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Can a Doctor Terminate a Pain Patient With No Taper or Referral to Another Doctor

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  • 10-31-2016, 04:23 PM
    mrlookitup
    Can a Doctor Terminate a Pain Patient With No Taper or Referral to Another Doctor
    My question involves malpractice in the state of: New Jersey
    On the day of my D.r appt with pain management, everything was normal at first, except there was no receptionist. The D.r asked for the cash 200.00 plus urine sample 50.00. i didnt have the cash yet.( i usually pay Bi-monthly.) so he said thats fine, (as usual) never had an issue with him about not having the money, he was pretty flexible. (90 days late max i believe was his limit) anyways, I asked for a bottle water because I didnt feel the need to use the rest room yet for the urine sample.
    So the dr said dont worry about it. we went to his office, he asked me how was everything...I was excited because I had just got a new job 2 days prior paying double the hourly wage of my prior job doing the same exact thing. I was so excited I even showed him the offer letter on my laptop.
    Dr congratulated me and asked the name of the company then looked the company up. I thought that was weird but hey...maybe he was really excited for me too!
    and then he pulls out a discharge letter and tells me im discharged because he tried to reach me and couldnt. My phone is off for non payment and so is my internet. (even still right this sec) he left a voicemail on my gmail number, but . i didnt get it until after he discharged me. and all the message said was,

    Mr. ****, it's ****** from **** pain management of New Jersey when you get a chance could you please call the office 856 ***-**** excuse me. Sorry that number was 856 ***-****. Thank you very much. Bye now.
    Play message

    well come to find out, he wanted to do a pill count. I've been with this dr alone for almost two years....NEVER had a pill count. He has 3 numbers on file for me. one is my dad. my dad lives in walking distance to my house. The dr couldve called other numbers. why ask for multiple ways to contact me if your only gonna try one. not to mention, he couldve even said pill count on the voice mail instead of (WHEN YOU GET THE CHANCE) in my book (when you get the chance) means...not that serious.. and I happen to be still dealing with a divorce and family court dealing with child custody fights with my ex wife. And I have the dated Court Docs to prove it.

    So, He discharged me.
    I''m prescribed 2 80mg oxycontin AND 4 30MG OXYCODONE PER DAY.
    I begged him to taper me down or at least something for withdrawl because i only had two days in on my job and i solder micro components on circut boards. (small enough to loose under your fingernail)
    HE REFUSED. gave me nausea, spazm"he said take spazm pill at night only to sleep" and stomach cramp meds. and said due to cdc new laws he cant give opiates to me nor taper me down.
    I immediately started searching for another dr. one of the new dr's called me and said my old dr acknowledged the records request but wont send them and said I need to call.
    He is refusing to send my med records because I didnt pay for the last visit and urine sample (he told me dont worry about the urine so i never even did it) and he discharged me and refused treatment to me. I shouldnt have to pay that. not to mention isnt it illegal to withhold records just because im behind on a payment?

    A provider cannot deny you a copy of your records because you have not paid for the health services you have received. If you believe that your doctor or other health care provider violated your health information privacy right by not giving you access to your medical record, you may file a HIPAA Privacy Rule Complaint with the U.S. Department of Health and Human Services (HHS) Office for Civil Rights. The easiest way to file a complaint is to go through the HHS Office for Civil Rights. If you have questions about privacy, security, or HIPAA, visit the Department of Health and Human Services Office for Civil Rights (OCR) privacy website . You can also search OCR’s HIPAA FAQ database.

    https://www.healthit.gov/patients-fa...ess-my-records

    thats right off a .gov website. My ex dr says thats wrong. and have an attorney call him. I didnt even get nasty with him in any way....I was more so pleading. Im suffering in full blown withdrawl right now. I dont have much fight in me. it took me 2 days to type this in my note pad then copy and paste it to the forum.i feel like death. and I spent a couple days in hospital because of withdrawl. im in hell......
    do I have a case? can he do this legally?
  • 10-31-2016, 04:41 PM
    Dogmatique
    Re: High Dose Pain Meds. No Taper Down, Forced Cold Turkey, Won't Send New Doctor Med
    You are not entitled to a free copy of your records. Did you offer to pay for a copy?
  • 10-31-2016, 05:32 PM
    Mercy&Grace
    Re: High Dose Pain Meds. No Taper Down, Forced Cold Turkey, Won't Send New Doctor Med
    A lot of doctors are dismissing pain patients. Those that are being prescribed high doses of opiates are the first to go. A lot of doctors are just tired of dealing with patients that don't want to pay for the doctors services and don't want to go by the rules. It is the patients responsibility to be sure the doctor has a good current way to contact them directly.

    Your doctor can't refuse you a copy of your medical records for the cost of copying them because you have an outstanding balance. I would recommend paying the doctor. If you don't he might write something in your medical records that could make other doctors not want you as a patient. You can make a complaint, but that is going to take time. You can hire an attorney, but chances are paying what you owe the doctor will be cheaper.

    When a patient takes opiates, they are aware they may have problems if the medications are suddenly withdrawn. Chances are your pain contract stated that. Taking high doses makes it worse. Just because a doctor prescribes something does not mean you have to take the prescription or get it filled. A new doctor may not keep you on the same medications you have been on or at the same doses. Most doctors start patients out on the least amount of medications.

    Based on what you have said, your doctor may be planning on closing his practice Nov 1, which is tomorrow. If you can't get in touch with him directly about the medical records, look up your state laws regarding how medical records are to be handled when a doctor closes their practice. A doctor can dismiss a patient and not taper them, not write them a prescription or give them a referral to another doctor.
  • 10-31-2016, 06:12 PM
    Dogmatique
    Re: High Dose Pain Meds. No Taper Down, Forced Cold Turkey, Won't Send New Doctor Med
    Quote:

    Quoting Mercy&Grace
    View Post

    Your doctor can't refuse you a copy of your medical records for the cost of copying them because you have an outstanding balance.

    M, could you clarify something for me please?

    Is a provider not allowed to charge a patient for providing a copy of their medical records? :confused:
  • 10-31-2016, 06:39 PM
    Mercy&Grace
    Re: High Dose Pain Meds. No Taper Down, Forced Cold Turkey, Won't Send New Doctor Med
    Quote:

    Quoting Dogmatique
    View Post
    M, could you clarify something for me please?

    Is a provider not allowed to charge a patient for providing a copy of their medical records? :confused:

    Dogmatique , a doctor can charge for the cost of copying the medical records and postage if they have to be mailed. Federal law states a doctor can't charge a fee for searching for them or similiar things. Unfortunately, some states haven't incorporated federal law into their state laws, yet. So some doctors do charge an extra fee. A federal complaint can be made, but that won't get the patient a copy of their medical records any time soon. The feds do suggest making a copy of the law and showing it to the person in charge of making the copies or the doctor. Although doctors rarely, if ever, deal with copies of medical records.

    "Charges
    A provider cannot deny you a copy of your records because you have not paid for the services you have received.

    However, a provider may charge for the reasonable costs for copying and mailing the records. The provider cannot charge you a fee for searching for or retrieving your records"

    http://www.hhs.gov/hipaa/for-individ...rds/index.html
  • 10-31-2016, 06:59 PM
    Dogmatique
    Re: High Dose Pain Meds. No Taper Down, Forced Cold Turkey, Won't Send New Doctor Med
    Quote:

    Quoting Mercy&Grace
    View Post
    Dogmatique , a doctor can charge for the cost of copying the medical records and postage if they have to be mailed. Federal law states a doctor can't charge a fee for searching for them or similiar things. Unfortunately, some states haven't incorporated federal law into their state laws, yet. So some doctors do charge an extra fee. A federal complaint can be made, but that won't get the patient a copy of their medical records any time soon. The feds do suggest making a copy of the law and showing it to the person in charge of making the copies or the doctor. Although doctors rarely, if ever, deal with copies of medical records.

    "Charges
    A provider cannot deny you a copy of your records because you have not paid for the services you have received.

    However, a provider may charge for the reasonable costs for copying and mailing the records. The provider cannot charge you a fee for searching for or retrieving your records"

    http://www.hhs.gov/hipaa/for-individ...rds/index.html

    I think the key there was obtaining a copy versus retrieving and viewing. They're definitely two different wee animals, aren't they? Funny things, doctors offices. Funny things indeed.
  • 10-31-2016, 07:18 PM
    Mr. Knowitall
    Re: High Dose Pain Meds. No Taper Down, Forced Cold Turkey, Won't Send New Doctor Med
    Quote:

    Quoting mrlookitup
    View Post
    ...then he pulls out a discharge letter and tells me im discharged because he tried to reach me and couldnt. My phone is off for non payment and so is my internet. (even still right this sec) he left a voicemail on my gmail number, but . i didnt get it until after he discharged me.

    What does your contract say about your duty to update your contact information, and to respond to messages? Was the letter not mailed to you?

    Even if you have no access through friends or family, why don't you check your messages from a public location with free Internet access, such as the public library?
    Quote:

    Quoting mrlookitup
    ...and all the message said was,...

    You either got the message or you didn't. If you got the message and didn't understand that you needed to respond, you can argue that the doctor did not make it sufficiently clear that you needed to respond in a prompt manner. But you say that you didn't get the message, so it doesn't make a difference whether or not you would have understood the urgency of your need to respond before you were terminated as a patient.
    Quote:

    Quoting mrlookitup
    The dr couldve called other numbers. why ask for multiple ways to contact me if your only gonna try one.

    As you note, he successfully left a message for you at a number that you provided, and you did not check your messages. He did not get a notice that your Internet was down or that you hadn't paid your cell phone bill.
    Quote:

    Quoting mrlookitup
    ...not to mention, he couldve even said pill count on the voice mail....

    Again, you either received the message before you were terminated, or you didn't. You say that you didn't, so it makes no difference what he could have said.
    Quote:

    Quoting mrlookitup
    I immediately started searching for another dr. one of the new dr's called me and said my old dr acknowledged the records request but wont send them and said I need to call.

    You found a new doctor, and... the new doctor would not prescribe additional medication or a taper?
    Quote:

    Quoting mrlookitup
    Im suffering in full blown withdrawl right now. I dont have much fight in me. it took me 2 days to type this in my note pad then copy and paste it to the forum.i feel like death. and I spent a couple days in hospital because of withdrawl. im in hell......

    Acute withdrawal symptoms should have passed within three or four days.

    You are stating that you have an acute pain condition. You spent two days in the hospital. Why didn't the hospital place you on a taper or provide pain management? Why can't you find a pain management doctor who can work from the hospital records?

    To me, your story is missing some important details, and it seems that the root of your problem finding a new pain management doctor is not associated with any difficulty in obtaining your medical records from your former doctor.

    One way or another, your original doctor should have been willing to provide enough records to your new doctor to ensure continuity of care. If the new doctor did not accept you as a patient, as would appear to be the case from your suggestion that you were not able to get a continuation of your pain medications or a taper from that doctor, then that would not apply.
  • 10-31-2016, 08:05 PM
    Mercy&Grace
    Re: High Dose Pain Meds. No Taper Down, Forced Cold Turkey, Won't Send New Doctor Med
    Quote:

    Quoting Dogmatique
    View Post
    I think the key there was obtaining a copy versus retrieving and viewing. They're definitely two different wee animals, aren't they? Funny things, doctors offices. Funny things indeed.


    Dogmatique, some doctors are rather unusual. . LOL. I made a Federal Complaint regarding being charged the search fee for a copy of medical records. I spoke to someone before I made the complaint. I was told the seach fee didn't apply to copies of medical records or retrieving and viewing. Search fees are much more than the cost of copies. Search fees can also be in addition to the cost of copies.

    I don't know about the OP's state of New Jersey. Where I am, doctors don't usually charge other doctors for copies of patients medical records when they are sent from one doctor to the other.

    I agree with Mr. Knowitall. There is more to the story. The OP not showing up for a pill count, can be the same as failing it. A lot of doctors will work with patients when things happen and some won't. Chances are this may not have been the first time the OP didn't do what they agreed to do when they signed the pain contract.
  • 11-01-2016, 03:38 AM
    mrlookitup
    Re: High Dose Pain Meds. No Taper Down, Forced Cold Turkey, Won't Send New Doctor Med
    yes, I have offered to pay for records...Doctor stated I MUST pay 270 for the charge of my last appointment day(the day he discharged me) he also state I am allowed one copy of my records for free and he will have no problem giving me my free copy once my back balance is paid. I am aware he is allowed to charge me max 1.00 per page max 200.00 for entire file.
    again, Ive had no issues with him at all till this point. not one.

    paying him plus the new dr isnt an option for me right now considering the dr's abrupt discharge cause me to go into severe withdrawl and loose the new job i only had for two days. I also requested my records about a month or 2 prior to all this because my dr kept mentioning other dr's getting locked up and the cdc...and he was looking pretty nervous. plus my appointments are always on the day i run out of meds, and the dr left me a voicemail saying he had a family emergency on tues(day of my appt) and could resched me for Wednesday if someone cancelled or come in the following monday. i came in thursday (2 days without meds) and sat there until he made time for me. he said he was too busy(overbooked) however, i sat there for 2 hours and only 2 people came in and one was a walk in first timer. that was what caused me to ask for my records....(forgot about that....the was the first issue i had other than current issue) I felt like something funny was going on and didnt want to end up screwed....he never gave me my records though. he said it would be on cd. pdf file. never happened.

    Quote:

    Quoting Mr. Knowitall
    View Post
    What does your contract say about your duty to update your contact information, and to respond to messages? Was the letter not mailed to you?

    Even if you have no access through friends or family, why don't you check your messages from a public location with free Internet access, such as the public library?

    You either got the message or you didn't. If you got the message and didn't understand that you needed to respond, you can argue that the doctor did not make it sufficiently clear that you needed to respond in a prompt manner. But you say that you didn't get the message, so it doesn't make a difference whether or not you would have understood the urgency of your need to respond before you were terminated as a patient.

    As you note, he successfully left a message for you at a number that you provided, and you did not check your messages. He did not get a notice that your Internet was down or that you hadn't paid your cell phone bill.

    Again, you either received the message before you were terminated, or you didn't. You say that you didn't, so it makes no difference what he could have said.

    You found a new doctor, and... the new doctor would not prescribe additional medication or a taper?

    Acute withdrawal symptoms should have passed within three or four days.

    You are stating that you have an acute pain condition. You spent two days in the hospital. Why didn't the hospital place you on a taper or provide pain management? Why can't you find a pain management doctor who can work from the hospital records?

    To me, your story is missing some important details, and it seems that the root of your problem finding a new pain management doctor is not associated with any difficulty in obtaining your medical records from your former doctor.

    One way or another, your original doctor should have been willing to provide enough records to your new doctor to ensure continuity of care. If the new doctor did not accept you as a patient, as would appear to be the case from your suggestion that you were not able to get a continuation of your pain medications or a taper from that doctor, then that would not apply.

    The dr DOES have multiple numbers for me.
    the dr DID know my phone was off.
    the dr also DID know this was a google voice number because i told him plus offered to set one up for him because at the time he was having phone issues.
    The NEW dr cant even see me until my old dr released my records. the called me and said he acknoledged the request but said hes not sending the records and i need to call him. i called and he said i cant have records until back balance is paid.
    i dont know what to tell you about (i SHOULD be done withdrawl) tell my body that. i felt a tad better in hospital, within 2-3 hours of leaving boom, right back into withdrawl.
    again, me mentioning the dr shouldve mentioned pill count instead of say(when you get a chance) was just a side note.....he knows im going threw divorce fighting a custody battle and half way homeless and just started a new job that i lost 2 days after getting it because of this. he couldve called my emergency contact. or another number....or even emailed. they had no problem emailing and calling other numbers other times. why now plus the vague email.
    not right.

    Quote:

    Quoting Mercy&Grace
    View Post
    Dogmatique, some doctors are rather unusual. . LOL. I made a Federal Complaint regarding being charged the search fee for a copy of medical records. I spoke to someone before I made the complaint. I was told the seach fee didn't apply to copies of medical records or retrieving and viewing. Search fees are much more than the cost of copies. Search fees can also be in addition to the cost of copies.

    I don't know about the OP's state of New Jersey. Where I am, doctors don't usually charge other doctors for copies of patients medical records when they are sent from one doctor to the other.

    I agree with Mr. Knowitall. There is more to the story. The OP not showing up for a pill count, can be the same as failing it. A lot of doctors will work with patients when things happen and some won't. Chances are this may not have been the first time the OP didn't do what they agreed to do when they signed the pain contract.

    Quote:

    Quoting Mercy&Grace
    View Post
    Dogmatique, some doctors are rather unusual. . LOL. I made a Federal Complaint regarding being charged the search fee for a copy of medical records. I spoke to someone before I made the complaint. I was told the seach fee didn't apply to copies of medical records or retrieving and viewing. Search fees are much more than the cost of copies. Search fees can also be in addition to the cost of copies.

    I don't know about the OP's state of New Jersey. Where I am, doctors don't usually charge other doctors for copies of patients medical records when they are sent from one doctor to the other.

    I agree with Mr. Knowitall. There is more to the story. The OP not showing up for a pill count, can be the same as failing it. A lot of doctors will work with patients when things happen and some won't. Chances are this may not have been the first time the OP didn't do what they agreed to do when they signed the pain contract.

    THERE IS NO MORE TO IT!!
    I also did mention, I've been with this D.R. for almost two years and have never been asked to do a pill count.
    The fact that a few of you are saying its more to the story is sort of answering my question. basically, something aint right. and I also have a discharge letter stating that the reason for discharge was because the dr left a message and i never called him back. AGAIN.....NEVER HAD A PILL COUNT....NEVER FAILED OR MISSED A URINNE SAMPLE....NEVER MISSED A PHONE CALL UNTIL NOW. THATS ALL TO IT.
    i was charged full freight for discharge and final urine sample (even tho he told me never mind about urine sample after i asked for a bottled water so i could build up some urine)
    I spoke to receptionist yesterday, pleading about releasing my recs. she stated that it was my fault im going threw withdrawl. because i didnt fill saboxine script!!!WHAT SABOXINE SCRIPT????? I NEVER GOT ONE!!! she said, the dr said he gave you one and maybe thats why you were charged. I SAID NO....I DIDNT GET ONE, THATS NOT TRUE. I'm guessing she found out that dr didnt give me that, because she shut down on me and said i have to speak with dr directly.

    So, i owe 270. and can not...... get/forward/nor view....... my records until i pay 270.00
    my new dr cant schedule me an appointment until my old dr sends my med recs to new dr.
    In my contract I was told if i was discharged i would be given saboxine or dose would be lowered to taper me down. but dr said because of new cdc laws he cant even do that.
  • 11-01-2016, 07:35 AM
    geek
    Re: High Dose Pain Meds. No Taper Down, Forced Cold Turkey, Won't Send New Doctor Med
    Doctors are cracking down on opiates because they've become a big source of abuse in the US. The CDC has issued guidelines on opiate use- they are recommendations, not laws.

    If he asked you for a pill count it could be that some of his other patients were found to be diverting meds (giving or selling them to others).

    If you feel he broke the contract, or he's giving you a hard time about getting a copy of your records, I suppose you could make a complaint to the state medical board. I don't know how else you could compel him to give you a copy short of hiring an attorney.
  • 11-01-2016, 11:55 AM
    Dogmatique
    Re: High Dose Pain Meds. No Taper Down, Forced Cold Turkey, Won't Send New Doctor Med
    I concur with the others.

    I also think you're placing the blame on the wrong person.
  • 11-01-2016, 12:30 PM
    mrlookitup
    Re: High Dose Pain Meds. No Taper Down, Forced Cold Turkey, Won't Send New Doctor Med
    Quote:

    Quoting Dogmatique
    View Post
    I concur with the others.

    I also think you're placing the blame on the wrong person.

    please....do elaborate.
    i did mention my phone was shut off for non payment. thats my fault.

    how ever right on gov website it says he cant hold my records for not paying for services received.
    and how is it fair to charge me just to tell me get out.....
    seriously...maybe im looking at it wrong. thats why im here asking.
  • 11-01-2016, 12:44 PM
    Mercy&Grace
    Re: High Dose Pain Meds. No Taper Down, Forced Cold Turkey, Won't Send New Doctor Med
    If he normally writes patients a Suboxone prescription when he dismisses them, maybe he thought he wrote you one. Although I don't know how you could convince him of this. Unless you called and asked them to check your chart and see if there is a prescription there.

    If you want to see a new doctor, you are going to have to pay the doctor or hire an attorney. I'm pretty sure paying the doctor will be much cheaper. You can file a Federal Complaint, but that is not going to help you get your medical records any time soon.
  • 11-01-2016, 05:46 PM
    Mr. Knowitall
    Re: High Dose Pain Meds. No Taper Down, Forced Cold Turkey, Won't Send New Doctor Med
    The consistent complaint is that the doctor won't give you a copy of your records until you pay what you owe.

    You have been told that your doctor must provide to your new doctor(s) sufficient medical records to ensure continuity of care. To them, not to you. Not all, just those necessary.

    If you insist upon putting yourself in the middle, you are creating the problem instead of solving it.

    If the new pain doctor won't accept you as a patient until you produce records from your old pain doctor, and also won't accept the hospital records as an alternative, and in fact your former doctor won't provide those records necessary for continuity of care directly to the new doctor, then go to a different doctor. There are lots of doctors to choose from.
  • 11-01-2016, 06:08 PM
    Mercy&Grace
    Re: High Dose Pain Meds. No Taper Down, Forced Cold Turkey, Won't Send New Doctor Med
    Quote:

    Quoting Mr. Knowitall
    View Post
    The consistent complaint is that the doctor won't give you a copy of your records until you pay what you owe.

    You have been told that your doctor must provide to your new doctor(s) sufficient medical records to ensure continuity of care. To them, not to you. Not all, just those necessary.

    If you insist upon putting yourself in the middle, you are creating the problem instead of solving it.

    If the new pain doctor won't accept you as a patient until you produce records from your old pain doctor, and also won't accept the hospital records as an alternative, and in fact your former doctor won't provide those records necessary for continuity of care directly to the new doctor, then go to a different doctor. There are lots of doctors to choose from.

    mrlookitup, did you tell the doctors offices you called that wouldn't take you as a patient the meds and doses you had been on ? You need to be preoared to take a much lower dose of pain meds.

    Mr. Knowitall, The OP was on a high dose of opiates. That may make it difficult for them to find a new doctor. If the OP broke any of the rules, that will make it close to impossible for them to find a new pain doctor.
  • 11-01-2016, 06:45 PM
    Mr. Knowitall
    Re: High Dose Pain Meds. No Taper Down, Forced Cold Turkey, Won't Send New Doctor Med
    The OP has indicated that he has spoken to only one other doctor, and has given a dubious explanation for why that doctor won't provide treatment. Besides, according to the OP he's off the high doses of medication, so it's not an issue of walking into a doctor's office and demanding continuation of those high doses -- it's a blank slate. Further, the OP did receive inpatient treatment in a hospital, and would have been treated by doctors in that hospital who are very familiar with opiate medication and management of high doses of medication.

    The OP has identified only one issue with getting treatment from the new doctor: Provision of medical records. If the new doctor is refusing to treat the patient because the prior doctor stopped treatment over a missed pill count, that's not something that would be changed based upon provision of medical records. Recall, the OP does not deny missing the pill count, but instead argues that the missed pill count should have been excused.

    It also strikes me as odd that a doctor would terminate a patient who had no other violations of a contract for care other than a single missed pill count.
  • 11-01-2016, 07:37 PM
    Mercy&Grace
    Re: High Dose Pain Meds. No Taper Down, Forced Cold Turkey, Won't Send New Doctor Med
    Quote:

    Quoting Mr. Knowitall
    View Post
    It also strikes me as odd that a doctor would terminate a patient who had no other violations of a contract for care other than a single missed pill count.

    Mr. Knowitall, now days, it is not uncommon for a pain doctor to dismiss a patient for a missed pill count. Pain doctors are getting stricter than they have been before. Some pain doctors are also dismissing patients that have problems paying them or complain about the cost of visits, drug screens, etc. The OP mentioned he was paying him twice a month. I don't know if the OP was seeing the doctor twice a month or just making payments twice a month.
  • 11-01-2016, 08:33 PM
    Mark47n
    Re: High Dose Pain Meds. No Taper Down, Forced Cold Turkey, Won't Send New Doctor Med
    Quote:

    The OP mentioned he was paying him twice a month. I don't know if the OP was seeing the doctor twice a month or just making payments twice a month.
    The OP is paying the doctor every two months and is more than passingly familiar with the doctors limits on just how overdue the OP can be. It's in the first post.
  • 11-01-2016, 08:39 PM
    Mr. Knowitall
    Re: High Dose Pain Meds. No Taper Down, Forced Cold Turkey, Won't Send New Doctor Med
    Quote:

    Quoting Mercy&Grace
    View Post
    Mr. Knowitall, now days, it is not uncommon for a pain doctor to dismiss a patient for a missed pill count.

    It is not unusual for a doctor to dismiss a patient for a missed pill count when there have been other issues with the patient. It remains unusual for a doctor to dismiss a patient for a single missed pill count after years of treatment, with no other issues and without even asking for an explanation.
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