The perversion of pain.

Rebloogging because it’s still relevant. I now work in the same doctor’s office where I precepted. I work on a straight percentage of the billing collections for patients I see.

This is as true as it ever was. The doctor still prescribes too many narcs, now he’s under investigation by the board for it. I myself have discharge many of these patients for noncompliance – I now have a reputation in the community such that the narcotics patients, for the most part, don’t want to see me because they know I will hold them accountable for getting tests to document their supposed pain.

I stand by what I said. Fibromyalgia may be a billable diagnosis per ICD10, but that doesn’t make it a real disease. It’s a syndrome, meaning a collection of symptoms. There’s SOMETHING WRONG, people. Whether it’s pure depression, gluten intolerance, gallbladder, bone cancer (seen that recently) liver failure (seen that recently) giant cell arteritis (seen recently too) that other providers have, quite frankly missed because they just want to throw a narcotic prescription at someone instead of figuring out what’s wrong. So go ahead, take your narcs and sit on the couch and be sedated. Don’t worry if you end up going blind (arteritis untreated), overdosing on your narcs to numb the psychic pain (depression), suffer with joint pain and abdominal bloating for a lifetime (gluten intolerance), start bleeding from every orfice and dying (liver failure), get pancreatitis and end up dying (gall bladder), die of untreated cancer, or whatever else fires your imagination. There is ALWAYS a reason for the pain. ALWAYS. Fibromyalgia is still doctor speak for I can’t find anything wrong with you and I don’t care to try anymore so go away with this nice little narcotic prescription and leave me alone until it’s time to refill it.

It might interest some of you to know that the man who originally created the dignosis of fibromyalgia has since stated publicly that he wishes he had never done so, saying (paraphrase becaseu I can’t remember the exact quote) We all have pain and depression at certain times of our lives, it’s a natural part of life. So there you go.

The Tin Foil Hat Society


In the late 80’s some brilliant (sarcasm in use here people) doctor, who I assume later took a position with one of the companies who manufacture hard core narcotic pain medications, or at least was paid a significant ‘renumeration’ by them, decided that “pain is whatever the patient SAYS it is” and if patients were in pain, then medical and nursing staff were not doing their jobs properly.  This, regardless of whether the patient got better, or even had a medical problem that necessitated pain medication.

Once upon a time, drugs like oxycontin were reserved for patients who were dying of cancer, or in some other profound end-of-life type of pain.  Never used for maintenance.

And now, 30 years later, we have a positive epidemic of patients who are in chronic pain – it even has official diagnosis codes:  338.2 – chronic pain (can’t get paid for diagnosing this one…

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