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  1. #1
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    Default Does a Doctor Have to Wean a Pain Patient from Opiates After Terminating Care

    My question involves medical malpractice in the state of: Washington

    If a doctor stops prescribing an opiate for pain are they responsible for treating the patient to wean them off the drug? I ask because I was discharged without notice. I ended up suffering severe withdrawal symptoms for nearly 8 weeks before they completely subsided. That may sound extreme but I was on a heavy amount of opiates for a long time. When I called to inquire about about the symptoms or be treated for this, they hung up. They also refused to give me my medical records and I have had a hard time finding another PCP. Is this abandonment of the patient? Do they have to give me notice and allow me time to find another PCP? Is this malpractice or am I reaching?

  2. #2
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    Default Re: Pain Contract Question After Being Discharged

    When did this take place?

    (ie, when did the physician first refuse to treat you)

  3. #3
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    Default Re: Pain Contract Question After Being Discharged

    December of 2013

  4. #4
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    Default Re: Pain Contract Question After Being Discharged

    Thank you.

    So have you still not received formal notification of being discharged as a patient? For how long were you a patient?

    There are rules to be followed, and WA has stricter controls for some pain patients which don't apply to certain others. So let's narrow it down - are you being treated for cancer pain? Chronic non-cancer pain?

  5. #5
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    Default Re: Pain Contract Question After Being Discharged

    Non Cancer - Chronic pain.

    Received care from June to December. In December I was given notice that my opiate prescription would not be refilled. This is after a change of doctor at the clinic, a few of the other doctors had left, it is unclear why. I did not know I was discharged at this time. I thought I was still being treated as this was all over the phone. When I called in January to complain of withdrawals they hung up and said I was no longer a patient. Then I was ignored. Now I'm trying to find another provider and get my medical records and this has been very difficult as they won't cooperate. I also went to my regular doctor but he wanted my prior medical records and CT or MRI before prescribing, so this has been very difficult.


    Quote Quoting Dogmatique
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    Thank you.

    So have you still not received formal notification of being discharged as a patient? For how lo
    ng were you a patient?

    There are rules to be followed, and WA has stricter controls for some pain patients which don't apply to certain others. So let's narrow it down - are you being treated for cancer pain? Chronic non-cancer pain?

  6. #6
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    Default Re: Pain Contract Question After Being Discharged

    Quote Quoting ajmcello
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    Non Cancer - Chronic pain.

    Received care from June to December. In December I was given notice that my opiate prescription would not be refilled. This is after a change of doctor at the clinic, a few of the other doctors had left, it is unclear why. I did not know I was discharged at this time. I thought I was still being treated as this was all over the phone. When I called in January to complain of withdrawals they hung up and said I was no longer a patient. Then I was ignored. Now I'm trying to find another provider and get my medical records and this has been very difficult as they won't cooperate. I also went to my regular doctor but he wanted my prior medical records and CT or MRI before prescribing, so this has been very difficult.

    You have a different regular doctor? Why was he not treating you for pain?

    Perhaps more to the point, how did you end up going to the clinic for pain meds rather than your doctor?

  7. #7
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    Default Re: Pain Contract Question After Being Discharged

    My original PCP sent me to a pain management clinic. I moved a few miles and ended up changing PCPs but stayed with the pain clinic. The first PCP stated clearly that he did not prescribe opiates, but the second one does not have that policy, that is why I am now working on going back and getting my CT/MRI records because that is his policy before prescribing them.


    Quote Quoting Dogmatique
    View Post
    You have a different regular doctor? Why was he not treating you for pain?

    Perhaps more to the point, how did you end up going to the clinic for pain meds rather than your doctor?

  8. #8
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    Default Re: Pain Contract Question After Being Discharged

    Your PCP can get your records very easily - all it needs is your signature. Bear in mind that if you actually want a copy yourself, the original provider is allowed to charge you.

    What I'm seeing here though, is that at least one of the physicians involved believes you're drug-seeking. Whether you are or not really isn't the point - if they think you've displayed certain habits associated with drug-seeking they're within their rights to discontinue treatment.

    It was correct to refer you to the pain clinic. Ideally though, the clinic (no matter who was treating you) would use multiple modes of therapy. You were a patient at the clinic continuously, yes? Was it your PCP or the pain clinic prescribing (or not prescribing)?

  9. #9
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    Default Re: Pain Contract Question After Being Discharged

    Pain clinic was prescribing then not. Certainly they are allowed to cut me off and discharge, but they must follow some sort of procedure and discharge protocol, because in the end I had withdrawal symptoms that did last some time. That is why I am bit angry, they may be at some fault, and this is what I'm trying to find out.

  10. #10
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    Default Re: Pain Contract Question After Being Discharged

    Here's how things are done in WA:

    A physician can - to put it bluntly - abandon you for virtually any reason other than blatant illegal discrimination or other civil rights issues. Non-compliance, having huge bills, suspected drug-seeking, all of these are valid reasons.

    So next it's protocol. 30 days notice in writing is the norm, and they are generally required to provide you with urgent or emergency care in the meantime. Unfortunately for many pain patients, inadequate pain relief doesn't fall under either of those categories. If there is such a letter in your file, it's assumed that you received one in the mail. CRRR is common sense, but again not legally required. They should - but are not legally required to - have a face to face meeting with you.

    They can also tell you that they'll be happy to keep you as a patient, but will not prescribe opiates. While coming off opiates cold turkey is not a happy experience, it's also not considered life-threatening by any means.

    One thing is for sure - no physician is obliged to wean you off of narcotics before they "fire" you.

    With that said, you're of course free to file a complaint here: http://www.doh.wa.gov/LicensesPermit...Complaint.aspx

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