Wednesday, January 3, 2018

OB/GYNs on opioid amendments: "excessive and unrealistic"

Local gynecologists and obstetricians opposed the "opioid amendments" approved by the Mississippi Board of Medical Licensure last month.  Posted below are letters from the Mississippi Section of the American Congress of Obstetricians and Gynecologists and Jackson Healthcare for Women submitted to the Board in October.  The two letters are short and sweet but they show what the medical community serving women in Mississippi thinks of these proposed regulations. 


Kingfish note: The "7-day rule" that is referred to in the Jackson Healthcare for Women letter was changed to ten days.  Doctors are allowed give a ten-day prescription for opioids for acute non-cancer/non-terminal pain and a a refill prescription for an additional ten days.  The original proposal set the prescription term at seven days each.

It is no surprise the doctors are screaming against these regs since law enforcement is attempting to dictate health care policy.  Cops trying to play doctor, what could possibly go wrong?

These letters were obtained through a public records request.  Notice how none of these letters have appeared in the media.  If not for this site, they would have fallen into a dark bureaucratic hole.  

Earlier posts
Medical Board releases approved opioid amendments 
 Irresponsible!  Orthopedic surgeons oppose opioid regs
 Bomgar on opioids: We have a death problem, not a prescription problem.
 
"Stop the nonsense. Talk to real doctors." (Letters)
 It would be nice if we could do this behind closed doors.
 Medical Board approves opioid regs with little notice. 

  Never let a good crisis go to waste.  
 Board of Medical Licensure calls meeting yesterday to discuss opioid regs tomorrow.
State Health Officer warns of unintended consequences    
 Doctors on proposed opioid regs: "dangerous", "Ill-conceived", "idiots" (Letters) 
  How much pain will proposed opioid regs create for doctors?  (Regs analyzed)
Can medical weed fight opioids?  
 Opioids prescription: Mo' taxes, mo' spending, mo' jail (Gov.'s task force report)




22 comments:

Anonymous said...

The media was complicit is whipping up the hysteria and complicit in hiding the whole truth from the public.

Kingfish said...

Bomgar approached the CL reporter after he made his remarks at the November hearing. He definitely brought up an angle no one else had that day. She said she had already turned in her story for deadline. She never contacted him about a followup.

Anonymous said...

Everyone needs to recall that Easterling's original efforts were to restrict prescriptions for opioids to only THREE DAYS.

There is a reason why Republicans are losing so many PR battles.

Anonymous said...

KF, were any JFP reporters present?

Kingfish said...

Nope. November hearing, MPB, CL, MT, et moi were present. Just MPB, Mississippi Matters, CL, and yours truly were present at the December one.

Tired Doc said...

The GYN and Orthopedic specialties and even Dr. Currier, our State Medical Officer, have gone on record as opposed to Kim Jong Easterling's idiocy. Getting a PMP on all my new patient's even if I don"t Rx a controlled drug?? Drug screening patients with pain from an acute injury?? Not being able to write pain meds for a patient who legitimately requires chronic benzo meds?

Easterling's control freaks have dreamed up a set of rules that do little to address the acute problem, hamstring the health care providers with outrageous amounts of useless time consuming paperwork, burdening our patients with $100 drug screens (not covered by insurance) even when it is blatantly inappropriate, and will result in the net effect of harming patient care.

People with chronic non-cancer pain will have 3 choices: suffer, go to the street, or commit suicide. Most docs are NOT going to write pain meds because they don't want to deal with the CME (150 hrs each year of opiate continuing ed), paperwork hassles or they are afraid the MSBML Gestapo will come get them in the night.

The state medical association as well as the specialty groups need to grow a pair and stand up for us docs and for our patients by going on record (as did our State Health Officer, Dr. Currier) opposing the new rules. Limiting opiates is fine (I only Rx judiciously), but making it essentially impossible is wrong. The common sense approach would have been for the MSBML to monitor the docs and the patients that are outliers and deal with the problem directly.

Anonymous said...

Here we go AGAIN! Legislating behavior, I can't stand this! Where's the personal responsibility arguments of NOT becoming "hooked!?" You can hardly find a good nasal decongestant now, do to the methheads and now, people with terrible, chronic pain, will find it damn near impossible to have any relief, for the actions of some idiots! I'm so sick of this and like I said about the cold medicines, this will only affect the law abiding! The lawless are indeed LAWLESS and will find a way to get these prescribed drugs!

Kingfish said...

That is because Easterling and Charmane are joined at the hip.

Go ahead Connor, send me another stupid email.

Anonymous said...

Close physician acquaintance told me Sunday night that Marshall Fisher is behind all of this and is trying to criminalize physicians in order to bypass the Legislature. She said if these regs go through there will be a wave of medical community voters who otherwise wouldn't vote for AG Hood for Gov now voting for AG Hood for Gov.

Anonymous said...

Why do you say AG Hood is against these measures? He will get to vote on them by the Occupational Licensing Board. My bet is Phil votes for them (since they are from his Opiod Task Force), Delbert votes against (I'm sure his son will give him an ear full), and Jim makes the decision.

If he votes for them, he will stand with prosecutors and law enforcement and appear tough on crime. If he votes against them, he will appease the Docs but be soft on crime.

Tough decision for Jim.

Anonymous said...

I ask again, what is the appeals process for this rule? A lawsuit and injunction by the doctors? Legislature could overrule with new laws I guess but that is a longer term fix.

Anonymous said...

Ten days of a script at a time? Why not? Anyone who needs to continue a controlled opioid pain med for longer than ten days should be checked out. Maybe legit - if so, in the docs opinion, they can provide a renewal. Hell, nobody is bitching about the limits on Viagria scripts that require a docs approval for a refill.

Much of this "chronic pain" is hidden addiction, or at a minimum a desire to live in lala land. Some deal with this with a bottle of Kettle1, others with oxy. But normal folks take an advil and deal with getting older.

Also, bitching about rules that folks haven't bothered to read (not counting many of the docs on here who probably have read them as regards their practice, but certainly not all of the armchair docs --- including KF) is piling on because of whoever it is they don't like. Marshall Fisher. Phil Bryant. Randy Easterling. Whoever. Frankly,I don't give a damn; have three or four oxys in the drawer that were prescribed at different times - root canal, minor surgery - that I never wanted or took. Maybe I ought to advertise them here on JJ and see what I get offered.

Albert Schweitzer, M.D. said...

Hygiene is the corruption of medicine by morality. It is impossible to find a hygienist who does not debase his theory of the healthful with a theory of the virtuous. ... The aim of medicine is surely not to make men virtuous; it is to safeguard them from the consequences of their vices.

H. L. Mencken

We are in the grips of a buffoon wannabe politician who is at best a hygenist. Before he, and others, hobble honest patients by this idiocy, we should take a few steps back and question
A. How many are affected? And what are the consequences of their addiction? Dr. Currier has indicated we have abuse problems, but not a greatly increased fatality problem.
B Of those addicted, how many are recidivists? After withdrawal? After treatment programs? What percentage will relapse and continue their addictions?
C. The costs to the rest, the great majority who are not addicted? Not only in less ability to be treated appropriately, but also from the drug infrastructure-the addicts who steal and murder to pay for their addition? It seems that owing money to a drug dealer is far more dangerous than most things, as they will gladly kill in order to enforce their "street cred".

Sure, these are dangerous drugs-the federal stamp for narcotics used to be handled by the BNDD-the bureau of narcotics and dangerous drugs. But like so many other dangerous things, it is not that aspect that is important. It is the fact that they work. They make pain more tolerable.
D. In light of these questions, the overall question of the value of potential addicts? Not saying I believe this, but in fact has history shown that their costs are worth their salvation? Would Charles Darwin agree? We must come to the realization that so many other factors, in such distant past of these addicts (who are generally told that once they are addicted they cannot become clean-just watch the weak chinned, crop failure bearded person in blue scrubs with a stethescope around his neck, who proclaims this; his intent to enroll patients into an expensive treatment program).
Does personal integrity still exist, or are we becoming a nation of dependent victims?




Dr. Currier and the obstetricians have shown the best sense and judgement.
We would all do well to listen closely.

Anonymous said...

I'm not sure what is meant by 'outliers'. Can you clarify please.

"The common sense approach would have been for the MSBML to monitor the docs and the patients that are outliers and deal with the problem directly."

Anonymous said...

Those doctors that write you 90 Norco 10s for a headache or 2mg of Xanax three times a day cause fluffy dies. Does that help?

Anonymous said...

Not my post, but I see outliers as junkies and doctors who overprescribe. Punish them, not the entire profession along with their patients,

Anonymous said...

The social cost of long term pain drugs and Xanex like drugs is many of the people that take them check out of life. I hate to say it but in my decades of employing 100's of people, most of the barely get by folks who just don't seem to care about putting anything away or getting ahead are on these drugs. They work enough to make some money, are not reliable and sometimes don't seem to be all there. I pay 20-25 an hour as they have to have skills to work for me but the scragglers can not imagine getting through life without their drugs. When you see vast areas of people living like crap in run down housing although they appear to make ok money, drugs, alcohol and tobacco are feasted upon.

Anonymous said...

No one seems to have mentioned that not all patients should be treated like potential drug addicts.
My ob-gyn knows me and knows my family and that we are functional. She knows I'm over 70 years old and that I have an IQ in triple digits.
The odds that I would abuse any drug and could become addicted are zero. I'd have done it by now.
That I would be treated as if a life of accomplishment, making good decisions and being honorable counts for nothing... that I have earned no respect, is more than a little irritating.
Should I encounter any member of this board, I will treat them as if they are risks to society. I hope all of you will do the same.
If they come into your business,treat them as potential criminals. They could be shop lifters or vandals. Do check every bill, even a dollar,that they hand you to make sure it's not counterfeit. I wouldn't take their checks without calling the bank to see if they have sufficient funds. I wouldn't let anyone ride in a car with them as they may be drunk drivers or molesters. I certainly wouldn't darken their doorstep for fear they would suddenly become violent.
In short, treat them as they are treating us. Expect the worst of them regardless of whatever their life history may be.

Anonymous said...

We have, as a society, continued to attempt to use the nuclear option in response to single, individual and often isolated issues.

If it saves just one life....

Do it for the children....

The children and elderly need to be protected....

The social cost....

Kingfish said...

All right, no doxxing.

Anonymous said...

She knows I'm over 70 years old and that I have an IQ in triple digits.

Meaning you are only normal or average though your braggadocio quotient is indeed off the charts.

Anonymous said...

Lawmakers need to stay in their lanes and not crossover into doctors' lanes.



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