Following the sudden closure of a pain management clinic in Louisville, the Greater Louisville Medical Society is putting out a call for doctors willing to treat patients with chronic pain.
In June, the Bluegrass Pain Consultants clinic closed after Drug Enforcement Administration officials raided the clinic. It re-opened a few days later, but some patients reported having trouble filling prescriptions. Pain management doctor James Murphy said that clinic's sudden closure was a wake-up call that a central list of pain doctors would be useful.
“It was suggested we have a registry of doctors who would be willing at short notice to take on some patients or offer some advice to people who found themselves suddenly not having a pain practitioner to take care of them," he said.
In the letter that was sent to area doctors, Greater Louisville Medical Society Executive Vice President Bert Guinn wrote they’ve received numerous calls from people who were left without a pain management doctor.
“As we compile the list of practices willing to help, we will refer one practice at a time in the interest of not overwhelming any one practice,” Guinn wrote.
Few Options For Relief
The letter comes as the opioid epidemic continues to grow. In response, government regulations and medical research have pushed doctors toward prescribing fewer opioids, leaving some patients with complex diseases and chronic pain few options for relief.
In 2016, the federal government issued guidelines for prescribing opioids to patients with chronic pain issues. Providers were instructed to prescribe the lowest dosage possible, and to go slow on ramping up doses. The guidelines also set a seven day limit for people getting opioid prescriptions for acute pain from an injury. The Centers for Disease Control and Prevention wrote as part of it’s justification for the limit that more than half the opioid overdose deaths in 2016 nationwide were from prescription opioids.
"What happens is that although it makes sense to get somebody their medications, doctors will say, 'Why do I want to put myself in jeopardy to treat some pain patients — I’ll let someone else do that,'” Murphy said. “So a lot are getting out of the business of treating pain with opioids because of that reason.”
Skepticism
Molly Rutherford, an addiction and family medicine doctor in Crestwood, Kentucky, said she’s not very optimistic about doctors signing up to be on the Greater Louisville Medical Society's list of pain management doctors.
“I think there’s a lot of fear among doctors around opioid prescribing,” Rutherford said. “I know from experience that primary care physicians are pretty overburdened as it is, so I worry that doctors will be reluctant to take on one more thing, especially something as risky as high dose narcotics for pain.”
Charles Kodner, a professor and doctor at the University of Louisville, said he’s noticed an uptick in patients requesting new appointments for pain management. Kodner said because he works within a practice of doctors, the decision to take on more patients with pain issues would have to be a joint one by the entire group.
But he’s wary about whether doctors will be willing to be sign up to be on a list for new patients, even if just temporarily.
“I hope [the Medical Society] gets some responses to their letter, but I’m going to be honest, I don’t think they’re going to get a whole lot of physicians who want to take on this role,” Kodner said. “I think practices are going to incorporate some of these patients organically as they go about finding new doctors.”
Murphy meanwhile, said the issue with physicians taking patients piecemeal without a coordinated effort is that often when pain management practices close suddenly, patients go without medication and withdraw from the prescriptions they're on. Or they may seek opioids via illegal methods, similar to what happened after the prescription opioid crackdown in Kentucky, which resulted in people using illegal opioids like heroin.
“Besides from the fact that they could have increased pain, they could have a desire to get these medicines from other sources,” Murphy said. “We don’t want that to happen.”
