Posted by: notdeaddinosaur | September 17, 2011

File Under WTF

Got a letter today from Pain Management about a mutual patient that read, in part:

Patient has responded very well to epidural steroid injections and now reports that he is pain-free.

Great! Wonderful! Success! Gotta love those epidural steroids.

For the record, the patient is not being treated for any other pain syndromes. So I was at a loss to read further in the letter:

I have refilled vicodin 5/500, dispense number 60, 1 or 2 to be taken every 6 hours as needed.

Um, why are you refilling pain meds for a patient you’ve just said is pain-free? No mention of plans to taper (though he wasn’t on huge doses anyway), nor a note about just having the meds for PRN use in case of recurrence? Just a routine refill.

This is the kind of thing that gives pain docs a bad name.



  1. I’ve never seen a single patient who benefitted from this treatment modality, but insurers sure love to pay for it.

  2. Really? As a FP, I’ve had several patients benefit from ESI. Not long term but it does at least keep them off the narcotics for a little while. Simple fact is our treatments for LBP in all its iterations just suck.

  3. you missed the final part which says “and the patient has been directed to contact his/her primary care provider for further refills”

  4. My husband has seen some improvement with steriod injections, but it never lasts. When the pain comes back, it comes back quick and big. The pain doc might be trying to head off a frantic late night call.

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