When a physician sets out to become a healer, he has all the best of intentions.  He wants to use his gifts to help people.  What, then, motivates attorneys?  Certainly there are some who are altruistic, but for the most part, the profession is full of self-serving individuals… and once again we’re reminded of the expression “Follow the money.”   Congress itself is nearly entirely comprised of lawyers.  Is it any wonder, then, that working solutions can’t be gotten from them?

When it comes to children, the lawyers seem to set their differences aside and agree that they should have the care, whatever it takes.  What about the young adults, parents and grandparents, though?  States may be scrambling to provide insurance for minors, but they’re largely indifferent to the adults.  Meanwhile, the simple fact is that if the parents have insurance, their children will as well.  If the parents don’t, then just insuring the kids is nothing more than a minimal start, a step in the right direction.  The entire family needs to be able to embrace wellness for it to be safe for the children.  It doesn’t solve the problem if one or both of the child’s parents should become seriously ill or perish.

Wellness is a cornerstone to a prosperous society.  People simply can’t tend to the daily responsibilities very well when they’re sick.  When you happen to be one of those who are ill, it doesn’t much matter what the statistics and percentages of uninsured are.  When we’re talking about millions of people without health insurance, that’s simply too many lives in the balance, no matter what percentage they may represent.

While you’ve been reading this, someone has not gotten care because he or she can’t get insurance.  By the time you’re done reading it, someone will likely have become gravely ill because they didn’t get a much more cost-effective treatment earlier on.  There are a lot of issues and people to take care of.  Let the attorneys duke it out.  That’s what they do best.  Meanwhile, let’s do everything we can to get back to providing care for every patient in need.  In the overall, providing them with the best care possible, regardless of their insurance status, continues to be one of the very best ways to solve the healthcare crisis and avoid medical malpractice suits at the same time.

On a busy night, an ER can be slammed non-stop for 8-12 hours. Each ER doctor may be expected to see dozens of patients each of those hours, to attend to everything from minor traumas to the aftermath of a gang war shoot-out. In the midst of it all will be patients complaining of pain — tooth aches, belly aches, back pain, sunburn, sleeplessness… You name it, the addicts and dealers have thought it up. Pressed for time and unwilling to deny drugs that grant relief to a patient who is truly in pain, the physician will order an injectable and write a prescription for a pain medication. If the doctor begins prescribing a non-narcotic, the patient objects that he has already tried that, that an anti-inflammatory doesn’t work… perhaps even threatening the doctor. When that “patient” leaves, he leaves with a week or month’s supply of opioids that will be consumed in a night, perhaps bringing some of those drugs right back into the ER in the form of an overdose. Others may go directly to the morgue. Either way, when access to narcotics is abused, it doesn’t often end well.

At the core of it all are a few factors: Firstly, the doctor doesn’t want to inflict unnecessary misery on the patient who has legitimate pain. This brings us to that opioids don’t affect everyone equally. An amount which provides relief for one patient’s symptoms may barely scratch the surface of another patient’s pain, making it difficult to know how much is Relief, and when that turns to abuse. Finally, there’s a general lack of accountability. High profile cases like Michael Jackson and Heath Ledger’s deaths may fall under a forensic microscope, but in most circumstances, physicians are not called to justify or account for the prescription…or at least they haven’t been so far.

There is talk of establishing a standard and guideline for the prescribing of opioid drugs. If this should occur (and such legislation often follows high-profile cases,) the physician will have to add yet another issue to the list of things that he can be sued over. If a death can be even remotely connected to the prescription of narcotics, it’s a sure bet that the ambulance chasers will be circling overhead.

Today’s Medical Malpractice risk managment decidedly should include documenting the rationale employed for the prescribing of opioids and other narcotic substances. If the patient presents complaining of severe pain and that recommended non-prescription remedies have failed to provide relief, it may be wise to document this complaint and require that the patient sign to certify that they’ve made the complaint, along with the rationale which led to the prescription. Sending the patient home with a small supply or prescription and a referral to a pain managment specialist may be the best thing for the patient, the physician and the abuser who might otherwise have gotten those drugs on the street. “First, do no harm.”