Horrible attitude from Primary Care Physician

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Eternityroad
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Joined: Wed Jun 25, 2008 3:58 am
Location: Las Vegas, Nevada

Horrible attitude from Primary Care Physician

Postby Eternityroad » Tue Feb 14, 2017 6:16 am

I wanted to lay bare my most recent experience with the medical establishment and my use of opioids to control my RLS

After 10 years my Primary Care Physician retired and I had appointment with the new one to review my meds. Firstly, I have been taken Hydrocodone for nine years as an effective method to control my RLS and also for occasional sciatica. I take 2-1/2 to 3 tabs of 7.5-325 mg per day. Usually two at noon and 1/2 before I go to bed. I have not experienced argumentation either, in all those years.

So I go in and the Dr. asks me what I am using the Lortab for. I told him occasional sciatica and Willis-Eckbom Disease. He immediately and somewhat arrogantly corrects me and tells me it is Restless Leg Syndrome. I told him we had tried ropinerole and it upset my stomach and was ineffective after a week. Then he tells me hydrocodone is not a recognized protocol for RLS. To which I responded that I had read reliable sources on the internet that it is. To which he arrogantly fires back "Do you believe everything you read on the Internet? [my bad for mentioning the internet!] It says smoking pot is a viable protocol too [something, btw I had never read] Would you smoke pot?" I told him I never cared for pot, even in the 60's. He gave me my prescription, but I had to sign a paper about use and awareness. I have to go back every three months with a urine test to get the prescription renewed! Something I didn't have to do with my former doctor.

I didn't care for his attitude which was probably due to his wanting to"posture" for a female intern who was observing. He had a terrible bedside manner overall, but I did get my prescription.

Ken

ViewsAskew
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Re: Horrible attitude from Primary Care Physician

Postby ViewsAskew » Tue Feb 14, 2017 9:10 am

Ken - as soon as I read that the doc had retired, I figured where this was going. I remember when this happened to one of our long time members about six years ago. You know, if you'd ever increased your dose or were seeking additional or came in and said your dog ate your pills and you needed more - I'd get them coming down on you. Especially when it IS considered effective and therapeutic.

Glad you have it - for now. He may become more resistant over time, however. I know that when I had a doc who was initially resistant, but talked to my last doc and agreed, over time she put up more roadblocks until she finally refused. I wish I had been better prepared for that.

There are few published papers on opioids, but there are a few. One was out of Germany maybe two years ago - Trenkwalker was the lead author, IIRC. I know a link to it was put on this board - taking a research study such as that might really help.

I wonder if there is another doc in the practice you could switch to? You probably already thought of that...
Ann - Take what you need, leave the rest

Managing Your RLS

Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation, and are not medical advice.

stjohnh
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Re: Horrible attitude from Primary Care Physician

Postby stjohnh » Tue Feb 14, 2017 5:29 pm

Doesn't excuse the doc's attitude, but recognize that US docs are under lots of pressure not to prescribe opiates, including chart reviews, electronic prescription monitoring, pharmacist reporting etc. The fact that you got the prescription at all is a good sign. Providing some of the foundation's educational materials to the doc may help.

Also, when a doc retires, there are several ways new docs get assigned the old doc's patients, and your new doc may be overloaded with too many patients for the time being. Not a good recipe for starting off a good relationship.
Blessings,
Holland

Polar Bear
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Re: Horrible attitude from Primary Care Physician

Postby Polar Bear » Tue Feb 14, 2017 5:34 pm

I am angry on your behalf. It's not fair that as well as dealing with the RLS symptoms there is a doctor that isn't fully behind the treatment prescribed by the previous doctor. Be well prepared for your next appointment with appropriate documentation.
Betty
http://www.willis-ekbom.org/about-rls-wed/publications
Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation

Eternityroad
Posts: 79
Joined: Wed Jun 25, 2008 3:58 am
Location: Las Vegas, Nevada

Re: Horrible attitude from Primary Care Physician

Postby Eternityroad » Tue Feb 14, 2017 6:25 pm

Thank-you each for your replies. My general health is excellent so I do not foresee having to see this doctor often. My last physician was a bit reluctant to prescribe the opioids, but realized the necessity and was nice about it. Another factor is that my last physician was Filipino and this one is Mid-Eastern. Where are the doctors of my own race? Not that I object to foreign doctors but part of good health is overall relating to the healer. Feeling some kind of connection. I was raised in a small, one doctor town, where the doctor made house-calls and lived up the street (the 50's). All this is the "unspoken" of healing, the intangibles. I will give this a chance but if he keeps coming on with his brash, know-it-all, aggressive personality I will have to reconsider. My main fear is that if I go to another doctor they may be more reluctant to prescribe the lortab. At least now I am getting the prescription. This new doctor was dealt to me. It is sad if it comes down to going online to "shop" for a doctor, by looking at reviews, etc. But it may come to that.

Rustsmith
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Re: Horrible attitude from Primary Care Physician

Postby Rustsmith » Tue Feb 14, 2017 7:20 pm

Before I retired, my work took me all over the world and I had the opportunity to deal with professionals from many, many different cultures. Although I usually resist drawing any conclusions from cultural stereotypes, the initial interaction that you described with your new doctor occurred to me quite often during an initial meeting with a colleague from the middle east. I found that as our interactions proceeded, one of three things happened. My colleague would most quickly drop the abrupt persona if I was able to establish that my knowledge of the subject was equal to or greater than his (the rare women I had a chance to deal with were always happy to be treated as a peer and were usually quite shy). Since you are not a doctor, establishing a position as an equal would be difficult to do. The second type of relationship would develop slowly as we got to know each other. In this case, our relationship would not only become cordial, but often we would become good friends. In the last case, the arrogant attitude often turned out to be based upon his family's standing within his culture (relatives of the royal family, close ties to the religious leadership, etc.). In this case, he saw himself as superior to anyone outside of his culture and would never give up the arrogant attitude. Hopefully this is not the case with your new doctor and you can either elevate yourself in his eyes by carefully and very tactfully demonstrating your knowledge of RLS or you can develop a personal relationship that smooths over the rough edges. For the latter, an excellent starting point is to inquire about his children (often not a good idea to ask up his wife). I have seen even the most abrupt and arrogant individuals immediately drop the attitude when asked about their kids.
Steve

Augmentation Evaluation http://bb.rls.org/viewtopic.php?f=4&t=9005

Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation, and are not medical advice.

Eternityroad
Posts: 79
Joined: Wed Jun 25, 2008 3:58 am
Location: Las Vegas, Nevada

Re: Horrible attitude from Primary Care Physician

Postby Eternityroad » Tue Feb 14, 2017 7:48 pm

Steve,
Thank you for your considered reply. I had been with the Filipino doctor for 10 years and it had only been in the last year and a half that he started opening up, spending a little extra time to ask me about my life and share parts of his that related to what I had told him. Much of the problem is that there are so many patients to see that often the physician doesn't have time to "visit". Which is why I am giving it some more time with the new one. I also think my attitude may need a little adjusting. We can't ever go back to the "small town" practice and aura we grew up with, especially when we live in a big city like Las Vegas. I will be sure I am "armed" with reliable and solid info and studies on the subject when I return for the lab analysis appointment in May.

ViewsAskew
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Re: Horrible attitude from Primary Care Physician

Postby ViewsAskew » Tue Feb 14, 2017 8:49 pm

Ken - the amount of time that doctors have to spend is truly appalling. It makes it so hard to develop a relationship. The last time I needed a primary care doc, I asked a surgeon (I'd just had knee surgery and was new to the area) if he had a recommendation. I LOVED the person he recommended. She spent an hour with me on our first visit. She did the same with my husband.

About 8 years ago, there was an excellent public radio piece on a doctor who gave up his practice to create an old-fashioned type of one. He stopped taking any insurance, was able to lower his prices tremendously, needed one admin for 2 doctors instead of 5 admins per doctor, did his own lab work, and spent an HOUR with every patient - and still made as much money. Each insurance company has different methods to comply with, coding is so time consuming if you want to get paid, and so on. It's not at all the only part of why the US system isn't as functional as it could be, but it is part of it. At any rate, I was fascinated by it. And wished that this doctor was close to me. As I understand it, more doctors are going to this model, but it's still likely a fraction of all doctors.
Ann - Take what you need, leave the rest



Managing Your RLS



Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation, and are not medical advice.

2BassetMom
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Joined: Mon Mar 30, 2015 7:06 am

Re: Horrible attitude from Primary Care Physician

Postby 2BassetMom » Mon Mar 13, 2017 6:10 am

I had a similar experience a year ago April. After being treated by the same doctor for 30 years I was faced with finding a new one after his retirement. I had no problem getting a prescription for Hydrocodone from him for my ongoing back pain due to a bulging disk. An aside: When I had Ramsay-Hunt Syndrome (shingles in my ear) in 2008 he prescribed Hydrocodone 7.5/3.25 every 4 hours. He admonished me to take it every 4 hours and I would not become addicted. He knew me. Now back to spring 2016: I left the practice my retired doctor was in because the remaining doctor was swamped and it was very hard to get in to see him. On the recommendation of an optometrist my daughter-in-law works for I started going to a family medicine practice. I started out with a nurse practitioner that I really like but when it came to getting a new Hydrocodone script she balked and said she was afraid I would become addicted. I had to sign a contract similar to the one Eternityroad signed. It was very restricted and only allowed for 1/2 to 1 pill every 12 hours. She went on maternity leave in the fall and I saw the physician who recognized my need for pain meds and I get enough to stay on top of the pain. Meanwhile I was asked to see a pain management doctor who cannot prescribe but looks for ways to handle pain. I've had shots that don't work and she suggested upping my pain med dose. She actually spends time listening. She has her own practice now so I should be able to manage my pain. All that to say I haven't brought up the fact that taking 1/2 tablet sometimes helps my RLS. I plan to bring up the subject when I see her in the next week or so. I can't take Gabapentin, or Nortriptylene because of my A-Fib. I can't take NSSAIDS because I'm on Xeralto. So I pretty much stuck as far as alternatives. I am so glad I found your forum.

Eternityroad
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Location: Las Vegas, Nevada

Re: Horrible attitude from Primary Care Physician

Postby Eternityroad » Mon Mar 13, 2017 6:20 am

I appreciate your story, 2Basset. I have been on the same dosage for nearly nine years. Originally prescribed for regular shingles, but I found it helped my RLS. I usually take 2 or 2-1/2 tabs at noon and a half before bed. I told the doc that if he looks at the record of refills he would know I cannot possibly be abusing the med nor becoming addicted. Addiction would mean I needed more and more for the buzz. I don't really care about the buzz. I just do not want to pace the floor at three in the morning. Good enuf for me. I understand the papers I had to sign, but they don't know me. Guess they have to cover their butts though. One good thing is that he gave me three scrips that I can take to the pharmacy every month after a certain day of the month, before I have to return to his office for new scrips and pee test. The old doc didn't do this and I had to travel across town every month to pick up the script in person.

badnights
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Re: Horrible attitude from Primary Care Physician

Postby badnights » Mon Mar 13, 2017 6:53 am

I also get a script for three 1-month refills from my doctor. Even after seeing a doctor every 2 or 3 months for 10 years now, it still drives me nuts. I hate it. I would be very upset if I had to go every month like you did.

eternityroad wrote:I will be sure I am "armed" with reliable and solid info and studies on the subject when I return for the lab analysis appointment in May.

I find that a non-confrontational way to present any information you have is to ask the doctor's opionion of it. That way you acknowledge the superiority of his insight and judgements in the field of medicine, or at least you demonstrate respect for it, and you don't come across as telling him how to do his job. For this to work, it helps if you can believe that he actually does want to help you.
Beth - Wishing you all restful sleep tonight
WED/RLS AUGMENTATION:
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Discussion Board Moderator's posts don't reflect the RLS Foundation's opinion & are not medical advice

Eternityroad
Posts: 79
Joined: Wed Jun 25, 2008 3:58 am
Location: Las Vegas, Nevada

Re: Horrible attitude from Primary Care Physician

Postby Eternityroad » Mon Mar 13, 2017 7:21 am

Great idea about how to connect with the doctor. btw across town is 6 miles each way. If my next meeting doesn't go well then I will try to find another Primary Care doc. but this guy is good about giving my scrips. Don't think I want to risk another without good cause. My health is good enough that I don't have to see the doc for other things. So I can bear with, hopefully. What I really fear, and this may seem silly, is to have to go to ER or get a knee replacement (I had knee surgery five years ago) and they don't give me my meds. Getting the squirms and not being able to move.

2BassetMom
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Joined: Mon Mar 30, 2015 7:06 am

Re: Horrible attitude from Primary Care Physician

Postby 2BassetMom » Mon Mar 13, 2017 6:43 pm

I get my scripts 1 month at a time and that is after I call it into the pharmacy, which I have gone to for 15 years. They fax it over to my doctor and then I usually get a call from a nurse who goes over with my why I take it and then reluctantly says she will give the doctor a message. I might get a call the next day to let me know my script is at the desk. My doctor's office is 45 miles away in another town over a mountain pass. Not easy but I jump through the hoops. I write down every time I take a pill so I can document how I use it. I find if I awake with RLS and take 1/2 pill and have hot chocolate plus lay a heating pad across my lap (usually topped with a sleeping cat!) I can go back to bed in an hour and get maybe two hours sleep. I have other issues that awaken me dealing with my back but RLS is definitely the toughest to deal with.

Eternityroad
Posts: 79
Joined: Wed Jun 25, 2008 3:58 am
Location: Las Vegas, Nevada

Re: Horrible attitude from Primary Care Physician

Postby Eternityroad » Mon Mar 13, 2017 7:16 pm

They changed the rules a couple of years ago. I can no longer call in Hydrocodone and get it filled through fax. I have to pick up script in person. This may be just a Nevada law. I don't know.

Rustsmith
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Re: Horrible attitude from Primary Care Physician

Postby Rustsmith » Mon Mar 13, 2017 7:34 pm

Eternityroad, it might be Nevada law that you must pick it up in person but it is a federal rule that all Schedule II medications (which covers all narcotics and a bunch of other meds) require a paper prescription. These prescriptions can no longer be simply faxed or called in, as a doctor might for an antibiotic or blood pressure prescription. My doctor mails the paper prescription to me and then I have to mail it to my mail order pharmacy because no drug store in my town is willing to fill my methadone prescription.

2BassetMom, I am currently participating in an RLS study that requires me to sit with a heating pad on my lap for 30 minutes before bedtime. The only times that the heating pad is not weighted down by my cat is when she has already gone to sleep and thereby misses the opportunity for a warm lap sit. :D
Steve

Augmentation Evaluation http://bb.rls.org/viewtopic.php?f=4&t=9005

Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation, and are not medical advice.


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