Saturday, December 9, 2017

Mississippi doctors on new opioid regs: "Dangerous", "ill-conceived", "idiots"

More than a few Mississippi doctors objected to proposed opioid prescription regulations.  The Mississippi Board of Medical Licensure proposed new regulations that will overhaul how physicians prescribe and administer narcotics.* JJ obtained copies of the comments through a public records request.  Several are posted below.  More will be published in future posts. Earlier post covering proposed regulations.   Words such as dangerous, idiots, absurd, ridiculous, and burdensome are used.  Keep reading.


"Penalize everyone for the actions of a few"

Congratulations! You are about to penalize everyone for the actions of a few! To burden everyone to take the time to contact the PMP on every prescription and then maintain documentation forever is absolutely ridiculous! There is already too much time, money and effort spent on overreaching regulations to add this to the mix.  As a surgeon who writes only postoperative prescriptions for 5 day (10 pill) , these regulations will ,for better or worse ,make me stop writing pain meds altogether. As I talk to my colleagues they are incredulous that you have chosen regulations so burdensome. You know who the outliers are, you should address these individual's prescribing patterns and leave the rest of us alone!! And less I forget to mention it, take action against the criminal acts  of the patients in their drug seeking behavior and stop trying to hang everything on hard working physicians.

Dr. Jeff Cook

"Dangerous and ill-conceived"

A few of these recommendations are overly burdensome and costly. Hopefully the board members wont reflexively incorporate all these recommendations to the detriment of patient care in order to address political objectives.

While initial prescribing of opioids it is reasonable to obtain prescription monitoring and UDS, to require UDS testing at every follow up for stable compliant chronic pain patients is unreasonable and unnecessary, as well as a significant expense to patients.

“Benzodiazepines and opioids may not be prescribed concurrently, with limited exception for an acute injury and for no more than 7 days. “   This is absurd and dangerous to patient care. While physicians should seriously consider the risk of concurrent prescribing, to absolutely prohibit concurrent use will result in severe, possibly life threating withdrawal as well as cause patients in pain to not receive appropriate pain medicines. Frequently, benzo’s are written by other physicians who refer to us to take over opioid pain medicines. While we endeavor to address the concurrent use and encouraging weaning of both classes, this proposal is outright dangerous and ill conceived. It is upsetting to me that studies clearly demonstrate alcohol is involved in 50% of opioid deaths, and benzo’s involved 30% but nothing has been said of concurrent alcohol use, nor do the CDC guidelines even mention concurrent alcohol use….

Ken Staggs
MD Total Pain Care
Meridian

 "Unfair burden" on patients

As an orthopedic surgeon, I treat multitrauma patients and shoulder surgery patients that require post surgery opioids for a month or longer. Only allowing pain scripts post op for a seven day supply will place an unfair burden on those patients and our clinical staff. Please consider making some exceptions with regards to sometimes VERY painful surgeries.

Many times opioids are required for successful therapy to be obtained after these surgeries as well.  The proposed rule would require patients to come back weekly which again isn't fair to patients or our clinical staff.

Thank you for consideration for these patients. Please feel free to contact me for further discussion as required.

D. Ross Ward, MD

"Do we really need to run a background check on an 8 year old?"

I am a board certified emergency medicine physician practicing with the Singing River Hospital System here on the Mississippi coast. I've been licensed in Mississippi for 17 years. Although I wholeheartedly agree  there is an opioid abuse issue in the United States and Mississippi is no exception, I must vehemently protest the following clause in the MS State Board of Medical Licensure's plans on regulating narcotic
prescription writing:

"Every licensee regardless of practice specialty must review the MPMP at each patient encounter in which an opioid is prescribed for acute and/or chronic noncancerous pain"

This rule would be way too burdensome in a busy emergency department. Patients are already waiting hours to get seen by an Emergency Physician and this rule would simply add to our already busy workload. This will inevitably, significantly add to the patient wait times if we have to run a MPMP check on every patient we see who receives a narcotic prescription in the emergency department. Pain, not surprisingly, is by far the most common complaint seen in the emergency department (ED). This would yet again be another uncompensated mandate put upon us by government. You must understand the vast majority of patients receiving a narcotic prescription in the ED are not abusers. All of these innocent patients and doctors are going to pay a heavy price for this massively sweeping rule just to weed out a handful of narcotic abusers. Do we really need to run a background check on a 8 year old who has a fractured forearm before we prescribe codeine? Or even on an adult who has an obvious legitimate reason to receive a narcotic pain medicine, regardless of his prescription history? Am I not going to prescribe a narcotic to an adult who has acute 2nd degree burns even if he has filled several narcotic prescriptions in the past?

Please seriously reconsider the wording of this clause and consider the impact on all the patients who are waiting to receive care in our busy emergency departments. Please don't hesitate to contact me for any concerns or questions.

Thanks
Matthew L. Emerick. MD, FACEP

"This will add over an extra hour" each day

1. The requirement for all licensees to run a PMP report is too burdensome. The BOML should have the ability to login to the PMP and see if it has been checked remotely. It takes an average of 90 sec. to login and search for each patient-(try it and you will see). This will add over an extra hour, not included scanning to each provider, and unecessary burden. If implemented by BOML, an extra cost may have to passed to the patient for this.

2. Agree completely with opioid and benzodiazepines not to be prescribed concurrently.

3. Disagree with only a 7 day supply of opioids for acute pain. Rationale: As an orthopedist treating acute complex fractures, these patients have acute post surgical pain for fracture treatment. I service a rural community. It is not realistic to have them travel long distances each week to retrieve a opioid prescription.

Regards,
W.Todd Smith, MD
Starkville Orthopedi   Clinic

"Bureaucratic idiots"

Once again a bunch of bureaucratic idiots making a bunch of rules without reasonable judgement. No
balance at all.

Dr. Lance Line
Southern Bone & Joint Specialists (Hattiesburg)

What about methadone? 

I have a pain mgt. patient who is well controlled on methadone for 8 years.   May he continue his high functioning on methadone or must I no longer prescribe him methadone?

Dr. Ed Aldridge
OnCall Medical Clinic

 "Ridiculous"

This is patently ridiculous, a public bandaid for a problem CREATED by government policy. Yet another hurdle to taking care of my oncology and postoperative patients.

Dr. Phillip Ley

What about veterans suffering from PTSD?

I am a Physician Assistant working in Mental Health. The only change that I don't entirely agree with is not prescribing Benzodiazepines with Opioids. I have several military veterans that have suffered injuries that have severe PTSD that really need both medications to have a semblance of a normal life. I also work with PTSD patients that have chronic pain and were physically abused for 20 years. I understand the black box warnings and I understand this is an attempt to combat the epidemic in this country, but to take away the provider's discretion is taking away the treatment some people need. Thank you for taking my comments into consideration.

Sincerely,
Heather Huguley, PA-C

"Move out of Mississippi"

I maintain my license in Mississippi, though I am not currently practicing there. I am a full time emergency
physician in Dallas, Texas.

The proposed legislation is so restrictive, it is another reason for physicians to MOVE OUT OF MISSISSIPPI and not return to practice.

Increasing the labor and documentation burden for physicians will not have a significant impact on the drug problem in Mississippi. It will have an impact on your physician work force. Best of luck.

Dr. Walter Green

"Great work"

I am very much in favor if this ruling. However, there need to be stiffer penalties for prescribers who do not
adhere. Great work!

Dr. Gerry Morrison

More paperwork

This proposed policy will be an efficiency problem for all surgeons if we have to stop after every
operation/procedure to check website before writing prescription for post‐op pain relief.

Dr. John Bailey


Surgery patients need narcotics

I am very much in favor of making it harder for drug seeking patients to get opioid prescriptions. I am also in favor of making it harder for physicians who are enabling patients with their opioid dependence. However, of the
proposed changes that the Medical Licensure Board is recommending, I must disagree with the proposal to require all licensees to run a Prescription Monitoring Program (PMP) report at each encounter when prescribing opioids, especially for acute pain. I use the PMP regularly for patients who have any drug seeking behavior, but because patients who are having major surgery usually need a narcotic post operatively, it will not make a difference what the PMP report says when treating a patient with post operative pain. The PMP site is not the most user friendly site and can be very time consuming. To run a PMP on every surgery patient will be difficult for busy practitioners.

Dr. Ronald Young
OB/GYN

"Thank you for taking a bold step"

As a medical doctor who daily sees the harm caused by the over-prescribing of opioids and benzos, it is clear that certain physicians and NPs in our state are irresponsible or careless in prescribing these medications.

At our hospital, we have removed the automatic sleeping pill off all standing orders. We have developed a step-wise approach to pain management for which opioids are a second or third line choice and not a first line choice. We have developed rules that limit the number of days an opioid can be prescribed for acute pain management.

I fully support developing these proposed guidelines for responsible use of opioids and benzodiazepines as they primarily address patient protection and safety, and secondly address the epidemic of diversion that affects us all. Thank you for taking a bold step to be a strong advocate of responsible health care within our state.

Dr. Barry Bertolet

Please Exempt ER's from new rules

20 Emergency Physicians that treats over 100,000 patients in the two ED's of Singing River Health Systems feels the same. The Board of Directors of the Mississippi Chapter of the American College of Emergency Physicians is also opposed to these rules.

Our setting in Emergency Medicine is unique in that we treat patients with acute conditions on a daily basis at a fast pace that is episodic, chaotic and time demanding. These requirements are onerous in our setting.

When we do write for opiates or benzodiazepines in this acute setting, they are for smaller doses and fewer numbers of pills than our colleagues utilize in private practices and clinics. It has been shown that our setting is not responsible for the large numbers of these types of medicines being prescribed.

However, we definitely do selectively use the Prescription Monitoring Program website on a frequent, as needed, and case by case basis. This is appropriate, as some of our patients clearly do not have an acute condition and some are clearly in our departments inappropriately seeking prescription medications. Please consider exempting Emergency Departments from these proposed rules.

Dr. Lawrence Leak
Past President MSACEP

*Here is the nutshell version of the proposed regs that have drawn so much controversy:

1. Narcotic prescriptions must be limited to seven days for non-cancerous acute pain.  The patient must see the physician again to obtain a prescription for another seven days.  This includes patients recovering from major surgeries.

2. All physicians must run a PMP (Prescription Monitoring Report) on each new patient and every three months afterwards if the patient is prescribed controlled substances.  This includes patients suffering from non-cancerous pain or psychiatric conditions.

3. Rule 1.7 (K)  Point of service drug testing must be done each time a Schedule II medication is written for the treatment of non-cancer pain.....

There are other changes that are covered in the December 7 post but these are the ones addressed by the letters published in this post.


Earlier posts
How much pain will proposed opioid regs create for doctors? 
Can medical weed fight opioids?  
Opioids prescription: Mo' taxes, mo' spending, mo' jail

43 comments:

Anonymous said...

You doctors need to talk to Mike Moore, he knows more about OPIODS than you do. After all, he went to Ole Miss law school just like Dickie Scruggs did.

Anonymous said...

What Drug Dealer wants his job to be harder?

1 old doc said...

Let me review how we got to where we are today:

Not that many years ago the damned government and medical establishment decided we docs were undertreating pain. They coined the phrase "pain is the 4th vital sign". Who were we to judge how much pain a patient was in??? We were supposed to take the patient's word for their pain and it was implied that there could be malpractice implications for undertreating pain. I thought that was just more ridiculous PC BS and continued to write controlled drugs only when I thought it was needed.

Now fast forward 15 - 20 years and SURPRISE!!! we have an opioid crisis!! Of course, now they blame the docs for this fiasco. Now the pendulum swings too far in the other direction and the damned government and medical establishment want to essentially prohibit opiates for anyone not already in hospice. Opiates and benzos, like any other drugs, are beneficial when used appropriately. Your mama breaks her hip and gets 3 days of pain meds?? My patient with debilitating panic attacks will just have to learn to "suck it up like a man??" Have any of you suffered for weeks from a herniated neck or back disc? Get real!! Things need to be tightened up, but the MBML needs to go after the outliers and not treat all of us as a bunch of dope dealers.

I am old enough to retire, but still practice because I enjoy caring for my patients. The constantly encroaching government bureaucratic red tape busywork (Electronic Medical Record, HIPPA, etc.,) requires so much time that while I used to be able to see 4 patients an hour, I now only average 2 per hour. If the proposed additional busywork regs go into effect, I will just hang it up.

My partners and I alway check the PMP if we have any concerns about drug seekers. The political hacks on the MBML are not taking the real world into account with their overbearing regs that will do more harm than good. Write the rules where it won't smother the docs and will not harm our patients.

Anonymous said...

This could be serious for the docs. Some of them might be forced to sell one of their “extra” vacation homes.

Anonymous said...

Those Docs want to get em addicted so the customers keep rolling in for their fix. Easy money for doctors.

Anonymous said...

Some people are just born idiotic. I trust my doctor more than I do the government. And if I say I'm in pain, then I'm in pain. I'm not a drug addict. I haven't had any pain medication other than Tylenol or Advil in at least six years, but if I was in horrific pain, I would want a serious narcotic. This whole notion that everyone gets punished because some people choose to abuse drugs is stupid and unfair.

Idiots galore said...

10:23 obviously knows very little about how a doctor gets paid.

Anonymous said...

I posted this comment on the original thread and want to repeat it here. One thing i left out was the potential suicide rate increase for people with long term pain issues.
. I am 40 with a pinched nerve in my back that can not be fixed with surgery due to risk of complications. Or so I am told by numerous experts. I have done therapy, chiro, I exercise as best that I can and lost weight to try and “help myself.” I can take four Advil and four Tylenol four times a day and still not be able to work and raise my family. But by taking three norco a day I am able to survive and compared to most people in the world have a good life. But I have never sold stolen or doctor shopped for meds, which my prescription records would confirm. I work in a professional job and otherwise would be on disability as a drain to the taxpayer. I understand there are problems that need to be addressed but don’t stop legit doctors from treating legit patients. Chronic pain is depressing and difficult to deal with for those who have not experienced it. I was perfectly healthy until a car accident and it ruined my life. Just wanted to share my story. It is very tough when you can’t phyaically play with your children or do basic tasks. Celebrex raises my bloood pressure too much so I can’t take it every day. Have tried other stuff. Never used illegal drugs in my life. What am I supposed to do.

Anonymous said...

I am facing major cancer surgery early next year. It will be a difficult procedure. I will die without the surgery. I had similar surgery a few years ago and it took me weeks to recover, including using narcotic pain meds. I didn't get addicted. There is no way I can get by with two weeks of pain meds. These people are, indeed, idiots.

Anonymous said...

9:31:

Hat's off to you, in 'the real world', I was in a car wreck 10/2/17 and broke wrist, arm and screwed up shoulder. Got ok meds in the hospital, but when discharged got minimum dosage opioid which barely felt. But I spaced them out 4 hours then 6 then 8hrs. Impossible to sleep. Then they said no more after 2 1/2 weeks?! Tylenol, which tore up my stomach. I turned to bourbon. Thanks a lot, non-medical legislature and non-medical MBN...

Anonymous said...

Still waiting for one of Mississippi's Republican control freaks to explain how this top down regulatory straitjacket is any different than the heavy-handedness of Obamacare.

Anonymous said...

Quoting Dr. Phillip Ley:
"This is patently ridiculous, a public bandaid for a problem CREATED by government policy. Yet another hurdle to taking care of my oncology and postoperative patients".

This fiasco was created by freakin' government policy and organised medicine. Their knee-jerk fix is just as crazy and harmful to good medicine as their former policy of pressuring doctors to freely give pain meds. @9:31 summed it up well.

It is a fact that the doctor hating posters above will come begging for pain meds when they eventually experience intolerable pain with their kidney stone, spine problem, MVA, etc. I have been there and would have preferred to just die rather than live in pain. Finally recovered and came away with a new appreciation for life and the medical profession. I stopped the meds when finally got better and have had no desire to take any pain meds since then.

Anonymous said...

Years ago it was diet pills instead of what we have today. Many doctors had a business which only served the people who wanted diet pills. An office call took all of 5 minutes. They were busy from opening until closing. A different patient every 5 minutes. The doctor was paid for an office call and paid by the drug manufacturer to prescribe a certain drug.
When it became obvious to what was going on prescriptions from certain doctors would not be filled by many places. Some doctors bought drug stores just for the purpose of filling the prescriptions they wrote. They became rich. They were paid for the office call, paid for prescribing a certain product, and made a profit from the sale of the drugs.

The product has changed. The doctors haven't changed. The customers haven't changed. The drug manufacturers have not changed.

Kingfish said...

Well, when you let law enforcement dictate health care policy, don't be surprised at the results.

Notice how on this topic, the media is taking law enforcement's position and running with it. No questioning or critical reporting. The truth is, law enforcement runs this state and all too often gets what it wants. The media doesn't hold it accountable because it is too close and wants the access. I'm talking more about law enforcement at the state level, not the local level.

All Marshall Fisher every recommends is to ban and bust. It's all he knows since his background is DEA (Don't Expect Anything). Surprisingly, his solutions never work.

Anonymous said...

You hit the nail on the head, KF! Law enforcement should enforce the laws, not dictate policy. I respect and appreciate law enforcement but the officials in Jackson don’t have any place opining on health care issues.

Anonymous said...

When they start busting 85 year old veterans for cannabis because they can't get their pain meds.

I have had two elderly persons tell me they will go to cannabis when their pain meds are shut off.

Anonymous said...

85 year old Vets of, what, the Korean War will turn to pot? Get real.

Anonymous said...

Some of these complaints are the same/similar to when Mississippi banned getting Sudafed over the counter. Most Sudafed users needed the medicine to treat sinus infections, only a few used it to make crystal meth. Now when I get a sinus infection I have to wait in a Dr's office for 3 hours with a severe sore throat, take the prescription to Walgreens and wait an hour for the pharmacist to fill the prescription, instead of just being able to buy it OTC in 5 minutes. And what is the end result? I have to suffer with a sore throat for hours, and instead of a few shake and bake meth labs, we now have ultra-pure, large meth crystals coming out of Mexico, and the jails are full of mule runners. If the medical community thinks these regs will save lives or reduce dependency, I believe they are mistaken and the void will be filled by Mexican cartels producing and importing opioids and the jails filled with more mule runners.

Anonymous said...

I think a few of you are blaming the wrong credentialed professionals.

Gosh, it's awfully coincidental that the moral panic over the opioid epidemic and the jackpot justice lawyers dipping their toes in the pool with their first lawsuits seem to be happening at the same time.

Team Blue with 'My Body, My Choice,' really only applies to abortion. Otherwise, these busybodies need to regulate everything one does with one's body. Self-ownership is anathema to all they hold dear.

Team Red with "Personal Responsibility," really only applies to welfare. One is too stupid to make decisions for one's self that might not jibe with what they imagine Jesus of their hardly read King James Bible might not approve.

Both of them keep cigarettes legal, and raise the taxes incrementally, careful not to overdo it so that more smokers quit. They allow liquor sales, but only in a manner that continues to enrich the permit holders at expense of the consumer's convenience.

Everything a politician does is for his/her benefit. Period. Race, party, length of tenure...matters not. The only way we get from underneath their boot is to demand they have less authority over us, not more. I can't think of a single politician that I want to balance my checkbook, borrow my car, nor date my daughter. As long as my actions don't cause you harm...leave me alone. I assure you, were I to choose to abuse opioids, it would harm far fewer than those affected by some 'duly elected' politician's back room Tico's dinners.

Anonymous said...

I suspect that these regs were dictated to the "lawmakers", by large entities within the Health Care INDUSTRY. You don't have to peel back the outer layers of this onion, to see that it was DESIGNED to be ANTI-COMPETITIVE.

Adding all that extra paperwork, and adding the "background checks", means that large clinics/hospitals will have the advantage (because they'll simply add staff to do the extra work), while docs with small practices will suffer (or retire, or MOVE TO ANOTHER STATE).

Don't be surprised, when your small town's only doctor's office disappears, and you're forced to make the schlep to Hattiesburg or Tupelo or Jackson (or whatever "Regional Healthcare Hub" is closest).

And don't be surprised to see that healthcare is priced totally beyond reach, for a lot of people (we only THOUGHT it was bad, before).

As usual, 'Feel', and the "lawmakers", have done the bidding of the powerful, while ignoring the needs of the people.

Anonymous said...

This is getting perilously close to violating, and may violate, the separation of powers doctrine. The legislative branch establishes the law, and the executive branch enforces the law. The MSBML is obviously in the executive branch, and can regulate physicians. Without doing any heavy research, it looks like on the face of it that the MSBML could be stepping over the line from "regulating physicians" into making laws about dispensing and control of drugs by wrongly labelling these changes as a "regulation". Drug control laws must be passed by the legislature as a "law". If the MSBML violates the separation of powers doctrine, then these new "regulations" would be void. See "Howell v. State" from 1974 for a good discussion about drug control/scheduling and the related separation of powers conflict between the legislative and executive branches.

Anonymous said...

Ken Lippincott and Randy Easterling both are in the drug rehab/treatment industry. Wonder why the board thinks opiates and benzos are bad? this is your reason.

Anonymous said...

The medical profession has done a horse shit job of regulating itself on this issue. While the head of some medical organization or other was spouting his mouth in the paper the other day about how medical professionals were taking this issue head-on, I was undergoing a couple of medical procedures about that same time. I literally could not get a doctor to take a "no" for an answer to the question of whether I wanted opioids, and the scripts were always huge.

Anonymous said...

5:01 - You know that's bullshit and your claim serves no purpose. Your scrip was, at most, Hydrocodone-Acetominophen 5-325 @ 40 - one every six hours. He just didn't want your fat ass calling him in the middle of the night, whining. It's a typical prescription. Get over yourself.

Anonymous said...

It’s typical, it shouldn’t be, I’m not fat, and Advil worked just fine. Hydro-phucking-codone is not needed for everything.

Anonymous said...

Lynn, you might want to read JJ before penning your columns. Encouraging "more physicians to use the Prescription Monitoring Program"? Like doing so is optional?

Why don't you ask Bev if he feels children should be drug tested every 90 days simply to receive their physician prescribed medications.

Anonymous said...

The Doctors have no one but themselves to blame. I didn't have a doctor until about 10 years ago when I went to an "urgent care" type place. My back was killing me. After waiting in the little waiting room for a while, I decided I was leaving. That's when the Dr. came in and told me I wasn't an addict. I asked if they had run a PMP on me, and they replied they had, as it was standard procedure for this doctor to do so on any new patient complaining of pain. I have had a doctor from that day forward.

If the doctors had merely utilized the tool available to them, PMP, they could have cut off addicts and saved themselves these troubles. Of course, that would have also forced them to report their colleagues who were/are nothing more than drug dealers with a license. Too late to whine now.

Anonymous said...

It was within the recent few years that a cop from Pearl or Brandon was utilizing pmp database to try to catch doctor shoppers. He identified a person went to the doctors office and got the persons file. The person sued. Watch out as one day some cop may be deciding what you take and if he decides it's too much will arrest you.

Anonymous said...

All you self righteous good intentioned doctors shut up.

You know damn well why regulations are passed.

99% of physicians do an excellent job with patient care.

100% of physicians do a terrible job at policing their own.

The few bad apples you refuse to control dictate what happens.

Diet pills to cosmetic procedures to unnecessary surgeries to etc.

When you grow some balls and stop the 1% from gorging at the troughs this will stop.

Anonymous said...

This is insanity.
Yes we have a problem but rather than understand why we have a problem, there is yet again a knee jerk reaction with a " one size fits all" notion of a solution.
Phase one is to truly understand access and control access. Phase two is to fine effective means to treat those addicted effectively.
I don't think a dying or elderly person in chronic pain for any reason is part of the problem and likely to become a threat to society.
But, I also don't think that young people with acute pain need to be given refills or have the ability to doctor shop.
And, I do think that doctors generally need to consider that a pill, any pill, shouldn't have become the first choice of treatment simply because we've become a society looking for quick fixes to everything. Medicine as a business treats patients as " widgets" on an assembly line. It encourages and rewards doctors to treat symptoms without actually identifying the underlying cause these days.
Has it occurred to anyone that in this computer age, tracking prescribed narcotics shouldn't be that difficult and our pharmacology system could be an avenue of identification and control of both the rogue doctor and the at risk patient?
Instead, let's continue to politicize every f'ing thing and let talking heads whose expertise is being glib ,emoting, attaching blame and self-aggradizing come up with lame solutions because that's working so well. (sarcasm).

Anonymous said...

I hope every person that wants to make it impossible to get real pain meds is stricken with endless kidney stones immediately.
I’ve never abused them in my life and actually hate taking strong drugs, but when a doctor tried to prescribe Tylenol 3 instead of Dilaudid for a kidney stone I wanted to stab her in the chest and ask her if she needed a Bandaid.

Anonymous said...

ADHD meds are cat 2 controlled substances, will they be limited? Will my kids have to get drug screens to get their meds and be limited to 7 days? This is insanity. Bitch all you want about doctors, but when your kids flunk out cause we can't give them meds you will be the one bitching.

Anonymous said...

This is just like the sudafed regulation. Mississippi and Oregon are the only two states to require a prescription for sudafed, all because some damn tweakers want a cheap high. So instead of running into Walgreens, letting them scan your DL and paying $12 a box for some sudafed...they make you schedule an appt with the doc, wait 2 hours to get seen, pay your insurance co pay for a visit, then go to Walgreens and wait 30 mins for them to “fill” your sudafed, and then pay the insurance copay for the prescription. Totaling 3 hours of wasted time + $50-75 depending on your insurance. And don’t tell me that “meth production in the state has significantly decreased”.

Anonymous said...

And don’t tell me that “meth production in the state has significantly decreased”.

In the interior of the state it has, on the borders less so.

Anonymous said...

The opioid 'crisis' is majority heroin (often laced with Chinese fentanyl).

These are non-prescription drugs and illegal in any case. More regulation of doctors misdiagnoses the problem as patients becoming addicts. The overwhelming majority of overdose victims are not patients receiving pain meds by Rx, they are people with unemployment or childhood trauma.

Joel Bomgar did some great work on the issue and found that about one fewer person per 100,000 is dying from prescription-opioid overdose five years after restrictive policies went into effect, in exchange for nearly four more people per 100,000 dying from heroin and fentanyl.

For sources, see: https://www.cato.org/publications/commentary/opioid-crisis-keep-eyes-heroin-fentanyl

Phillip said...

For those of you criticizing my profession for not policing itself, I agree. The state Board of Medical Licensure, the Bureau of Narcotics, and the Board of Pharmacy are well-informed as to who the problem prescribers, dispensers and consumers are. They choose to act only upon complaint or catastrophe. As a practicing surgeon, I cannot fine, sanction or arrest anyone. I can complain, but physician complaints just don't seem to get too far, it seems. You might wonder why hospitals don't act; it is not in the purview of the surveillance and discipline of their medical staffs, and can lead to a costly legal battle for them. Almost all of this activity is outpatient and not under their control.
For the anonymous poster who says that Advil was fine, that's true for some, but not most. Many have been the times that patients have declined a narcotic analgesic then called after hours to request/demand a prescription. I took two hydrocodone tablets and a Dilaudid after my kidney was removed, but most do not have that tolerance. It is hard to estimate postoperative need. Intraoperative requirements are not a reliable predictor. Add in our inability to telephone prescriptions for Schedule 2 narcotics, the variability of pharmacy acceptance of electronically secure and verified narcotic prescriptions and it all adds up to a difficult problems.
No responsible physician or surgeon wants to contribute to addiction. Ad hominem attacks regarding vacation homes, income and lifestyle render your comments impotent, undermine your arguments and, simply put, invalidate your worth as a contributor to the discussion.

Anonymous said...

9:30, You actually took pain pills for a kidney stone?
That is the kind of bullshit we need stopped.
Grow up. Lay the cokes down nd you will not have kidney stones.
What kind of sissies do we have in Mississippi?

Anonymous said...

I've seen a half dozen young college age men with glorious futures put a bullet through their heads, a rope around their necks, or just plain die on the couch due to opioids abuse. I've seen friends and family go in the hospital for knee surgery only to wind up in a treatment facility a year later. If they are lucky enough to live through the addiction and treatment, they will spend the rest of their lives fighting this addiction. For these people disagreeing with change towards finding a solution, I can only say they are in denial.

Anonymous said...

Ever passed a kidney stone @6:03 PM? You're stupid comment about sodas betrays your ignorance.

Anonymous said...

Ad hominem attacks regarding vacation homes, income and lifestyle render your comments impotent, undermine your arguments and, simply put, invalidate your worth as a contributor to the discussion.

+ 1,000,000

Anonymous said...

Dr Phillip:

In response to your lame excuse “I cannot arrest anyone:”

That’s a cop out.

I have relatives who have are doctors who say on licensure boards and traveled nationwide to stop the problem doctors.

Even if you say you cannot you must form a group and excise the obvious violators.

Said another way - you can get with MACM (essentially immune from liability as a quasi state functioning system entity) and force the pill mill doctors out. You don’t because of fear of the unknown. What if they decide your practices are somehow unfit or deviate in some way?

Figure out a way to stop the abuses.

And thanks for your hard work.

Anonymous said...

"I have relatives who have are doctors who say on licensure boards and traveled nationwide to stop the problem doctors."

Is English your first language?

Anonymous said...

When you cannot edit after the post....

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Trollfest '09

Trollfest '07 was such a success that Jackson Jambalaya will once again host Trollfest '09. Catch this great event which will leave NE Jackson & Fondren in flames. Othor Cain and his band, The Black Power Structure headline the night while Sonjay Poontang returns for an encore performance. Former Frank Melton bodyguard Marcus Wright makes his premier appearance at Trollfest singing "I'm a Sweet Transvestite" from "The Rocky Horror Picture Show." Kamikaze will sing his new hit, “How I sold out to da Man.” Robbie Bell again performs: “Mamas, don't let your babies grow up to be Bells” and “Any friend of Ed Peters is a friend of mine”. After the show, Ms. Bell will autograph copies of her mug shot photos. In a salute to “Dancing with the Stars”, Ms. Bell and Hinds County District Attorney Robert Smith will dance the Wango Tango.

Wrestling returns, except this time it will be a Battle Royal with Othor Cain, Ben Allen, Kim Wade, Haley Fisackerly, Alan Lange, and “Big Cat” Donna Ladd all in the ring at the same time. The Battle Royal will be in a steel cage, no time limit, no referee, and the losers must leave town. Marshand Crisler will be the honorary referee (as it gives him a title without actually having to do anything).


Meet KIM Waaaaaade at the Entergy Tent. For five pesos, Kim will sell you a chance to win a deed to a crack house on Ridgeway Street stuffed in the Howard Industries pinata. Don't worry if the pinata is beaten to shreds, as Mr. Wade has Jose, Emmanuel, and Carlos, all illegal immigrants, available as replacements for the it. Upon leaving the Entergy tent, fig leaves will be available in case Entergy literally takes everything you have as part of its Trollfest ticket price adjustment charge.

Donna Ladd of The Jackson Free Press will give several classes on learning how to write. Smearing, writing without factchecking, and reporting only one side of a story will be covered. A donation to pay their taxes will be accepted and she will be signing copies of their former federal tax liens. Ms. Ladd will give a dramatic reading of her two award-winning essays (They received The Jackson Free Press "Best Of" awards.) "Why everything is always about me" and "Why I cover murders better than anyone else in Jackson".

In the spirit of helping those who are less fortunate, Trollfest '09 adopts a cause for which a portion of the proceeds and donations will be donated: Keeping Frank Melton in his home. The “Keep Frank Melton From Being Homeless” booth will sell chances for five dollars to pin the tail on the jackass. John Reeves has graciously volunteered to be the jackass for this honorable excursion into saving Frank's ass. What's an ass between two friends after all? If Mr. Reeves is unable to um, perform, Speaker Billy McCoy has also volunteered as when the word “jackass” was mentioned he immediately ran as fast as he could to sign up.


In order to help clean up the legal profession, Adam Kilgore of the Mississippi Bar will be giving away free, round-trip plane tickets to the North Pole where they keep their bar complaint forms (which are NOT available online). If you don't want to go to the North Pole, you can enjoy Brant Brantley's (of the Mississippi Commission on Judicial Performance) free guided tours of the quicksand field over by High Street where all complaints against judges disappear. If for some reason you are unable to control yourself, never fear; Judge Houston Patton will operate his jail where no lawyers are needed or allowed as you just sit there for minutes... hours.... months...years until he decides he is tired of you sitting in his jail. Do not think Judge Patton is a bad judge however as he plans to serve free Mad Dog 20/20 to all inmates.

Trollfest '09 is a pet-friendly event as well. Feel free to bring your dog with you and do not worry if your pet gets hungry, as employees of the Jackson Zoo will be on hand to provide some of their animals as food when it gets to be feeding time for your little loved one.

Relax at the Fox News Tent. Since there are only three blonde reporters in Jackson (being blonde is a requirement for working at Fox News), Megan and Kathryn from WAPT and Wendy from WLBT will be on loan to Fox. To gain admittance to the VIP section, bring either your Republican Party ID card or a Rebel Flag. Bringing both and a torn-up Obama yard sign will entitle you to free drinks served by Megan, Wendy, and Kathryn. Get your tickets now. Since this is an event for trolls, no ID is required. Just bring the hate. Bring the family, Trollfest '09 is for EVERYONE!!!

This is definitely a Beaver production.


Note: Security provided by INS.

Trollfest '07

Jackson Jambalaya is the home of Trollfest '07. Catch this great event which promises to leave NE Jackson & Fondren in flames. Sonjay Poontang and his band headline the night with a special steel cage, no time limit "loser must leave town" bout between Alan Lange and "Big Cat"Donna Ladd following afterwards. Kamikaze will perform his new song F*** Bush, he's still a _____. Did I mention there was no referee? Dr. Heddy Matthias and Lori Gregory will face off in the undercard dueling with dangling participles and other um, devices. Robbie Bell will perform Her two latest songs: My Best Friends are in the Media and Mama's, Don't Let Your Babies Grow up to be George Bell. Sid Salter of The Clarion-Ledger will host "Pin the Tail on the Trial Lawyer", sponsored by State Farm.

There will be a hugging booth where in exchange for your young son, Frank Melton will give you a loooong hug. Trollfest will have a dunking booth where Muhammed the terrorist will curse you to Allah as you try to hit a target that will drop him into a vat of pig grease. However, in the true spirit of Separate But Equal, Don Imus and someone from NE Jackson will also sit in the dunking booth for an equal amount of time. Tom Head will give a reading for two hours on why he can't figure out who the hell he is. Cliff Cargill will give lessons with his .80 caliber desert eagle, using Frank Melton photos as targets. Tackleberry will be on hand for an autograph session. KIM Waaaaaade will be passing out free titles and deeds to crackhouses formerly owned by The Wood Street Players.

If you get tired come relax at the Fox News Tent. To gain admittance to the VIP section, bring either your Republican Party ID card or a Rebel Flag. Bringing both will entitle you to free drinks.Get your tickets now. Since this is an event for trolls, no ID is required, just bring the hate. Bring the family, Trollfest '07 is for EVERYONE!!!

This is definitely a Beaver production.

Note: Security provided by INS
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