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Link Posted: 9/27/2016 5:29:01 PM EDT
[#1]
You aren't over reacting. Nuts to that guy. You are a potential patient he is making money from seeing, not a parolee or something. Let the free market do it's thing on his business.
Link Posted: 9/27/2016 5:35:06 PM EDT
[#2]
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Just to check, is this a piss test to screen for drugs or to check body functions?  I know some of the meds I'm on I have a blood/urine test every 4 to 6 months.  

If it's a drug test, I'd say fuck that noise and go find another doc.
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Went to doc today, they have new policy to piss test EVERY patient who is on or might get on ANY medication.  And they want it in advance before they even seat you in a patient room, even if you don't know whether the doc will prescribe you anything.

This doc is in an upscale area, not the hood.  I put up with this shit for 12 years in the Army, being treated as a criminal.  Not doing it.  It is humiliating and degrading, especially at a private doc.

Am I overreacting?


Just to check, is this a piss test to screen for drugs or to check body functions?  I know some of the meds I'm on I have a blood/urine test every 4 to 6 months.  

If it's a drug test, I'd say fuck that noise and go find another doc.


The most sensible response so far.
Link Posted: 9/27/2016 5:37:02 PM EDT
[#3]
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Test to see what drugs I am on, and to see if I am taking what they actually prescribed to me.  Front desk girl couldn't give a coherent explanation, just kept saying it was to screen for drug abuse.

I wanted to cross-examine her on it, but she didn't create the policy.

I refused to piss, got to see doc anyway.  
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Am I overreacting?


Yeah, but that's fun to do sometimes. Is it just a test for dope? Or pre-screen for the beetus, kidney problems, etc.?


Test to see what drugs I am on, and to see if I am taking what they actually prescribed to me.  Front desk girl couldn't give a coherent explanation, just kept saying it was to screen for drug abuse.

I wanted to cross-examine her on it, but she didn't create the policy.

I refused to piss, got to see doc anyway.  


What did he say about it?
Link Posted: 9/27/2016 5:39:30 PM EDT
[#4]
I'm going to pretend he has my interest at heart

I know it's not always true but pissing once a year is pretty standard for labs and physicals.
Link Posted: 9/27/2016 5:45:09 PM EDT
[#5]
Link Posted: 9/27/2016 5:51:36 PM EDT
[#6]
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I saw a guy come in for a refill of an ungodly number of pain pills, like 540 tabs of morphine IR and 360 morphine SR. His urine drug screen was negative.

He was fired from the practice that day.
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They claim it is to make sure I am not abusing prescription drugs.  I said, so the piss test tells you if I am actually taking the drugs you prescribed?  "Yes."  So what if I am, you prescribed them??  "" was the only response I got.



I saw a guy come in for a refill of an ungodly number of pain pills, like 540 tabs of morphine IR and 360 morphine SR. His urine drug screen was negative.

He was fired from the practice that day.


It's to make sure you're taking your medication  and your body is   getting the proper proper dosage. And as far as narcotics it's to make sure you're taking them and not selling
Link Posted: 9/27/2016 5:54:29 PM EDT
[#7]
Link Posted: 9/27/2016 5:58:47 PM EDT
[#8]
PT typical for pain management. Yes, they are testing for levels of the drugs your are prescribed. If you are going for some other reason that is not connected to prescriptions of a controlled substance then the test is highly suspect (unless, as mentioned, they are testing for some other levels based on your symptoms [see below])

Getting back to OP, you cannot decide what is medically necessary without seeing the doctor first. Requiring a test to see the doctor sounds highly suspect unless we are missing part of the narrative.
Link Posted: 9/27/2016 6:00:49 PM EDT
[#9]
Yeah, whatever. Find out what your insurance is paying out for that? And find out who's testing it and who's getting paid.
Link Posted: 9/27/2016 6:16:56 PM EDT
[#10]
I can understand it for narcotic type drugs (understand it, not agree with it, thanks 'War on Drugs'), but just to get in there to see the doc sounds screwy.
Link Posted: 9/27/2016 6:21:20 PM EDT
[#11]
Doc has figured out a way to make money from your insurance company for you pissing in a bottle.  Simple.  Follow the money.
Link Posted: 9/27/2016 6:27:55 PM EDT
[#12]
Sounds like the Dr's rest rooms are going to have a lot of piss on the floor, walls, all over the toilet, sink, toilet paper, paper towels.
Link Posted: 9/27/2016 7:04:46 PM EDT
[#13]
Take a few drops of bleach, liquid dish soap, ammonia, salt, or something like that with you and squirt it into the sample...it will completely screw up the assay.   A trick convicts used was to dip their finger in bleach prior to the test, then pee over the dried bleach.  That way they could not be dinged for failure to submit to drug testing, but the test was worthless. I do not know if testing has advanced enough nowadays that they can get decent results even with contamination like mentioned above.
Link Posted: 9/27/2016 8:09:02 PM EDT
[#14]
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My wife has to take urine tests for her pain management doctor to ensure she has drugs in her system and she's not selling them.
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So does my wife. The problem is now it is every visit instead of every other or every third. Insurance will only cover a certain amount per year then it is all out of pocket.
Link Posted: 9/27/2016 9:10:07 PM EDT
[#15]
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Its becoming more common.


Just one more thing that the druggies have fucked up for the decent folks.


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You mean the idiotic war on drugs and over reaching, unconstitutional agencies?
Link Posted: 9/27/2016 9:12:29 PM EDT
[#16]
Money to be made in the lab business if you own your own lab.  Not like it was prior to 1/16...but if you're a PCP group with multiple offices/doctors/mid-levels...that lab testing easily turns into a few hundred per day.  Every day.
Link Posted: 9/27/2016 9:15:45 PM EDT
[#17]
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Money to be made in the lab business if you own your own lab.  Not like it was prior to 1/16...but if you're a PCP group with multiple offices/doctors/mid-levels...that lab testing easily turns into a few hundred per day.  Every day.
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I really feel pity for people who need to resort to do that.

I honestly hope that's not the case.
Link Posted: 9/27/2016 9:18:02 PM EDT
[#18]
I have no issues with this.
Link Posted: 9/27/2016 9:23:21 PM EDT
[#19]
The "upcharging" and "bundling" racket.

Bundling groups of useless procedures that are not at all necessary in order to charge insurance companies more money.

You go in for one minor, seemingly obvious thing... then "we have to run some tests, some more tests, we need urine, etc."

What was a simple $100 visit is now a $600 visit.
Link Posted: 9/27/2016 9:24:22 PM EDT
[#20]
piss test is typically for people on pain meds
Link Posted: 9/27/2016 9:26:28 PM EDT
[#21]
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I really feel pity for people who need to resort to do that.

I honestly hope that's not the case.
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Money to be made in the lab business if you own your own lab.  Not like it was prior to 1/16...but if you're a PCP group with multiple offices/doctors/mid-levels...that lab testing easily turns into a few hundred per day.  Every day.

I really feel pity for people who need to resort to do that.

I honestly hope that's not the case.


You have no idea.  No idea at all.  I promise you I am writing a book when I retire.

Now post a pic of that sweet Land Cruiser.  
Link Posted: 9/27/2016 9:27:55 PM EDT
[#22]
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The "upcharging" and "bundling" racket.

Bundling groups of useless procedures that are not at all necessary in order to charge insurance companies more money.

You go in for one minor, seemingly obvious thing... then "we have to run some tests, some more tests, we need urine, etc."

What was a simple $100 visit is now a $600 visit.
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You're using that word in the wrong context.  But yes, it's all about CPT codes and raising the level of the encounter.
Link Posted: 9/27/2016 9:28:29 PM EDT
[#23]
blame their over prescribing Opiates....

the FDA and State Med Boards are cracking down.
Link Posted: 9/27/2016 9:29:27 PM EDT
[#24]
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Hhmm...
I have never heard of such a thing
If I had to stand around and wait for all you morans to pee before I saw you, I would never see an end to the day
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+1

The only drug testing I've done was if it was mandatory.
Link Posted: 9/27/2016 9:35:24 PM EDT
[#25]

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Oh bull shit.



This nanny state mentality makes me want to puke.



Back when I was on the clock the boss decided he wanted to start drug testing. I told him he better start looking for employees cause about half the shop would tell him to fuck off. None of us took drugs. We don't take shit, either.

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Ma Man!



I wouldn't take a drug test, either. Sure, 99.9% of the time the test is reliable. But what if that 1/1000 false positive is you? It's not like they take a B sample for appeal later!



 
Link Posted: 9/27/2016 9:40:24 PM EDT
[#26]
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Because of the illegal market in opioids and the abuse potential, if you prescribe that stuff you are essentially part of federal and state monitoring programs, if it gets back to you that somehow the drugs that you prescribed, even if you meant to do it in good faith, have gotten abused or on the illegal market, you could get fined or lose your license.

It's why many people refuse to prescribe them anymore and just punt them to pain specialists who routinely deal in this nonsense.

You can thank the war on drugs for that.
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+1

It's actually gotten ridiculous what they're asking us to do.  I hate to break it to them, but I've never prescribes Heroin or Fentanyl powder.  That's all from Mexico.
Link Posted: 9/27/2016 9:40:25 PM EDT
[#27]
Same here man!
Link Posted: 9/27/2016 9:43:04 PM EDT
[#28]
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I have no issues with this.
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Interesting.  Why not?  Specifically, what information are you looking for from teh drug screen and what would you use that information for?
Link Posted: 9/27/2016 9:45:33 PM EDT
[#29]
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They claim it is to make sure I am not abusing prescription drugs.  I said, so the piss test tells you if I am actually taking the drugs you prescribed?  "Yes."  So what if I am, you prescribed them??  "" was the only response I got.
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My wife was getting norcos for years. PA said she needed a pee test. Okay, yeah we know the law changed. They knew up front insurance was not going to cover it, since it was not medically necessary? They sent the urine sample to some fancy lab for a total out of pocket cost of $850. Wife raised hell got it reduced to $100. Seriously?  $850?  For a drug screen?  

Link Posted: 9/27/2016 9:46:46 PM EDT
[#30]
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I went to a neurologist.  Not for pain, but for numbness.  I am on no pain killers.

She said it was law to drug test patients randomly and that illegal drugs affect her diagnosis.

I thought the law bullshit was bullshit since I wasn't on pain medication, nor was I prescribed any.  

But the need to establish whether illegal drugs were causing a problem, I figured was reasonable.

But after the third test, in 4 visits, none showing illegal drugs and Vitamin B-12 being the only "prescription", I was kind of done.

I may find another neurologist.

One time, the lab wanted to charge me $3000.00.  I don't know what happened to that.

Make sure they give you an upfront cost.
 
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Went to doc today, they have new policy to piss test EVERY patient who is on or might get on ANY medication.  And they want it in advance before they even seat you in a patient room, even if you don't know whether the doc will prescribe you anything.

This doc is in an upscale area, not the hood.  I put up with this shit for 12 years in the Army, being treated as a criminal.  Not doing it.  It is humiliating and degrading, especially at a private doc.

Am I overreacting?
I went to a neurologist.  Not for pain, but for numbness.  I am on no pain killers.

She said it was law to drug test patients randomly and that illegal drugs affect her diagnosis.

I thought the law bullshit was bullshit since I wasn't on pain medication, nor was I prescribed any.  

But the need to establish whether illegal drugs were causing a problem, I figured was reasonable.

But after the third test, in 4 visits, none showing illegal drugs and Vitamin B-12 being the only "prescription", I was kind of done.

I may find another neurologist.

One time, the lab wanted to charge me $3000.00.  I don't know what happened to that.

Make sure they give you an upfront cost.
 


$850 for my wife. Got it reduced to $100.
Link Posted: 9/27/2016 9:47:05 PM EDT
[#31]
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My doctor is cool as fuck.  I'd laugh in his face if he asked to piss test me for no reason.  

ETA:  I'd love to know how the insurer feels about all that unnecessary lab work?
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I hate to break it to you but most testing is unnecessary.  It's lazy doctors who don't want to take the time and effort to get a good history and physical on a patient and use testing as a (poor) substitute.  My partner sees 40% more patients than I do but orders 7 times more testing.
Link Posted: 9/27/2016 9:49:54 PM EDT
[#32]
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They either got in trouble, are following state regulations, or both.

I'm predicting in the future most doctors will stop prescribing pain medications altogether because it's not worth the risk and hassle
.
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No it isn't a new thing, OP.

No one that I know in a regular practice does such a thing.  Docs that prescribe narcotics may do it to make sure you are taking the medications as prescribed (lots of people have a side business of selling their narcotics and they will have a negative result on the urine test).

Maybe the doc you saw got into some trouble for prescribing meds and is covering their ass?


They either got in trouble, are following state regulations, or both.

I'm predicting in the future most doctors will stop prescribing pain medications altogether because it's not worth the risk and hassle
.


NH went full retard last year with Schedule II opiates.  I haven't prescribed it for any new patients since then.  I can't lose my license because that punishes all my other patients and it's not fair to them.  I have certified many medical marijuana applications since they are low risk to my license.

Link Posted: 9/27/2016 9:56:14 PM EDT
[#33]
It's part of obamas war on doctors where they don't bother the addicts because they are noble victims and instead punish the doctors.  This is to cover their asses, or the doctor has a stake in the lab.
Link Posted: 9/27/2016 9:57:33 PM EDT
[#34]
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NH went full retard last year with Schedule II opiates.  I haven't prescribed it for any new patients since then.  I can't lose my license because that punishes all my other patients and it's not fair to them.  I have certified many medical marijuana applications since they are low risk to my license.

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No it isn't a new thing, OP.

No one that I know in a regular practice does such a thing.  Docs that prescribe narcotics may do it to make sure you are taking the medications as prescribed (lots of people have a side business of selling their narcotics and they will have a negative result on the urine test).

Maybe the doc you saw got into some trouble for prescribing meds and is covering their ass?


They either got in trouble, are following state regulations, or both.

I'm predicting in the future most doctors will stop prescribing pain medications altogether because it's not worth the risk and hassle
.


NH went full retard last year with Schedule II opiates.  I haven't prescribed it for any new patients since then.  I can't lose my license because that punishes all my other patients and it's not fair to them.  I have certified many medical marijuana applications since they are low risk to my license.



Is $850 reasonable for a drug profile urine test?
Link Posted: 9/27/2016 10:18:52 PM EDT
[#35]
Link Posted: 9/27/2016 10:47:32 PM EDT
[#36]


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Is $850 reasonable for a drug profile urine test?


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Quoted:


No it isn't a new thing, OP.





No one that I know in a regular practice does such a thing.  Docs that prescribe narcotics may do it to make sure you are taking the medications as prescribed (lots of people have a side business of selling their narcotics and they will have a negative result on the urine test).





Maybe the doc you saw got into some trouble for prescribing meds and is covering their ass?








They either got in trouble, are following state regulations, or both.





I'm predicting in the future most doctors will stop prescribing pain medications altogether because it's not worth the risk and hassle
.






NH went full retard last year with Schedule II opiates.  I haven't prescribed it for any new patients since then.  I can't lose my license because that punishes all my other patients and it's not fair to them.  I have certified many medical marijuana applications since they are low risk to my license.











Is $850 reasonable for a drug profile urine test?


No, but they'll charge you that anyway
 



12 panel insta-cups are $3
Link Posted: 9/27/2016 10:57:06 PM EDT
[#37]
Or he has a brain and a penis!  

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You're either overreacting or have something to hide.
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Went to doc today, they have new policy to piss test EVERY patient who is on or might get on ANY medication.  And they want it in advance before they even seat you in a patient room, even if you don't know whether the doc will prescribe you anything.

This doc is in an upscale area, not the hood.  I put up with this shit for 12 years in the Army, being treated as a criminal.  Not doing it.  It is humiliating and degrading, especially at a private doc.

Am I overreacting?



You're either overreacting or have something to hide.

Link Posted: 9/27/2016 10:58:38 PM EDT
[#38]
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They claim it is to make sure I am not abusing prescription drugs.  I said, so the piss test tells you if I am actually taking the drugs you prescribed?  "Yes."  So what if I am, you prescribed them??  "" was the only response I got.
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It's to guard against "patients" from visiting more than one MD and harvesting prescriptions for opioids and such.
Link Posted: 9/27/2016 11:03:23 PM EDT
[#39]
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They claim it is to make sure I am not abusing prescription drugs.  I said, so the piss test tells you if I am actually taking the drugs you prescribed?  "Yes."  So what if I am, you prescribed them??  "" was the only response I got.
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I am a doctor, and though I don't deal with patients on narcotics, the current emphasis on controlling the use of narcotics means the doctors will do urine tests to make sure that the patient who is prescribed narcotics is actually taking them (as opposed to selling them to someone else). They may also want to know if you are getting narcotics from another doctor and using them, before they write you a(nother) prescription for narcotics.

I think some may also test family members to see if THEY are taking the drugs. A lot of this comes from state licensing boards and DEA pressure to crack down on prescription drug abuse, especially with the oxycontin epidemic in full swing.

No doctor wants to get sideways with the DEA or state licensing boards.
Link Posted: 9/27/2016 11:04:11 PM EDT
[#40]
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No, but they'll charge you that anyway  

12 panel insta-cups are $3
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No it isn't a new thing, OP.

No one that I know in a regular practice does such a thing.  Docs that prescribe narcotics may do it to make sure you are taking the medications as prescribed (lots of people have a side business of selling their narcotics and they will have a negative result on the urine test).

Maybe the doc you saw got into some trouble for prescribing meds and is covering their ass?


They either got in trouble, are following state regulations, or both.

I'm predicting in the future most doctors will stop prescribing pain medications altogether because it's not worth the risk and hassle
.


NH went full retard last year with Schedule II opiates.  I haven't prescribed it for any new patients since then.  I can't lose my license because that punishes all my other patients and it's not fair to them.  I have certified many medical marijuana applications since they are low risk to my license.



Is $850 reasonable for a drug profile urine test?
No, but they'll charge you that anyway  

12 panel insta-cups are $3


The cup alone was $100. Srsly.  They sent it to a lab for exact readings.
Link Posted: 9/27/2016 11:08:30 PM EDT
[#41]
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If you are paying via insurance, or if this doctor accepts insurance and bills this out, then it is lacking medical necessity and is potentially deniable.  Ask the office if they accept medicare or medicaid and if they do this to those patients.  If they say yes...then inform them you will report them to RAC and see if RAC wants to come perform an audit for non-medically necessary tests being charged to Medicare/Medicaid.

ETA:  Here's the link, report the doctor here on the cell phone right in front of him and watch the hilarity ensue.  When RAC comes in, they comb through the past 7y of medical records looking for improper payments and perform a takeback (literally taking money out of the doctor office's bank account) for anything they find.  https://www.cms.gov/research-statistics-data-and-systems/monitoring-programs/medicare-ffs-compliance-programs/recovery-audit-program/
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Your legal theory is interesting. However, if CMS, DEA, and FDA and state licensing boards are cracking down on prescription drug abuse, and suggesting this testing be done to prevent prescription drug abuse, I doubt that they are going to prosecute said doctors for fraud. There are a lot of tests that are not 'medically necessary' that get ordered and I bet billed, not for the benefit of the patient, but for the benefit of society.

Go ahead and do this. Maybe you can get a qui tam cut from any fine or penalty. Or maybe your doctor will kick you out of his practice.
Link Posted: 9/27/2016 11:09:25 PM EDT
[#42]
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If you're not, who is?
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They claim it is to make sure I am not abusing prescription drugs.  I said, so the piss test tells you if I am actually taking the drugs you prescribed?  "Yes."  So what if I am, you prescribed them??  "" was the only response I got.


If you're not, who is?


BINGO! We have a winner. You are breaking the code.
Link Posted: 9/27/2016 11:12:06 PM EDT
[#43]
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I saw a guy come in for a refill of an ungodly number of pain pills, like 540 tabs of morphine IR and 360 morphine SR. His urine drug screen was negative.

He was fired from the practice that day.
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They claim it is to make sure I am not abusing prescription drugs.  I said, so the piss test tells you if I am actually taking the drugs you prescribed?  "Yes."  So what if I am, you prescribed them??  "" was the only response I got.



I saw a guy come in for a refill of an ungodly number of pain pills, like 540 tabs of morphine IR and 360 morphine SR. His urine drug screen was negative.

He was fired from the practice that day.



And some people wonder why doctors treat patients like adversaries.
Link Posted: 9/27/2016 11:12:54 PM EDT
[#44]
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Just put the cup on the sink and step 3ft back and piss "in the cup".

Then take to the nurse and hand it to her hot and wet and say "hey, some asshole pissed all over your bathroom".

After the third or fourth visit they may not ask you for a urine sample.

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Probably won't be a third or fourth visit.
Link Posted: 9/27/2016 11:15:29 PM EDT
[#45]
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Is $850 reasonable for a drug profile urine test?
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No it isn't a new thing, OP.

No one that I know in a regular practice does such a thing.  Docs that prescribe narcotics may do it to make sure you are taking the medications as prescribed (lots of people have a side business of selling their narcotics and they will have a negative result on the urine test).

Maybe the doc you saw got into some trouble for prescribing meds and is covering their ass?


They either got in trouble, are following state regulations, or both.

I'm predicting in the future most doctors will stop prescribing pain medications altogether because it's not worth the risk and hassle
.


NH went full retard last year with Schedule II opiates.  I haven't prescribed it for any new patients since then.  I can't lose my license because that punishes all my other patients and it's not fair to them.  I have certified many medical marijuana applications since they are low risk to my license.



Is $850 reasonable for a drug profile urine test?


IIRC, the ones mandated here cost about $150 and must be done per state law every 3 months.  A lot of patients can't afford that.

Link Posted: 9/27/2016 11:15:45 PM EDT
[#46]
Nobody will be meat gazing when you piss, so who gives a fuck?
Link Posted: 9/27/2016 11:17:26 PM EDT
[#47]
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Then I will tell doc to either find new med-mal provider or find new patients, because I am finding new doc.
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Might be requirement for his malpractice insurance?  So if a drug seeking patient ODs their survivors or the DEA can't claim he is just prescribing pills unethically or criminally.  




Then I will tell doc to either find new med-mal provider or find new patients, because I am finding new doc.


How many medical malpractice insurance companies do you think there are, at this point in time, in the US?

I suspect your doctor will be happy to move on to the next patient on the waiting list. Don't take it personally.
Link Posted: 9/27/2016 11:19:15 PM EDT
[#48]
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And if they find weed or heroin in my piss, are they gonna call the cops?

Luckily, I said I would take it up with doc, and doc decided not to prescribe me anything, so it was not an issue -- this time.

Damn, I was angry.  I felt like that Louisiana redneck on YouTube who keeps getting arrested for DUI on his lawn tractor.  "Ah know mah RIGHTS!!!"
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They claim it is to make sure I am not abusing prescription drugs.  I said, so the piss test tells you if I am actually taking the drugs you prescribed?  "Yes."  So what if I am, you prescribed them??  "" was the only response I got.


If you're not, who is?


And if they find weed or heroin in my piss, are they gonna call the cops?

Luckily, I said I would take it up with doc, and doc decided not to prescribe me anything, so it was not an issue -- this time.

Damn, I was angry.  I felt like that Louisiana redneck on YouTube who keeps getting arrested for DUI on his lawn tractor.  "Ah know mah RIGHTS!!!"


They won't call the cops, but they might elect not to prescribe anything stronger than naprosyn for your pain.
Link Posted: 9/27/2016 11:21:58 PM EDT
[#49]
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Good luck finding it anywhere for sale, but codeine cough syrup is schedule 5 and technically over the counter if you sign a log book. I went looking back when I was in medical school and couldn't afford a doctor's appointment. I was unable to find any pharmacy who would sell it OTC even though it was legal.
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The one thing that really pisses me off is that more and more doctors are refusing to prescribe codeine syrup when you are clearly not a junkie and clearly have a dry, rasping cough that's keeping you up all night.  I fucking hate having a cough and there is absolutely nothing OTC that works.


Good luck finding it anywhere for sale, but codeine cough syrup is schedule 5 and technically over the counter if you sign a log book. I went looking back when I was in medical school and couldn't afford a doctor's appointment. I was unable to find any pharmacy who would sell it OTC even though it was legal.


Their pharmacy, their rules. There is not a lot of profit in selling codeine, so no particular incentive to stock it, and comes with hassles. Meh.
Link Posted: 9/27/2016 11:23:11 PM EDT
[#50]
I get piss-tested for work, as a precondition for renewing my medical card, randomly whenever my name is drawn from a random list at work, and twice a year when I see my doctor about my diabetes management. I hate to do it, but it's part of the game I have to play.

What irritated me not long ago was when I handed over the specimen cup to a new nursing tech. She informed me that I was going to fill up all of the little cups for her out of the big cup, and I could find myself some gloves, if I thought I needed them. I merely glared at her, shook my head, and set the cup down in front of her as I walked back to the waiting room. I have only one job, to pee in the cup and to not flush when I'm done.
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