When prescribing drugs in the ER, doctors often find themselves in Catch-22

SERIES: The Addict Next Door

Dan Weinbaum
November 14, 2017 - 6:22 am
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Doctors and nurses in Kansas City emergency rooms sometimes find themselves in a difficult position when it comes to prescribing opioid medications.

"You see the same patient multiple times, called frequent flyers," said "Reggie," a registered nurse who has worked in multiple ERs in the KC Metro, and did not want to use his real name. "They come in trying to seek these narcotic prescriptions."

"We as providers are under pressure to maintain certain patient satisfaction scores," Reggie explained. 

The problem occurs when physicians have to honor their oaths to treat patients while maintaining careers in their chosen profession.

"A physician is under a lot of pressure because they can't get too many complaints," Reggie said. "They're in the crosshairs of the hospital, the crosshairs of management."

The new drug registry in Missouri, when it comes online, will help, as frequent flyers can be more easily denied prescriptions.

Reggie finds himself feeling pessimistic because until drug registries communicate across state lines, border hoppers will remain a problem. 

The frequent flyer problem is not not as bad at the University of Kansas Health System, said Samaneh Wilkinson, a pharmacist. The KU pharmacy is now integrated with EPIC, a system that reveals other physicians' prescriptions with the hospital system, a measure that helps prevent doctor-shopping. 

Kansas also has an internet-based prescription drug monitoring program called K-TRACS. All pharmacies are required to electronically submit prescriptions into the online database.  

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