Day: 04/05/2015

Cannabis Churches

http://www.cannalawblog.com/cannabis-churches/

Seeing an opportunity, the First Church of Cannabis, Inc., was granted approval last week by the Indiana secretary of state to organize as a religious corporation. In its certificate of incorporation, it lists cannabis as a sacrament…

http://www.peyoteway.org/

Church membership is open to all races. We encourage individuals to create their own rituals as they become acquainted with the great mystery. We believe that the Holy Sacrament Peyote, when taken according to our sacramental procedure and combined with a holistic lifestyle (see Word of Wisdom), can lead an individual toward a more spiritual life.

Peyote is currently listed as a controlled substance and its religious use is protected by Federal law only for Native American members of the Native American Church. Non-Indian Peyote use is protected in five states : AZ, NM, CO, NV, and OR. We do not have access to Peyote where it grows in South Texas and Mexico. As it is an endangered species, we believe an essential and inseparable part of our religious practice is the growing and stewardship of the Holy Sacrament Peyote…

Wikipedia:  …peyote (/pəˈjoʊti/) is a small, spineless cactus with psychoactive alkaloids, particularly mescaline. The English common name peyote comes from the like-spelled Spanish name, which in turn comes from the Nahuatl name peyōtl /ˈpejoːt͡ɬ/, said to be derived from a root meaning “glisten” or “glistening”. Native North Americans are likely to have used peyote, often for spiritual purposes, for at least 5,500 years…

War on pill mills: Maura Healey targets rogue doctors fueling opioid abuse

http://www.pharmaciststeve.com/?p=9982

http://www.bostonherald.com/news_opinion/local_coverage/2015/04/

war_on_pill_mills_maura_healey_targets_rogue_doctors_fueling

Calling it one “prong” of her plan to fight the opioid epidemic, Healey has ordered several of her top lieutenants to cull through Medicaid databases and chase tips of doctors and clinics dishing out powerful painkillers “willy-nilly.”

Only focusing on the poor people with Medicaid, huh?  The ones that can’t fight back?  When it’s actually the middle-class white people you should be looking at, along with doctors prescribing pain meds to their family members and friends.  That’s where most of the diversion is happening.

And isn’t it the State Medical Board’s job to go after rouge doctors and pill mills?

Healey’s crackdown comes as state police yesterday reported nearly 220 suspected fatal overdoses in just the first three months of this year — a death toll that doesn’t include Boston, Springfield and Worcester. The state Department of Public Health previously reported 978 overdose deaths related to opioids in Massachusetts in 2013, up from 668 the previous year.

Population of Massachusetts:  6.7 million (2014)

Gov. Charlie Baker has also assembled an opioid task force to address the emergency, with a public meeting planned for today at the State House…

Healey is also calling for the state to beef up its Prescription Monitoring Program…

Yeah, because federal funds are basically endless to support the blacklisting of pain patients via the PDMPs.

But Healey emphasized that “this is not an attack on doctors.”

Too late.  Doctors have and will continue to stop prescribing the drugs on the DEA’s hit list, leaving pain patients without any options for treatment.  As livingonchi (in Massachusetts) mentioned in an earlier comment, she had to wait a year to get an appointment with a pain clinic — only to be told, after that year was up, that they had no record of her appointment.

Under comments:

Paul Rae · Top Commenter · Umass amherst

Punyamurtula Kishore goes on trial Monday; it’s only been 3 1/2 years after all since Martha Coakley closed down his non-narcotic treatment clinics (52 of them). Gee, what’s happened since then? Ruined the guy’s life on a bunch of phoney charges. Hundreds of OD deaths since. Will the Herald bother covering that?

Terri Anderson · Top Commenter

The Attorney General is targeting the wrong doctors. She should go after interventional pain physicians who are harming back pain patients on a grand scale. Preventable medical error is now the 3rd leading cause of death – not to mention a major player in driving up patient pain. Check out the July 2014 U.S. Senate hearing chaired by Senator Bernie Sanders (Vermont). Interventional “pain” docs are driving up the need for opioid consumption instead of solving the back pain dilemma in the U.S., which is a leading cause of disability: http://missoulian.com/lifestyles/hometowns/ravalli-county-residents-take-epidural-warning-to-fda/article_b45c9d85-c265-5f16-a6b2-31adeb21f053.html

Pain Care is Legal
Do a google search for Attorney General Maura Healey and you will find her campaign website for her AG campaign, which quite nicely contains her facebook and twitter accounts. Please, I encourage all of you pain sufferers, to be sure to drop by and say hello to her 🙂

It’s at times like this that I wish I had a facebook account.

So, let’s look at the suicide rates in Massachusetts, shall we?

Click to access suicide-update-spring2014.pdf

In 2011, there were 588 suicides that occurred in Massachusetts; a rate of 8.9/100,000 persons. The number of suicides was 2.9 times higher than homicides…

During the period of 2003-2011, approximately 4,500 persons died of suicide in Massachusetts. Suicide rates increased an average of 4% per year. The overall increase was 35%; from 6.6 to
8.9. There were 164 more suicides in 2011 than in 2003.

The increase in suicide rates was primarily among White, non-Hispanic males whose rates increased an average of 5% per year between 2003 and 2011…

In 2011, suicide methods varied by sex. For males, suffocation/hanging (N=217) and firearm (N=110) were the most common methods used. For females, the leading methods were poisoning (N=69) and suffocation/hanging (N=56).

http://www.masslive.com/news/index.ssf/2014/12/rash_of_suicides_plagues_nantu_1.html

https://www.wbur.org/2014/09/18/massachusetts-national-guard-suicide

But in the last two years, eight of Radke’s fellow Massachusetts National Guardsmen — including one of his friends — completed the act of suicide. That’s a significant increase from five suicides over the previous nine years…

http://www.enterprisenews.com/article/20141027/NEWS/141026876/12145/NEWS

Suicide at Plymouth jail highlights alarming problem in Massachusetts prisons

http://web.mit.edu/~sdavies/www/mit-suicides/

MIT had the highest suicide rate: 10.2 per 100,000 undergraduate and graduate students.

8/29/2011, New pain-management rules leave patients hurting

http://www.seattletimes.com/seattle-news/new-pain-management-rules-leave-patients-hurting/

Denis Murphy’s last doctor got suspicious when he saw him sitting in a restaurant. Murphy, 72, who contracted a painful nerve disorder after a case of shingles, had told the doctor his condition is so painful he often has to stand up. At his next appointment, the doctor accused him of flimflamming him: making up a story to score narcotic pain relievers…

Murphy, a retired IRS pension-plan examiner and manager from Edmonds, was humiliated. Now, he has a new doctor and a new prescription — but also a growing fear that he could suddenly lose the only relief he’s found in six years. Then, he worries, he’ll find himself back in the throes of pain he describes as “a blowtorch to my testicles.” He has reason to worry.

Over the last several months, an effort in Washington to curb a steep rise in prescription-drug overdose deaths — the most ambitious crackdown in the nation — has prompted a number of doctors and clinics to stop taking new chronic-pain patients on opiates, and in some cases to cut off current pain patients…

“A lot of it is because other providers have stopped doing it,” said Dr. Peter McGough, chief medical officer for UW Medicine’s Neighborhood Clinics. “I think there’s been a fair amount of patient abandonment going on.”

Dr. Carl Olden, head of the family practitioners’ group, said pain-management specialists in Yakima are overwhelmed with pain patients, particularly those on Medicaid, who say their primary-care doctors no longer prescribe the meds they seek.

Linda Van De Bogart, 62, an Eastern Washington resident who has an often-painful genetic defect called Ehlers-Danlos Syndrome, as well as ADD, has been on pain meds for 25 years.

But after being dismissed by her doctor when she and her husband had fallen behind on their clinic bills, she’s had no success finding a new provider after calling dozens of doctors and clinics, she says…

Across the state, more than half of those who died were patients on Medicaid, according to state figures, and the most common pain drug was methadone, increasingly prescribed for Medicaid patients after the state restricted other medications…

Voices of pain patients on drug tests and abandonment

http://www.dailystrength.org/c/Chronic_Pain/forum/18977479-dr-abandonment-no-meds

(6/2/2014)  Before they took me back for the test, I asked the doc about refilling my meds. after a bit of waiting the nurse walks in and says ” the doctor won’t refill your medication because your last urine test showed positive for THC”. I am not stupid, I know that THC is in weed, and I don’t use it in any shape or form… neither do I have any friends that use it. I immediately asked to be restested, right then and there. my contract says that I have a right to retest before they stop medicines, or incur disciplinary actions… the nurse then said “Well since you are about to have surgery anyway, you would have to go through your neurosurgeon for them anyway” I said “My neurosurgeon only does those kind of meds during or after surgery in the post op period. even if he scheduled surgery today, that may not be for weeks? what do I do in the meantime?” She then said “Sorry, we won’t refill them… (she then smiled ear to ear) ok be back in for you in a moment for your procedure!”

So I went to the ER, and the ER doctor said it was patient abandonment, and did a blood drug test on me… and surprise! clean as a whistle. The ER doctor gave me some medication to tide me over, and I see the new pain management doctor on thursday….but the agony I have endured since tuesday has been barbaric. Needless to say I am pursuing a legal case against the other doctor…

Reply #6 – 06/02/14 1:56pm:  ” My aunt runs a hospital lab so I hear all kinds of mix-up stories…not necessarily on the lab side but the office side as well. A number of things can happen that can result in your test not yielding accurate results which is probably why they have in the contract it can be retested before disciplinary action. Is this a stand-alone office or are they affiliated with a hospital? If they are affiliated with a hospital or medical system, my suggestion is you contact the ombudsman/patient advocate office and state this doctor’s office is breaching the contract and it is resulting in patient abandonment, illegal under common law. Case law supports that, in many cases, even 30-day notice is not generally permissible under common law (but this can be a gray area).

If that isn’t possible or doesn’t yield any results, I suggest going to your state medical board and filing a complaint on breach of contract and patient abandonment. As Aronia alluded to, a legal case may not yield the most tangible results. Even medical board complaints solely related to effective pain treatment are few and far between. I think you have a better chance of receiving a resolution if you bring up the breach of contract and patient abandonment angles. 

Reply #9 – 06/03/14 2:48am:  Anyhow after two weeks in the hospital my pcp dr said when we did your ursine test when you were first admitted you had methadone & methamphetamine’s in your system!

I said Hell No! I told him the last time I had taken methadone for pain was back around 04 and you couldn’t pay me enough to take it again. I was almost hysterical by this point I asked him what methamphetamine’s were. I had no idea & said I sure as hell didn’t take any. I said did you double check the test meaning take a second sample he said ahh no I didn’t. I told him I demanded that it be taken off my record. I told him I had a pain contract & would never do anything to jeopardize it I respect my pm Dr to much & myself. I said I don’t lie about my meds nor would I screw with them. I honestly didn’t know what methamphetamine’s were. It turns out the night before I had taken NyQuil liquid caps. We got the ones from behind the pharmacy counter & these can cause a false positive of methamphetamine’s. I looked up MN law regarding drug testing & it said if someone tests positive for what I did it was mandatory to do a second test. Not only did he break the law it’s also still on my record.

Redefining… DENIAL OF CARE ?

http://www.pharmaciststeve.com/?p=9978

According to the Daily Caller, the National Institute on Drug Abuse (NIDA) issued a revised report for the month of April, stating, “recent animal studies have shown that marijuana can kill certain cancer cells and reduce the size of others. Evidence from one animal study suggests that extracts from whole-plant marijuana can shrink one of the most serious types of brain tumors. Research in mice showed that these extracts, when used with radiation, increased the cancer-killing effects of the radiation.”

While one government agency is admitting the benefits of marijuana in medical treatments, the Justice Department is pushing forward with prosecuting medical marijuana users…

Why it’s so hard to find a pain doctor (Virginia)

Virginia Board of Medicine (2009)

All prescribers are encouraged to use the Prescription Monitoring Program (PMP) to access
information about patients for whom you prescribe or anticipate prescribing. Patient consent is
no longer required to access the data; however your patient must be informed that you might
check their data…

The Ryan Haight Online Pharmacy Consumer Protection Act is the name of federal law that was
enacted on October 15, 2008; it amended the Controlled Substances Act to better prevent the
illegal distribution of controlled substances over the Internet…

If you treat a licensed healthcare provider for mental disorders, chemical dependency or
alcoholism, you must report the individual to the respective licensing board unless you have reason to believe that individual is competent to continue in practice or would not
constitute a danger to self or to others…

Board Decisions

Summary suspension – continued practice is a substantial danger to the public health and safety based on allegations of multiple patient cases of abandonment; failure to maintain timely, complete patient records; failure to provide medical records to patients or other practitioners; failure to provide notice to patients of office closure; failure to properly dispose of controlled substance medications…

Reprimand and complete HPIP program based on patient abandonment and inability to practice with reasonable skill and safety due to mental or physical illness or substance abuse…

Reprimand based on patient abandonment due to no documented notice to patients allowing a reasonable time to obtain other OT services…

Indefinite probation; license subject to terms and conditions based on threatening harm to self and others; patient abandonment and failure to provide continuity of care…

Reprimand; license subject to terms and conditions based on multiple patient cases of failure to obtain adequate patient histories; document chronic pain treatment plans; authorizing medication renewals without medical indication; failure to require patients to enter into a Pain Management Agreement; continuing to write narcotic prescriptions for pain despite
signs of narcotic pain medication abuse…

Revocation of license based on inability to practice with reasonable skill and safety due to substance abuse; failure to record comprehensive exams, document treatment plans and rationale, explore alternative treatments and monitor effects of medication in one patient case for treatment of chronic pain…

Surrender for Suspension based on inappropriate prescribing of controlled substances via the internet outside a bona fide practitioner-patient relationship in multiple cases; prescribing controlled substances without proper documentation; prescribing to a family member outside a bona fide practitioner-patient relationship; and multiple patient cases of improper prescribing for treatment of chronic pain.

Reprimand; license subject to terms and conditions based on improper treatment and prescribing of opioids in two chronic pain patient cases…

Continued on suspension based on improper care and treatment of multiple pain management patient cases to include inadequate medical recordkeeping; authorizing renewals of medications with no examination; failure to consistently require a pain management contract; failure to enforce pain management contracts; allowing patients to direct and manage their own treatment; failure to change or end initiated narcotic therapy regimens when adverse reactions and/or overmedication were reported by the patient or family members, some resulting in patient deaths; and inappropriately prescribing a medication only approved for breakthrough cancer pain to patients with chronic pain, fibromyalgia pain symptoms, or headaches.

Indefinite suspension of license based on failure to obtain medical and substance abuse histories, perform comprehensive examinations/diagnostic tests and improper medical recordkeeping in multiple long term care patients and chronic pain patients; improper prescribing of controlled substances for pain medications and weight loss medications; and prescribing controlled substances for a family member to divert for her personal and unauthorized use.

Suspension of license based on multiple patient cases of prescribing controlled substances without obtaining patient histories, performing appropriate physical exams, failing to document treatment plans for chronic pain management, failure to review or assess patients’ progress, authorizing renewals with no examinations or medical indications to justify the renewals, improper medical record documentation and failure to enforce Pain Management Agreements.

Reinstatement denied based on failure to provide proof of compliance with the suspension Order entered 07/20/05 regarding patient notification; submitting false or misleading statements on the reinstatement application; and inappropriate prescribing and treatment of multiple chronic pain patients and improper recordkeeping.

Permanently restricted from providing chronic pain management services; indefinite probation with terms and conditions based on failure to properly manage chronic pain treatment in multiple patient cases; prescribing Phentermine for weight reduction without documentation of medical history, physical exam and monitoring; failure to communicate with other medical practitioners to coordinate care; providing medical care to staff without maintaining complete medical records; and failure to maintain proper inventory/documentation of controlled substances.

Reprimand; license subject to terms and conditions based on inappropriate prescribing of narcotic medications for treatment of chronic pain in one patient case.

Permanent surrender of license for revocation based on guilty pleas in the US District Court for the Western District of Virginia, Danville, VA, to one felony count of Illegally Distributing a Schedule II Controlled Substance and one felony count of Illegally Distributing a Schedule III Controlled Substance.

Surrender for suspension based on writing fraudulent prescriptions to obtain Vicodin for personal use on multiple occasions and inability to practice with reasonable skill or safety due to illness and/or substance abuse.

Surrender of license for indefinite suspension based on larceny of blank prescriptions forms; forgery of prescriptions in order to obtain Schedule II-IV controlled substances for personal use…

Reprimand and $10,000 monetary penalty based on prescribing Schedule VI controlled substances via the Internet and outside a bona-fide practitioner-patient relationship for multiple individuals.

Indefinite probation; license subject to terms and conditions based on prescribing Schedule II & III controlled substances in one patient case for pain management without proper monitoring and proper response to misuse of other medications; failure to obtain/document a complete history or obtain records from other treating physicians; failure to perform a physical examination; inadequate record keeping; failure to enforce the patient’s pain management contract; failure to decrease the pain management dosage; and failure to have a clear understanding of a physician’s role to provide pain management treatment.

There are more, but I think you get the idea.  I’m sure the records for every state’s Medical Board look similar.

NM Medical Board, Meeting on 11/21/2013

Click to access minutesNov2013.pdf

New Mexico Medical Board

Fourth Quarter Meeting

November 21-22, 2013

Recommendations made regarding mandatory participation in the NM Monitored Treatment Program… violations of the Medical Practice Act and advisory letters reminding physicians of the Board’s Regulations on prescribing controlled substances for chronic pain… conduct likely to harm the public, patient abandonment…

John Thayer of the NM Monitored Treatment Program was present to discuss the status of mandatory MTP participants…

Dr. Jenkusky informed the board that at the last meeting of the American Psychiatric Association the Board of Trustees approved a policy statement saying that there is no justifiable, scientific reason for the use of any medical marijuana… Ms. Hart concluded by stating that the legislation is egregious in this regard, and that she hopes it will be defeated.

(Ha, instead, PTSD was approved as a qualifying condition, and Ms. Hart was recently fired.)

https://painkills2.wordpress.com/2015/02/05/because-i-cant-sleep/

https://painkills2.wordpress.com/2015/02/05/medical-board-mum-on-directors-ouster/

Mr. Rubin reported that there were 4 pending requests for public documents…

(Let’s see, what kind of public documents from the Medical Board would chronic pain patients be interested in seeing?)

Dr. Jenkusky informed the Board that Senator Udall would like to put forth legislation in regard to the overuse of opioids… The bill would direct the Human Services Department to provide grants for states to enhance their PMP programs…

Lorena Rodriguez, Diversion Investigator for the Drug Enforcement Administration presented the Board with an overview…  

Untreated Chronic Pain is Acute Pain

http://doctordeluca.com/wordpress/archive/why-untreated-chronic-pain-is-a-medical-emergency/

Cannon describes how adrenalin, “Liberated Normally in Fear, Rage, Asphyxia and Pain,” a reflex response to pain and major emotion, leads to hyperglycemia necessary “for putting forth supreme muscular efforts,” and to vascular changes that shunt blood away from vital organs in the gastrointestinal and urinary system in order that “the ‘tripod of life’ – the heart, lungs and brain (as well as the skeletal muscles) – are, in times of excitement… abundantly supplied with blood…”

In a New York Times Magazine article in 2001, Dr. Daniel Carr, director of the New England Medical Center, put it this way:

“Some of my patients are on the border of human life. Chronic pain is like water damage to a house – if it goes on long enough, the house collapses,” [sighs Dr. Carr] “By the time most patients make their way to a pain clinic, it’s very late. What the majority of doctors see in a chronic-pain patient is an overwhelming, off-putting ruin: a ruined body and a ruined life.”

Following our discussion in the preceding section, the medical consequences of untreated pain are legion. In addition to the direct morbidity of pain induced physiologic stress, including chronic hypertension, ischemic cardiac disease, renal insufficiency, stroke, and gastrointestinal bleeding, we must also consider often profound decrements in family and occupational functioning, and iatrogenic morbidity consequent to the very common mis-identification of pain patient as drug seeker. The overall deleterious effect of chronic pain on an individual’s existence and outlook is so overwhelming that it cannot be overstated. The risk of death by suicide is more than doubled in chronic pain patients, relative to national rates…

What happens to patients denied needed pharmacological pain relief is well documented. For example, morbidity and mortality resulting from the high incidence of moderate to severe postoperative pain continues to be a major problem despite an array of available advanced analgesic technology.[6] In a study of pain following hip fracture, undertreated pain was demonstrated to significantly increase the risk of delirium…

One very important reason that untreated pain is a medical emergency, particularly in the United States, has nothing to do with neuropathology or cardiovascular complications or even the current state of the medical art. Chronic pain patients are routinely treated as a special class of patient, often with severely restricted liberties – prevented from consulting multiple physicians and using multiple pharmacies as they might please, for example, and in many cases have little say in what treatment modalities or which medications will be used…

It is well known that chronic pain can result in anxiety, depression and reduced quality of life. Recent evidence indicates that chronic pain is associated with a specific cognitive deficit, which may impact everyday behavior especially in risky, emotionally laden, situations.[19] The areas involved include the prefrontal cortex and the thalamus, the part of the brain especially involved with cognition and emotions, and it is these same areas that were found in 2004 to undergo striking atrophy in chronic back pain patients, compared to normal controls…

Pain Contracts: “Cooperation” or Coercion?

http://www.veteransformedicalmarijuana.org/content/pain-contracts-cooperation-or-coercion

These “contracts” are not legitimate, legally-binding contracts. They are essentially one-sided demands from your doctor, signed under duress, which treat you as a suspect in advance, rob you of your privacy and your right to be an active participant in your own health care and your rights to accept or refuse treatments, and allow the physician to renege on his moral and ethical duty to treat you with a pseudo-legal agreement that you signed with the moral equivalent of a gun pointed at your head.

To understand the nature of the gun pointed at your head, you have to understand the concept of “duress.”  Under contract law in most states and common law countries, a contract is unenforceable if it is signed under duress…

You do not have to be a lawyer to realize that narcotics contracts very clearly meet the definition of duress. They enable your doctor, who is in a position of power, to take advantage of you by not only refusing medical care at will, but forcing you to undergo any and all treatments he recommends or be tortured…

Voices of pain patients on abandonment

http://www.wisegeek.com/what-is-patient-abandonment.htm

anon947561:  I was not aware my doctor was going on vacation. I called for an appointment and was told by the receptionist that he was on vacation. I asked what I should do as I am on several narcotics and will go into withdrawal. She said I always call late “like I can just come in anytime” and the covering doctor was full.

I asked again what I could do (I usually call a week ahead because I do not have anyone to drive me. If I make the appointment when I leave a visit I worry if my back is so bad I may have to cancel). This woman is so nasty. I called the next day again because I called several walk-in urgent clinics and they said they wouldn’t deal with this. She repeated I could not be helped.

I asked about the N.P. as I could make the methadone stretch and she replied “she can’t prescribe any medications that are narcotic.” I feel this is patient abandonment as she had said the doctor I see would be back in two weeks. She said she wouldn’t give me anything until three days after he gets back. This is absurd. I have gotten appointments the same day for severe nausea and once for severe pain. I don’t know what to do. Thanks for any help.

anon337898:  I am a patient with chronic pain. My doctor treated me for about four years, then I moved to Florida for two years, but I moved back and the doctor has been treating me for two years, so a total of about six years, on and off.

The doctor has been prescribing pain medication (yes, controlled substances). I have many medical conditions including: fibromyalgia, degenerative arthritis throughout my body including my back, knees, ankles and neck. I have carpal tunnel in both hands, neuropathy, bulging discs (four of them) bone spurs in my shoulders, back and feet. I also have a leaky heart valve, lordosis of the neck, scoliosis and other things.

This is what happened to me: A pharmacy decided I should not be taking two different narcotics together and refused to fill my script. They called my doctor and she decided not to fill that script again. In fact, she decided I need to go to pain management and she cannot treat me anymore. I already tried pain management four years ago and have gone through two years of physical therapy with no help for the pain. Controlled substances are the only things that help me to be able to even get out of bed and want to live.

What do I do now? I have not seen anyone other than my doctor, and I have only taken what she prescribed. The pharmacy treated me like a junkie. My doctor now treats me like I am a bad person. Is this doctor abandonment? The doctor did say they will give me one more prescription for pain medication and that is it.

Also, you should know that I do not have insurance, but I do not owe the doctor anything and I have always paid her what I owe her. Anyone who wants to answer this or give me some advice, please respond here. You should also know that I called three pain management clinics in my area and they do not accept cash patients. Now what do I do? I am afraid if I go through withdrawals I will have a heart attack since I do have heart problems and honestly I don’t want to live if I have to live in pain.

http://www.medhelp.org/posts/Pain-Management/What-if-your-doctor-refuses-to-talk-to-you/show/1105511

When I went to refill my RX for Norco my doctor refused it. They will not answer my calls and I guess I no longer have a doctor…

http://www.bluelight.org/vb/archive/index.php/t-591364.html?s=2f10f85f93969d5442f65c62468bafb8

(2011) In the South Puget Sound area, a University of Washington Medicine neighborhood clinic stopped taking new chronic-pain patients on opiates about two months ago, after patients flooded in, saying their doctors had cut them off.

“A lot of it is because other providers have stopped doing it,” said Dr. Peter McGough, chief medical officer for UW Medicine’s Neighborhood Clinics. “I think there’s been a fair amount of patient abandonment going on.”

Patient Abandonment

https://edsinfo.wordpress.com/2015/04/05/patient-abandonment-rules-not-for-pain-patients/#comment-3266

http://www.alllaw.com/articles/nolo/medical-malpractice/negligent-doctor-abandon-patient.html

A doctor’s abandonment of a patient who is in need of care can give rise to a medical malpractice lawsuit. This article discusses the applicable laws, as well as how patients must prove their medical malpractice cases when they have been harmed by a doctor’s failure to treat.

Abandonment in Emergency Situations

If a patient arrives at a hospital in the midst of an emergency health issue, federal law requires the hospital to treat the patient, regardless of the patient’s ability to pay and other factors such as the patient’s citizenship or immigration status. This law is called the Emergency Medical Treatment and Active Labor Act.

According to the act, when the patient arrives at the ER or urgent care center, the hospital must determine whether the patient’s condition constitutes an emergency. If it does, the hospital must make all reasonable efforts to stabilize the patient. If a hospital fails to comply with the act, the patient may sue the hospital for both the monetary equivalent of the harm caused by the failure, and for an additional penalty of up to $50,000…

Transfer Without Proper Instruction

Once a doctor initiates treatment of a patient, the doctor must not only terminate care at a proper time, but also in a proper manner. If a doctor transfers a patient to the care of a second doctor, the second doctor may not be familiar with crucial details of a patient’s care. So, the first doctor has an ongoing obligation to provide the second doctor with proper instructions and all relevant records (treatment notes, test results, etc.). Failure to do so could rise to the level of medical malpractice.

Patient’s Failure to Pay

A doctor cannot terminate care of a patient when the patient is at a critical stage of treatment, solely because the patient is unable to pay for the care. However, if the patient is in a stable condition and is given ample warning of the termination, a doctor may be able to stop treatment. For example, in a 1989 case in Iowa called Surgical Consultants, P.C. v. Ball, a patient had gastric bypass surgery and suffered abscesses afterwards. She sought treatment from the operating physician, who saw her 11 times post-surgery but then refused to continue seeing her because she had not paid her bill. This was not considered abandonment because the patient was not considered to be at a critical stage of treatment…

http://www.ncbi.nlm.nih.gov/pubmed/20034249

When physicians fire patients: avoiding patient “abandonment” lawsuits. (Nov. 2009)

Abstract
While patients have the unfettered ability to fire their physicians at any time, physicians can end their relationships with patients only after giving them reasonable notice and an opportunity to find another physician. Physicians who fail to take these steps may expose themselves to lawsuits for the tort of “patient abandonment.” This article examines what circumstances may lead to a cause of action for the tort of”patient abandonment” under Oklahoma law. In addition, this article discusses the American Medical Association’s (AMA) guidelines on terminating the physician-patient relationship and recommended practices by legal scholars.

Taos broadband network nearly done, but what’s the cost?

http://www.santafenewmexican.com/news/local_news/taos-broadband-network-nearly-done-but-what-s-the-cost/article_08d47beb-85e1-5456-8a9a-9e06669dadb8.html

TAOS — Right now, residents of Las Vegas, N.M., can get 20 megabits-per-second Internet service for $69.95 a month. If you live in northeastern Oklahoma, the same price will get you a 50 mbps connection. And folks in central Missouri are actually looking at 100 mbps service for 10 bucks cheaper. But if you want access to Kit Carson Electric Cooperative’s brand-new fiber network at your house, $69.95 a month gets you 10 mbps.

“That sounds a little high to me,” said Sharon Strover, a professor in the College of Communication at the University of Texas at Austin and an expert in rural broadband policy, when told about Kit Carson’s advertised cost of $199.95 for 20 mbps for business access. “On the face of it, $200 doesn’t sound very good.”

By comparison, the same download speed in Las Vegas, N.M., is $70 from Plateau Telecommunications and $80 from Guadalupe Valley Electric Co-op in relatively rural central Texas…

A few years back, Kit Carson was among a batch of awardees that got generous grant and loan packages under the federal stimulus program to expand superfast Internet to places for-profit companies were unlikely to approach. The co-op got a $45 million grant and $19 million loan to bring fiber-optic service to every customer it serves…

While its prices may still seem steep, the new fiber network appears to be impacting for-profit competition already. CenturyLink, for instance, is offering the fastest speeds it can give a customer for $29.95 a month for 12 months. But CenturyLink’s DSL network is limited, and doesn’t extend very far into less populated parts of the county…