should be able to report (1) improved pain control, (2)
increased function or increased activities, (3) no serious side effects, and
(4) no episodes of running out of medication, lost or stolen medication, or
increasing the dose on your own. If you are being seen for pain management,
you'll need to complete a questionnaire before you can be seen. You agree to
drug testing for both prescribed drugs and illicit drugs at any time. You
agree to use one and only one pharmacy for pain medications. |
Controlled substances |
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There
is a risk of addiction with the use of painkillers. The risk appears low
unless there is a family or personal history of addiction to drugs or
alcohol. However, the physician cannot guarantee that you will not become
addicted to your medication. You freely agree to the use of the medication
and understand that no guarantees regarding safety or addiction are stated
or implied. Some signs of addiction include increasing the dose on your own,
seeing multiple prescribing physicians, running out of medication early and
getting extra medication from friends and family. REMEMBER IT IS NOT LEGAL
FOR THE PHYSICIAN TO PROVIDE AN EARLY NARCOTIC REFILL IF THE PATIENT
INCREASED THE DOSE ON HIS OR HER OWN. |
Addiction
(for more info click here) |
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Any
patient could experience a medical emergency at any time. If you believe
yourself to be having a medical emergency, call 911 or go to the nearest
emergency room. |
Emergencies |
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You may
from time to time wish to contact the physician and report on your progress.
However, if you're experiencing a new type of pain or a significant change
in your condition, you should be seen and evaluated by a physician. Please
remember that the Medical Board of California and the Department of Justice
do not find it ethical or legal to make new diagnoses over the telephone, to
make major changes in pain treatments over the telephone, or to prescribe
narcotic medication without an in person medical evaluation. If you had a
change in your condition and you wish to change your narcotic medication,
you must be seen for an appointment. |
Telephone calls |
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Breakthrough pain does not necessarily mean that your regular medication is
not working. Breakthrough pain usually occurs when physical activity has
increased. Breakthrough pain often is a protective response to tell your
body to stop overdoing activity. Therefore, in general, breakthrough pain is
not treated with narcotic medications. However, there may be occasional
periods of breakthrough pain that may respond to extra medication. If
needed, you'll be allowed a breakthrough pain medication individualized to
your condition. If your flare-up is unusual, you should be seen to verify
that it does not represent a new condition. Long-acting medications such as
OxyContin, MS Contin, Kadian and Duragesic are NEVER used for breakthrough
pain. |
Breakthrough pain and flare-ups |
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All
medications could interact with each other. Medications may interfere with
birth control. All medications have side effects, some of them serious. The
medications could be fatal. Alcohol is not considered safe in conjunction
with the medications typically used in this practice. You must assume that
no medication is safe during pregnancy or during breast-feeding. You must
assume responsibility for your own behavior and recognize whether you are
impaired by these medications. You must not drive or operate machinery,
etc., if you are impaired by the medications.
Because any medication could interact with another, you must let each of
your healthcare providers know about every medication you use and about
every health condition you have. You freely agree to use these medications. |
Medication interactions and side effects |
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Successful pain management usually requires more than pain medication; it
requires physical activity, therapy, counseling and lifestyle changes.
Medication is only one part of a successful pain management program.
Patients who use only medications and who do not engage in physical
activity, therapy, lifestyle changes and other forms of treatment typically
do NOT show significant improvement. |
Complementary therapies |
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1. Narcotics CANNOT be refilled early if the medication was lost or
stolen or if you used more than was prescribed.
2. It is not legal or ethical to prescribe new narcotics by telephone. You
need to be seen in person.
3. We provide a prescription for your medication at the time of the
appointment. It has enough refills to last until your next appointment.
4. Controlled substances (narcotic pain killers) cannot be prescribed if you
have not been seen in more than 90 days.
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These common issues are listed for your
convenience
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