Comments on
Be Heard– Raise the Cap!

By J.T. Junig, MD, PhD

People who read this blog are aware of the shortage of physicians who can …

4 Comments to
Be Heard– Raise the Cap!

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  1. Wouldn’t it make more sense to require a physician to take a course on prescribing addictive pain pills and put a cap on how many patients the Dr. can treat with drugs that are highly addictive? If addiction is an illness, then physicians should be able to treat the illness. There are many illnesses where symptoms are managed by drugs and/or lifestyle changes, but the illness or condition itself has no cure.

    • There are discussions going on about that specific issue, i.e. requiring additional training to prescribe narcotics for pain. The devil’s advocate argument is that prescribing narcotics already requires a special certificate and DEA registration, which is often suspended or revoked in cases where narcotics are misused or inappropriately prescribed. It is hard to conclude that even a month-long course would change dramatically change physician behavior, since the training of physicians is already such a lengthy process that adding a month would be a drop in the bucket. For example, an anesthesiologist who works in a pain clinic has had 4 years of biological study in college, then 2 years of intensive pharmacology/biochem in med school yrs 1 and 2, then 2 years of clinical work in yrs 3 and 4 of med school– often 60 hrs/wk or more… then a year of internship, consisting of 80 or more hours per week of clinical work… then 3 years of anesthesia residency, consisting again of 50-60 hrs/wk of intense clinical work, including working in pain treatment programs. That comes to 6 years of intense clinical work, and 6 years of biological science study. I just don’t know if another course, on top of that, is the answer….. but it will probably be mandated anyway, in response to the current crisis.

  2. Physical pain is no longer tolerated and is avoided by the use of opium derivatives in pill form. This is good news for doctors; most patients are pain suffers who often return for refills. But a competitor has arisen in the form of an unemployed youngster who is offering the same product at a discount. The source of supply for the young drug dealers are patients with medical insurance coverage, they get the pain pills for free and by selling them on the open market their incomes are supplemented. It is a money maker for everybody but doctors whose waiting rooms are now only half full.

    • Your comments would have been accurate 5 yrs ago. Many doctors who used to treat pain using opioids have been shut down; many more have stopped on their own, for fear of prosecution. Heroin has replaced oxycodone in me part of the country.

      As for doctor offices, they will likely remain full, especially in the field of psychiatry. My post has nothing to do with full offices or making money; addiction treatment attracts few new doctors, as it is not a field that will help them pay off their debt any sooner (averages debt is now well over $100,000). My post is about allowing doctors who treat addiction to see more than 100 patients in their practices, to help with the shortage of doctors in many areas who are willing to treat pain pill or heroin addiction.

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