How Do You Handle Patients That...

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Specializes in psych/medical-surgical.

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Want to manage their own medicine? I recently had someone on Xanax that wants to adjust her dose and get an early refill. She just messaged me directly asking for a week early refill because of "the holiday (July 4th)" claiming this would impede her ability to get the medicine. When I called her out, she says, "I been wanting to increase my dose anyway" and made no mention or didn't take responsibility for her own mistake. The fill date according to PMP would have made her due on July 9th, I checked twice.

Thankfully, in 1 year this is the only time this has really happened. I haven't had someone NOT on a controlled substance do this with me. If they want to, they AT LEAST usually ask me first, instead of trying to backwards-rationalize their own treatment... 

This person was on Xanax TID for a long time before she met me... I mean firstly her actions were unethical/manipulative, but I can't help but feel guilty seeing as HER report was that WEED and XANAX are the only things that help her nausea & panic... She lives in a state where THC is legal... praise the government and their dysregulation of damaging psychotropics!

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Specializes in Surgery.

Simple; "I'm sorry I can't do that. Take care and see you at follow up."

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Specializes in Former NP now Internal medicine PGY-3.
On 7/15/2022 at 6:12 PM, DrCOVID said:

Want to manage their own medicine? I recently had someone on Xanax that wants to adjust her dose and get an early refill. She just messaged me directly asking for a week early refill because of "the holiday (July 4th)" claiming this would impede her ability to get the medicine. When I called her out, she says, "I been wanting to increase my dose anyway" and made no mention or didn't take responsibility for her own mistake. The fill date according to PMP would have made her due on July 9th, I checked twice.

Thankfully, in 1 year this is the only time this has really happened. I haven't had someone NOT on a controlled substance do this with me. If they want to, they AT LEAST usually ask me first, instead of trying to backwards-rationalize their own treatment... 

This person was on Xanax TID for a long time before she met me... I mean firstly her actions were unethical/manipulative, but I can't help but feel guilty seeing as HER report was that WEED and XANAX are the only things that help her nausea & panic... She lives in a state where THC is legal... praise the government and their dysregulation of damaging psychotropics!

Looks like it’s time to taper her off

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Specializes in CTICU.

Have a written agreement and if she comes up short, she doesn't get extra meds. If it's repeated, you can discharge her from your care. Getting an early refill due to a holiday, and independently changing her own dosing are two different things.

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Specializes in psych/medical-surgical.
On 7/19/2022 at 5:34 PM, Tegridy said:

Looks like it’s time to taper her off

She fired me and found another provider. 

On 7/24/2022 at 11:09 AM, ghillbert said:

Have a written agreement and if she comes up short, she doesn't get extra meds. If it's repeated, you can discharge her from your care. Getting an early refill due to a holiday, and independently changing her own dosing are two different things.

I think that is a great idea and going to add that to my disclosure, thank you!

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Specializes in Former NP now Internal medicine PGY-3.
7 hours ago, DrCOVID said:

She fired me and found another provider. 

I think that is a great idea and going to add that to my disclosure, thank you!

That’s a good thing doubt they will deal w that garbage and those pt who abuse the system aren’t worth the time and money to deal with

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