Just back from follow up with "Pain Management" doc

It has taken me a little while to calm down since returning from this appointment. My only purposes in going today were to FIRE her because she put into my record that I had "High levels" of a pain med that had been legitimately prescribed, as well as a muscle relaxant that had also been legitimately prescribed. Both were noted in her summaries for my prior visits, and she was well aware that I was on these meds.

At the end of this ridiculous visit, I did hand her NURSE my letter telling her that I wanted to terminate our relationship, and that I wanted to terminate the narcotic contract which had never been used.

I also needed my insurance refusal letter back from her for radio-frequency ablation on my c-spine. (She never did write them a letter as she promised to do, to attempt to overturn their negative decision for that procedure)

When I ASKED her why she had written "HIGH LEVELS" in my record, she said "because there were high levels reported" She said, "here, I'll print it out for you" She did, and yellow-highlighted where it said POSITIVE. I said, of course it's positive, you knew I was taking these meds legitimately when I gave you my urine sample!

I said "Why didn't you just write POSITIVE for these meds instead of "HIGH levels"? I said, "don't you know what it infers when you write that" She got angry, told me that today's visit was our last, and that we obviously could not have a working relationship.

Note: I was extremely calm, friendly and cooperative throughout this sham visit. When I asked her for my insurance denial letter back, she said oh, I know I dictated a letter to them last month, let me look on my PHONE. Which she proceeded to do. Of course, she didn't find it, and at this point we were standing at the counter, outside the exam room, and her nurse was really trying to find it on their computer, which of course, she never did.


I didn't notice until I got out to the parking lot that the drug screen from the outside lab had listed under medications: clonazepam. ONLY clonazepam (I have taken this forever, from my neuro for both muscle cramping and migraine rescue. Mind you, only .5 mg twice a day. Plus, I am currently tapering off this nightmare drug because I read up on it. scary stuff.

SHE DIDN'T WRITE IN THE NAME OF THE TWO PRESCRIBED DRUGS THAT SHE WAS SUPPOSEDLY TESTING ME FOR. Naturally, this is going to make it look worse for ME, as if I didn't report that I was prescribed these meds. Shouldn't she have listed ALL controlled substances, especially the opiod????

THANK goodness, I have my records from the prior visits where my medications were documented, at the doses I was taking prior to that urine drug screen. I just couldn't believe my eyes! I called the testing lab, talked to the nicest tech, and he explained that they can AMEND my report if my doctor allows it. (As far as putting the known meds I was taking that day)

HA! She would never but I AM going to go back, when I know who to talk to there, and get my records changed. I have requested a report from my state, spelling out EVERY SINGLE controlled substance that I have been prescribed, and by whom going back 6 years.

This gets worse. The surgeon THERE, (mind you, same practice that did two ACDFs on me 10 years ago) had told me in March I think.. that I had "arthritis" and he's the one who referred me to their pain management doc.

If you have been following this crazy story, you would know that I have been to a NEW spinal orthopedic surgeon (GREAT REPUTATION, GREAT REVIEWS and at a teaching hospital) in the meantime, with the flexion x-rays and MRI reports and scans taken at the original ortho practice.

He looked at them very slowly and carefully and went through them with me, and told me that he was 99% sure of pseudo-arthrosis. That I would probably have to have a major revision surgery if it was confirmed by ct scan. IT WAS. I see him again tomorrow afternoon.

She said, "Well, our surgeon here is very conservative, and your new doctor is not very conservative, and that's probably why he didn't suggest surgery. To top it off, she printed out my visit notes from THEIR surgeon. He actually said IN THOSE NOTES, not the ones I had, that I probably had a pseudo-arthrosis. !!!!OMG

I told her that THEIR flexion xray radiology report didn't even ADDRESS C5/6 where most of the pain is coming from, it only the place where there is still hardware in place, C6/7!! They said "stable" but it is not. She got so mad. My NEW ortho surgeon didn't say much, but he just shook his head when I told him that I had been told I had "arthritis".

I WILL follow up with this practice to clear my record to the best of my ability, and I surely do hope that I am able to do so.

Is there anything else, any advice that you guys have? I just took my dog for a walk, and I am paying for it now. OUCH. Thanks for listening!

My guess is that you're in a pickle. I would not count on your records getting changed. Anything entered in your record is permanent. Even if it were a hand-written report, the most you could expect is a single line drawn through the comment (so it could still be read) with an amendment added.

The basic rule of thumb is if it isn't written in your record, it never happened, it was never said,....or in this case,....that it did.

I applaud your efforts to seek corrections however! My doc has an area at the patient portal specifically designated for whenever a patient sees something inaccurate in their chart that needs to be addressed, and then a confirmation is sent via email.

I would do everything in writing via return-receipt-requested mail, or certified. Sure, doing things in-person makes things swifter, but it doesn't back you up as much as the postal service records and copies of everything YOU write, and everything THEY write.....virtually ALL communications. Include SASE's if you need to. Those post-marked/dated envelopes can serve to your benefit.

I wish you the best of luck, and please let us know how you make out. I'm hoping to learn from your experience. I've had similar things happen to me in the past,.....more like my comments were taken out of context. VERY out of context, and twisted to reflect negatively on me, and thus my chart, my care, my reputation.

Get as much in writing as you possibly can and keep copies. If I think of anything else that may help you out, I'll post. In the meantime,....sincerely wishing you luck on getting this mess straightened out. It seems quite obvious and blatant that mistakes were made, and she's more worried about her notes than your patient-reputation.









M.

Sorry you're going through this.

I quit my PMD two months ago for a lot of reasons.

My PCP of 12 years is writing 90 Norco 10 mg a month until I get back in Pain Management.

I don't think a good Doctor is gonna treat you differently for that.

Good luck with your future Doctor,

Rick

It is not uncommon for doctors to not write down what medications a person is on during these drug tests, but it is uncommon for them to go off the deep end when a person's drug test come back positive for medications they know their patient is on.

The reason doctors do not write down on the drug test application what medications a person is on is so they can see what drugs a person does test positive for instead of just getting back a report that says...Normal.

As has been said odds are that you will not be able to get anything in your medical file changed, but you do have a leg to stand on and that is the records you have that shows where you were prescribed those medications. Be sure to take them with you when you go and see your next doctor and all your doctors and insist they make a copy of them and place it in your chart.

Drs can make corrections in medical records.The problem is getting them to do it.

Talon after 30 years in the medical field and having written millions of notes and notations in medical files I can assure you that they are not corrected nor changed and any amendment must be done with a totally separate document and not on the original. Any corrections must have only one single line drawn through it lightly not obscuring the original entry and the new statement or word written above or below and initialed. Your records are permanent and considered legal documents and must remain in original context and legible should they ever be called into legal dispute.

Any type of edit or erasures are considered fraudulent and admission of error.

That's the way it is and always has been and stands just as true now that many documents have become computerized they still must be transcribed in their original wording and context without corrections and only amendments.

I just found the greatest "scholarly article" on interpreting urine drug testing. It gives the mean, median and ranges for most every drug that is ever tested. I compared my "detected levels" on the drug screen to the values in this article, and they fall below the mean values. That makes me feel better...at least the test looks like it was performed correctly. My biggest issue with this is that the doctor FAILED to write the drugs that I was prescribed on the Lab form!!! I WILL be returning to this office once I have my full rx report from my state. Thanks! Here is the link for this great information:
http://cdn.intechopen.com/pdfs-wm/28113.pdf I hope the link works for you guys. :)