A couple of weeks ago a patient came into get her medication refilled. This is a patient who had a stroke a couple of years ago and while she more or less recovered, she was left with a thalamic stroke and post-stroke pain. This is among the worst pain patients can suffer with and usually responds poorly to anything.
She was already on OxyContin when I saw her. After trialing a few things, I trialed her on methadone. When I trial patients on methadone, I always ask the family doc to agree to get a methadone licence to follow the patient indefinitely. I do this so that my clinic doesn't fill up with methadone patients and I can actually see new patients. Her family doctor agreed.
On this visit, the patient brought a letter from her old family doctor which basically said that he was changing the way he was practising and that she would have to find a new doctor. She was actually able to find a new doctor, who surprise, surprise, told her he would look after her other medical issues but would not prescribe OxyContin (which means he will never prescribe methadone I suspect).
Like the title of this blog says, I use to be disgusted, now I try to be amused so I took this in stride as the new face of medicine and I suppose I have married another patient.
Today in the newspaper, presumable in response to complaints there was an article on this doctor with a testimonial from the head of the college of family physicians praising him for modifying his practice and discharging 500 patients at "random".
Like I say, I used to be disgusted.