Posted by: notdeaddinosaur | May 12, 2008


I’m not sure why, but my traffic seems to have picked up lately. What that also means is that people are reading and commenting on old posts. (Thanks, folks.) Here’s a recent comment by Dr. Sissy (no blog link; start one and I’d be happy to send you some linky-love) on my post about identifying drug seekers in the primary care setting:

Any advice for a new FP? The narkies are coming out of the woodwork. I offer referral for counseling, hospitalization, pain management and physical therapy, along with NSAIDs, tramadol and other lower risk meds and watch them leave in a huff.

Yes, I do have some advice: keep it up; you’re doing exactly the right thing. Here’s why:

After I’d been in practice for only a few years, I saw a patient for a non-drug-related problem (bronchitis or something like that) who mentioned as part of her medical history that she was an active heroin addict. I looked up at her and told her point-blank I wouldn’t prescribe any narcotics for her. Here’s what she said:

Oh, I know. The word is out on the street: don’t call Dr. Dino. No drugs to be had there.

My honest reaction was to swell with pride! That’s obviously why the narkies were leaving me alone. Stick to your guns; once you establish your reputation, you’re home free. By the way, I told the patient it was the nicest thing anyone had ever said about me. She didn’t leave in a huff, either. Maybe someday, when she’s ready, I’ll be the one she comes back to. In the meantime, I treasure the reputation I worked so hard to achieve.


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