I thought of that as I read this story from the New York Times about emergency room doctors who prescribe opioids to known addicts:
But, as one of my colleagues whom I greatly respect said to me in the emergency room recently: “Why wouldn’t I give patients a Percocet prescription? It makes their life easier and my life easier.” Another colleague overhead this and wholeheartedly agreed, speaking truth to the fact that the system is set up so that refusing these demands is much more difficult and time-consuming than it is to simply give in to them.What is this doctor's solution to her problem (and to mine)?
What makes absolute sense in medicine is the furthest thing from reality in education. The words from West Point's Cadet Prayer come back to me: Make us to choose the harder right instead of the easier wrong.But the truth is, a deep cultural shift within our health care system is needed. Physicians need to know that if they don’t prescribe a narcotic because it’s not clinically indicated, or worse yet, because the patient already has an addiction problem, that they have the backing of administrators at every level, from their own department to the head of the hospital all the way up to state officials. If patients are seeking narcotics and have a documented history of doing so — and become combative or refuse to leave after discharge — they may need to be escorted out of the emergency room by security and their treatment terminated to avoid interrupting the care of other patients.What my patient said to me that Saturday morning is right: We health care providers created the problem. Now it’s up to us to take steps to try to solve it.