HCPLive Network

Advice on How to Spot a Doctor Shopper

 
The brochure “Ever Been Scammed? Learn How to Protect Yourself from Those Seeking to Abuse Medications” was developed by the Pennsylvania Medical Society for physicians who are looking for information and resources “to help them differentiate patients with pain from those seeking to abuse or divert prescription medications.”
 
This 12-page brochure provides working definitions of “tolerance,” “dependence,” and “addiction;” discusses factors that may have contributed to the increase in opioid misuse and abuse; and identifies “red flags” that may be exhibited by individuals who are in search of prescription painkillers beyond what is therapeutically required.
 
Potential red flags that may indicate a patient is a doctor shopper include patients who:
  • Present with a poorly defined or difficult to diagnose injury
  • Deliver well-rehearsed stories of pain, stress, or insomnia
  • Refuse non-addictive alternatives and insist on addictive alternatives
  • Push for the maximum amount/largest quantity of an addictive drug
  • Tell physician which drugs work best
  • Routinely request early refills or replacement prescriptions
  • Make frequent claims of lost or stolen medication
 
The brochure also identifies several valuable resources that can help physicians identify drug seekers, including the Current Opioid Misuse Measure (COMM), which is available for download at PainEdu.org; the Addiction Behaviors Checklist, which is “a 20-item questionnaire designed to track behaviors that are characteristic of opioid addiction in chronic pain populations” that is available at the Partners Against Pain website; and the Pain Assessment and Documentation Tool, which measures “the four A’s of pain treatment outcomes: analgesia, activities of daily living, adverse effects, and aberrant drug taking,” and is available at the HealthInsight website.
 
Physicians will also find guidance on documenting a pain assessment, the benefits of using their state’s prescription drug monitoring database (PDMD), referring patients for substance abuse counseling and treatment, and the proper disposal of opioid medications.
 
 

Further Reading
In this segment, Dr. Peter Salgo asks Dr. Alfred Deluca to "talk about some of the assurances about Ebola we’ve heard from public health officials, versus some of the truths as you see it."
With the Ebola outbreak now reaching the United States, news reports of confirmed, suspected, and possible cases of the deadly virus have made the virus Topic A. From serious medical journal articles to bizarre postings on Twitter, Ebola news was everywhere. In Princeton, NJ, Ebola panic resulted in some residents tacking up “wanted” posters for NBC News Correspondent Nancy Snyderman, who was recently given state orders to stay home until OCt. 22 because she may have been exposed to the virus during a reporting trip.
Differential expression of long noncoding RNAs identified in prostate cancer cell lines, patient tissue samples, and patient urine samples can detect prostate cancer, according to a study published in the November issue of the Journal of Molecular Diagnostics.
For patients with node-negative breast cancer (NNBC), the 70-gene signature is unlikely to be cost-effective for guiding adjuvant chemotherapy decision making, according to a study published online Oct. 6 in the Journal of Clinical Oncology.
A Manhattan Research survey recently found that many physicians believe digital communication technologies, including mobile apps, can be used to improve patient outcomes, according to an article published Oct. 8 in Medical Economics.
Cumulative years of regular endurance exercise are associated with an increased risk for atrial fibrillation and atrial flutter, according to a study published in the Oct. 15 issue of The American Journal of Cardiology.
Simulation-based training improves clinicians' performance of gastrointestinal endoscopy in both test settings and clinical practice, according to research published in the October issue of Clinical Gastroenterology and Hepatology.
More Reading