I also never, ever prescribe Soma. I hear about it all the time, but then, that's for the patients that I have red flags about anyway. The other no-no is Xanax. I just won't go there. I've seen toooooo many people who have a hell of a time getting off of it.
I do randon drug screens on anyone who gets any scheduled medication. They all sign an agreement with me before receiving any prescriptions. And they all come in monthly.
Our pain docs are the same as Brian's...consults or interventional only. One recent problem is that most of our pain specs will not see anyone on Medicare, Medicaid, or managed care. Guess who usually needs the consults? Another problem is there is no one local and pts must travel 1.5 to 2 hours. It becomes a problem for some pts, but we all have to find ways to get things done in this small rural town.
I'm very clear about policies...and often suspect individuals do not come back after that first visit.
Barbara
