Not all doctors are smart

[PWMDMD]

I prefer very old PCP doctors. They are very agreeable, and give you whatever medicines you need without you having to fight with them about prescribing you something as simple as an anti-biotic or cholesterol/high blood pressure medicine.
But the younger doctors don't want to give you any medicine, they are too cautious. Going to younger doctors is like: give them your money and they spend the whole visit telling you why you should'nt get any medicine.

Also, if you've ever had surgery or a broken bone, and are in verifyable severe pain, the older doctors will give you pain medicine, but the younger ones say: "Just take Tylenol".

Legitimately prescribed opioids are the start of addiction for many people too often. When I trained I was taught that everyone had a right to excellent pain management and that I was a bad dentist if I did not provide this service. This idea was based in part on flawed research that showed people prescribed opioids for short durations were at no greater risk for addiction than the general population. Turns out this is not true and that there are a significant number of people whose addiction starts with short-duration opioids prescribed for legitimate purposes.

I'm not advocating people live for long periods of time in excruciating pain but the idea that we as humans are never going to have to endure short periods of moderate pain in life is not realistic. There's also a lot of research that shows ibuprofen alternating with acetaminophen is more effective for short-term pain than opioids. Some of the old guys are just old dogs who don't want to learn new tricks but that doesn't make them right.

 

[Bill7]

Tylenol is pain medicine.

LOL. The point I was trying to make was that some doctors know they can't get themselves in trouble by recommending an over the counter pain medicine like Tylenol or Iebuprofen for any diagnosed and verified pain situation. If I was a doctor, perhaps I would be the same way. Why stick your neck out on a limb if you don't have to. But if you're the patient and are in severe pain, the over the counter pain medicine is likely not going to stop the pain.

 

[PWMDMD]

LOL. The point I was trying to make was that some doctors know they can't get themselves in trouble by recommending an over the counter pain medicine like Tylenol or Iebuprofen for any diagnosed and verified pain situation. If I was a doctor, perhaps I would be the same way. Why stick your neck out on a limb if you don't have to. But if you're the patient and are in severe pain, the over the counter pain medicine is likely not going to stop the pain.

The non-stop drug seekers are exhausting...

My PCP tells patients right from the start he doesn't have a controlled substance license and that he is unable to prescribe narcotics and if that's a problem he's not the guy for you. This stemmed from years of calls in the middle of the night from patients claiming pain just to not show up in the office the next day.

 

[Bill7]

Legitimately prescribed opioids are the start of addiction for many people too often. When I trained I was taught that everyone had a right to excellent pain management and that I was a bad dentist if I did not provide this service. This idea was based in part on flawed research that showed people prescribed opioids for short durations were at no greater risk for addiction than the general population. Turns out this is not true and that there are a significant number of people whose addiction starts with short-duration opioids prescribed for legitimate purposes.

I'm not advocating people live for long periods of time in excruciating pain but the idea that we as humans are never going to have to endure short periods of moderate pain in life is not realistic. There's also a lot of research that shows ibuprofen alternating with acetaminophen is more effective for short-term pain than opioids. Some of the old guys are just old dogs who don't want to learn new tricks but that doesn't make them right.

My wife went to a dentist who left her in severe pain where it might have been warranted to give her a 1 to 2 day dose of something stronger. The Iebuprofin/Tylenol wasn't sufficient. She couldn't sleep, was up all night in agony, and suffice it to say we never went back to that dentist again.

Most states have implemented electronic pharmacy records available to doctors so doctors can see the medical history. I agree with you, if a patient has a record of a lot of pain prescriptions, it's a bad idea to give them more. But if they had maybe 1 small pain prescription in the last 10 years, it would be an indication that this person should be considered for such medication if the pain warrants it.

 

[PWMDMD]

My wife went to a dentist who left her in severe pain where it might have been warranted to give her a 1 to 2 day dose of something stronger. The Iebuprofin/Tylenol wasn't sufficient. She couldn't sleep, was up all night in agony, and suffice it to say we never went back to that dentist again.

It's very likely a narcotic wouldn't have controlled her pain either - there is pain for which no pill will be sufficient to control it. That sucks, but as I said the idea that we will never feel pain is unrealistic. I'm also not saying there's no place for narcotics, but they should be very judiciously used. That line of when to prescribe is very dependent on each and every prescriber.

 

[Astro14]

Folks, Bob is not the medical guy, so, we aren’t going to debate pain management, or, for that matter, medical care, though I do appreciate the perspective of an actual doctor in this conversation. Lock time.