i work part time in a family practice office. i work for all providers at one time or another. we have a doc (lets call hime smith) that is famous for giving pain meds. he'll switch them from lortab, to percocet, to methadone, to dilaudid, to whatever. we have a pt that filled her methadone then 2 days later siad they weren't working and he gave dilaudid. orders demerol 150mg im for obvious drug seekers.
the nurses know if the pt complains of pain in the hosp, he doesn't think twice about putting them on a pca. (even had a lap chole on a ms pca. 45 min after d/c of drugs pt felt good enough to leave. go figure!)
we had a surgeon admit a pt under dr. smith's care d/t lortab/percocet abuse post-op with dx of narc. addiction, even though we are not a rehab facility. the pt left with a script for lortab. she had been getting percocet #300 previous to surg.
my question for all of you is.....when does this become an ethical question for me? working in the hospital and/or working in the office. i have told the doc repeatedly my opinion that these are drug seekers and they need help. i have said......"they walked in here and joked around....then needed 150mg of demerol????????" he disagrees, and when he does defend the pt he simply says pain is subjective. uh, yeah, but can't you think for yourself? i like the doc as person. very interesting company and good conversation, but don't i have a line where i am enabling these drug seeker too???? i might add no nurse at the hospital would let him be their doc. he is scary most of the time...and in difficult cases we know the pt would have a much better chance with another doc.
i have recently heard talk around the office that i might soon be offered a job working full time for this provider..(i'm full time right now med-surg) ethical delima or not....i know it sounds like i've made up my mind....but i would like your imput.
i like the doc as person. very interesting company and good conversation, but don't i have a line where i am enabling these drug seeker too???? i might add no nurse at the hospital would let him be their doc. he is scary most of the time...and in difficult cases we know the pt would have a much better chance with another doc.