Posted: 3/28/2016 4:51:52 PM EDT
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Fuck You Very Much,
Sincerely, Fish223 If you haven’t yet heard, today marks the first business day of the new regulations regarding prescribing medications in the (formerly) Great State of NY. It started a few years ago, as the narcotic abuse epidemic started to exponentially increase. The powers that be decided to implement a plan to cut down on the access to controlled substances, but, as with many things, there are always unforeseen consequences. I certainly don’t disagree that narcotic use and abuse is out of hand, but this new shit sucks moose balls. The first step was having to run every patients name through the NYS database of controlled substances. This would allow providers to see if a particular patient was filling similar prescriptions from other providers, with the goal of identifying abusers and doctor shoppers. So for each and every patient I wanted to give a script for any narcotic or other controlled substance to, I have to log on to the NYS database, enter the patients demographics, and run a query. It takes me two to three minutes to run the query, for each patient. There are a couple of exceptions to having to run the query, one of which is prescribing 5 or less days worth of medication. So, for the approximately 20-25 patients I see per day that I write a narcotic for, now, they only get 20 pills, and I just saved myself 45-60 minutes of otherwise wasted time each and every day. Next up is the actual e-prescribing which was supposed to go into effect last March, but something like 70% of providers had not integrated the technology by the deadline, and the Princess postponed it for a year. Yea. So there are basically two choices: Use your own practice management software, or contract with a third party that does it for you. If I went third party, my staff has to completely duplicate the data entry of all patients demographics in a separate program. Several minutes each for those same 20-25 patients means a couple of hours of duplicated work, per day, plus the few hundred dollars a month to the third-party software. In perpetuity. So its obviously easier to use the in-house practice management software. The only catch here, is that the software and hardware upgrades necessary for implementing the system was over $13K. There goes the next two family vacations. And I still have to sit down in front of the computer for an extra few minutes on each and every patient. For security purposes, I need to log into the system each and every time. And for controlled substances, after logging in, I need to log in a second time with a 6 digit variable passcode delivered on my smartphone, which changes every 60 seconds. Another 60-90 minutes per day, every day, instead of writing a paper script which takes maybe 30 seconds. To add to this burden, if the pharmacy happens to be out of stock, or closed, I have to do it all again, and specify a different pharmacy. If it happens that I am already gone for the day, patient is screwed until the next business day. Also, many times my patients take a paper script, but don’t fill it unless they need it. Now, the pharmacy has to fill every single one, even if the patient doesn’t actually pick it up or want it. And no more after hours emergencies. I’m not going through this shit on my damn phone via VPN. You need something and I’m closed? Call back tomorrow. Or Monday. Sorry. God forbid the internet or my service provider, or my cell provider goes down, everyone is screwed. In theory, I can then write a conventional prescription, but it is discretionary as to whether or not it will be honored at the pharmacy. There other other implications too, like having your entire prescribing history going forward available in a single state controlled database, instead of just at your local pharmacy., and some other shit that escapes me at the moment, but equally intrusive and unnecessary. Anyway, in summary, FUAC, and all the rest of the NYS lawmakers and politicians who played a role in this burden. |
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Quoted:
Fuck You Very Much, Sincerely, Fish223 If you haven’t yet heard, today marks the first business day of the new regulations regarding prescribing medications in the (formerly) Great State of NY. It started a few years ago, as the narcotic abuse epidemic started to exponentially increase. The powers that be decided to implement a plan to cut down on the access to controlled substances, but, as with many things, there are always unforeseen consequences. I certainly don’t disagree that narcotic use and abuse is out of hand, but this new shit sucks moose balls. The first step was having to run every patients name through the NYS database of controlled substances. This would allow providers to see if a particular patient was filling similar prescriptions from other providers, with the goal of identifying abusers and doctor shoppers. So for each and every patient I wanted to give a script for any narcotic or other controlled substance to, I have to log on to the NYS database, enter the patients demographics, and run a query. It takes me two to three minutes to run the query, for each patient. There are a couple of exceptions to having to run the query, one of which is prescribing 5 or less days worth of medication. So, for the approximately 20-25 patients I see per day that I write a narcotic for, now, they only get 20 pills, and I just saved myself 45-60 minutes of otherwise wasted time each and every day. Next up is the actual e-prescribing which was supposed to go into effect last March, but something like 70% of providers had not integrated the technology by the deadline, and the Princess postponed it for a year. Yea. So there are basically two choices: Use your own practice management software, or contract with a third party that does it for you. If I went third party, my staff has to completely duplicate the data entry of all patients demographics in a separate program. Several minutes each for those same 20-25 patients means a couple of hours of duplicated work, per day, plus the few hundred dollars a month to the third-party software. In perpetuity. So its obviously easier to use the in-house practice management software. The only catch here, is that the software and hardware upgrades necessary for implementing the system was over $13K. There goes the next two family vacations. And I still have to sit down in front of the computer for an extra few minutes on each and every patient. For security purposes, I need to log into the system each and every time. And for controlled substances, after logging in, I need to log in a second time with a 6 digit variable passcode delivered on my smartphone, which changes every 60 seconds. Another 60-90 minutes per day, every day, instead of writing a paper script which takes maybe 30 seconds. To add to this burden, if the pharmacy happens to be out of stock, or closed, I have to do it all again, and specify a different pharmacy. If it happens that I am already gone for the day, patient is screwed until the next business day. Also, many times my patients take a paper script, but don’t fill it unless they need it. Now, the pharmacy has to fill every single one, even if the patient doesn’t actually pick it up or want it. And no more after hours emergencies. I’m not going through this shit on my damn phone via VPN. You need something and I’m closed? Call back tomorrow. Or Monday. Sorry. God forbid the internet or my service provider, or my cell provider goes down, everyone is screwed. In theory, I can then write a conventional prescription, but it is discretionary as to whether or not it will be honored at the pharmacy. There other other implications too, like having your entire prescribing history going forward available in a single state controlled database, instead of just at your local pharmacy., and some other shit that escapes me at the moment, but equally intrusive and unnecessary. Anyway, in summary, FUAC, and all the rest of the NYS lawmakers and politicians who played a role in this burden. Regulating everyone right into a moving van. |
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So with certain prescriptions someone may have to run to the pharmacy every 5 days to refill? For older folks that's gonna be a f-n pain in the arse! Screw cumhole  Dude, it get's better. 5 days is the max for controlled substances if I want to avoid having to query the database first. And, there is NO SUCH THING as refills on a controlled substance. None. So if someone who I gave 5 days to wants a refill, I have to start over from scratch. And there is no fucking way I'm gonna do it because someone calls me at the office. You want more narcotics? Come on in and show me why. If, and only if, you can convince me that 5 days worth is not enough, then I might, if I'm not too busy, query the database, and write you for a maximum of 30 days supply. Which I'm not gonna do. Because it falls outside the usual and customary pattern that I have been doing for years and years. And that triggers a red flag on my DEA number, and that triggers a call from narcotics enforcement, and that is a fucking nightmare that I would not touch for anyone. Because documentation, and auditing, and I'm not even opening up the door for that at all. Nope, Nope, Nope. I have my good name and reputation pristine, and I won't even entertain the thought of opening that particular can of worms. Fuck that. and FUAC, just because. |
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5 day supply and every refill requires another co-pay from the patrient. Maybe the insurance companies are part of this mess too. No additional copay, falls under follow up care and a global fee for all services related to the original service, for 90 days. And, I don't participate with any medical insurance plan, Medicaid, or medicare, so it would not matter to me anyway. I saw the light several years ago, when Obamacare was still just a blip on the radar. |
| My ex who was abusing suboxone film had 3 docs and filled out prescriptions all over the place. One doc was crooked. All behind my back too. I thought they'd clamp down on this ever since the off-duty ATF agent was killed in a robbery of a pharmacy here on LI. (Agent was the brother of a member here) |
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Do you want heroin addicts? Because that's how you get heroin addicts. Quoted:
Do you want heroin addicts? Because that's how you get heroin addicts. meh. dopers gonna dope. Since when have laws made honest people dishonest, or prevented criminals from a life of crime? Quoted:
My ex who was abusing suboxone film had 3 docs and filled out prescriptions all over the place. One doc was crooked. All behind my back too. I thought they'd clamp down on this ever since the off-duty ATF agent was killed in a robbery of a pharmacy here on LI. (Agent was the brother of a member here) Again, while I sympathize with the underlying problem, a crooked doc is gonna be crooked anyway. Now it is several clicks on a computer, but ultimately, the bad guys find a way around the laws, and all it really does is inconvenience the rest of the honest people. We should look to Portugal for a framework for the drug "war". All the other bullshit in the WoD is expensive and useless. Kinda like the unSAFE act. |
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I saw a week or so ago some cunt on tv telling people in pain to take aspirin or ibuprofen if they are in severe pain. I took two Vikadin in 1988 and threw the rest away. Never had any prescription painkillers since, despite 26 broken bones, axe into the tibia, stick through the shin, etc. There are times to tough it out, and given what's happened, sounds like Americans in general need to get a bit tougher. |
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I took two Vikadin in 1988 and threw the rest away. Never had any prescription painkillers since, despite 26 broken bones, axe into the tibia, stick through the shin, etc. There are times to tough it out, and given what's happened, sounds like Americans in general need to get a bit tougher. Quoted:
Quoted:
I saw a week or so ago some cunt on tv telling people in pain to take aspirin or ibuprofen if they are in severe pain. I took two Vikadin in 1988 and threw the rest away. Never had any prescription painkillers since, despite 26 broken bones, axe into the tibia, stick through the shin, etc. There are times to tough it out, and given what's happened, sounds like Americans in general need to get a bit tougher. Some people just have a tendency to get hooked, others don't. Maybe people should be responsible for their actions and stop blaming doctors or anyone else for their addiction. |
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I took two Vikadin in 1988 and threw the rest away. Never had any prescription painkillers since, despite 26 broken bones, axe into the tibia, stick through the shin, etc. There are times to tough it out, and given what's happened, sounds like Americans in general need to get a bit tougher. Quoted:
Quoted:
I saw a week or so ago some cunt on tv telling people in pain to take aspirin or ibuprofen if they are in severe pain. I took two Vikadin in 1988 and threw the rest away. Never had any prescription painkillers since, despite 26 broken bones, axe into the tibia, stick through the shin, etc. There are times to tough it out, and given what's happened, sounds like Americans in general need to get a bit tougher. yep, that's my mo. In the old days I'd take the paper script and simply hold on to it for a few days and see if I could deal with the pain. Most I never filled. In 2 or 3 days often the injury pain had subsided. Other times I took two pill like you and in a week dumped the rest. |
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I see a far more sinister thing happening here. Do you mean having all of your electronic medical records and complete prescribing history available to anyone with access to the system? Do you mean the increased stigmatization of anyone who uses any controlled substance? Do you mean the increased level of control the government has over more and more aspects of our daily lives? Do you mean the possibility of same name misidentification making a medication error possible? Do you mean the added expenses raising associated costs across the board for everyone? Do you mean the ease in which responsible permitted gun owners can be cross-referenced with their health and medications? Because the full implications of EMR and ePrescribing have not even begun to play out, and it scares me. |