Home Forums Discussions General Discussion E-Rx with Exostar, as Verizon will no longer support Controlled E-Rx

Thank you Bert.
I think you made my point -- the medical system has been infested with parasites, who do everything possible to increase the needless complexity so that no one can do simple tasks without signing on to their protection-racket schemes.

Beginning about 20 years ago I dutifully, along with countless of my colleagues, attended multiple workshops (required by the Board of Medicine and the legislature, BTW) to tell us that we needed to treat pain with combinations of long and short acting drugs -- in high doses if necessary -- because people with "chronic pain" needed to be taken seriously, and the risk of addiction was so low as to be inconsequential if you were treating pain. I had a number of patients who were accepted by "pain specialist consultants" only on the condition that I continue and monitor the drug regimen they started (which until recently, would included methadone and fentanyl)

You know that story, of course -- and now for the last 3-4 years it has been the wrenching pullback, and the "PCP"'s are having to accept the blame for this situation which was not of their own making. A couple of years ago I went to a Univ. of Washington Medical School "Primary Care Review" -- and the first words out of the mouth of the first speaker (a pain specialist) were that the "PCP"'s caused the problem because they were "insufficiently trained."

In any case, I am drastically, but slowly, reducing the opiate prescriptions of my chronic pain patients, and am finding that people on chronic opioids, for the most part, will accept the fact that they have been prescribed too much -- whoever is to blame-- and that they will have to get by with less. For some, it is relatively easy to taper slowly -- they discover that their pain level really doesn't change very much, that they always have pain, just as they did with the higher doses, and they can adapt to lower doses. I have set my goal at 30 MED for everyone on chronic narcotics and have told them that it is just something that will have to happen - the law requires it. Only a few actually push back, but of course, they don't have any recourse, since they are stuck with me -- no other doctor in the state will take on a new chronic narcotic patient in the current climate.

30 MED (that term wasn't used then) was roughly what was considered "acceptable in the mid-nineties, and the acceptable dose was actually quite a lot less in the mid-70's which was another period of demonization of narcotics. Yet people with pain seemed to get along about as well (or as badly) in those days as they do now on higher doses -- so except for addicts, I am not seeing much of a problem.

With respect to printing C-II prescriptions -- I use nothing fancy. We get 8.5 x 11" sheets of tamper-resistant (Medicare approved) stock which comes from the printer pre-perforated in quarter sheets.
I then use a cheap HP laser printer to print the quarter sheets, using the stock HP software driver to fit the AC prescription to the quarter sheet. It comes out with very tiny print since I am reducing a full sheet to a quarter sheet, and there is no control over font size in AC, but it is legible, and the pharmacies don't complain. It's more legible than my handwriting, for sure. And that way, controlled drugs come out of the prescription module in AC, but meet all the current Federal and State requirements. Very hassle free. It goes without saying that "lost" prescriptions are not replaced -- the security is up to the patient, not to some third party that wants to charge ME for looking out for A PATIENT'S prescription security.