Hi, remember I posted about a month ago that I was in a really bad flare and I phoned my Rheumy's office and asked if he would call in some pain meds ... and the response was that he would do nothing for me but give me Enbrel, period. I have been his patient for almost four years and never, never asked for any pain meds - I only took Aleve.

I was in such terrible pain that I went back to my original Rheumy, even though he is semi-retired and only works two days a week. He also wants me to try Enbrel but at least he helped me by upping my MTX from three pills to five, gave me a pain shot, did blood work. Today when I went for my appointment, he casually asked if I had received a letter from my former Rheumy's office "firing" me. I say Huh? He said he had another new patient who was going to the same group of Rheumys that I was and she got a letter in the mail telling her that if she did not take XXX medicine (he didn't mention which one) to not come back.

No, I didn't get a letter yet, but that's pretty much what I got told on the phone when I was in such terrible pain, asking for help.

It is my understanding that we as patients make the decision to take the risks (or not) of these drugs. If we decide for our own bodies that we do not want those drugs or the side-effects, then I guess the game plan is to force us to go find another doctor who is willing to at least help with pain management. So they can concentrate on more patients willing to take the expensive medicines?

I thought the world of my former Rheumy and I really can't bear to think this is really about incentatives to sell expensive drugs, but I admit after today it has crossed my mind.

I would be interested in your thoughts or if you've had any similar experiences.

Right now, I just don't know what to think.


<br><br>[<i>This Message was Edited on 08/20/2009</i>]

[This Message was Edited on 08/20/2009]

Last year I had a brand new PCP 'fire' me from my long time clinic because I refused to take Methadone for chronic pain. I was (and still am) already taking Humira, MTX, Prednisone etc. My previous PCP at the same clinic had been giving me Lortab. This new doctor refused to refill it saying she 'had to worry about her license.' !!! That made me think her license had probably been in jeopardy before.

Before I could even make an appt. with my old PCP there--I got the 'you're fired' letter. I immediately got a copy of my records and everything in them was fine except for the two visits in which I had seen her. She had written unbelievable things about me--and I threatened to sue.

I have a new PCP now who will only give me Tramadol, but my wonderful long time Rheumy now rx's Lortab. She always preferred in the past for my PCP to handle any pain meds--but she understands I do need them and that I am responsible with them. I cannot take Tramadol late in the day because I cannot sleep then--so the Lortab is taken before bed.

It really IS up to us! These are our bodies and if we do not want to take a certain medication for ANY reason---the doctor should understand. I can't believe WE can get fired considering it is we who hire the doctor!!!

I didn't know about doctors being able to "fire" a patient.

The most important person in your healthcare decisions is YOU.

With the incredible amount of information available on the internet, it is not difficult to be well informed on the specifics of a particular medication and its interaction with other drugs. I firmly believe that some patients are better informed on certain aspects of these drugs than the physicians are.

Plus, if you have had a bad prior experience with a particular drug, you have every right to refuse to subject yourself to those side effects.

If you do not have a Rheumatoligist that understands this and will not work with you on your medications, then YOU SHOULD FIRE THEM.... not the other way around.

Unless you have no other options, you should definitely look for a Rheumy who cares about their patients.

Dar

who do these doctors think they are!!!!!! We go to them for help with this disease and the pain and then...we get subjected to "abuse" that seems to come from the desire for them to make more and more money from the drug companies that want them to prescribe the newest and most expensive drugs.

I agree with whoever said it should be up to us to decide if the side effects are worth the possible help with our disease and not the doctors decision.

Somewhere I read that the meds available for this disease is a crap shoot and that pretty well describes it. The drug reps push the doctors to advise us to take the next drug which is always more expensive than the last. It is like chasing your tail.

As for being fired by a doctor.... I thought it was our decision to fire a doctor and not the other way around. Maybe you need to report him to the medical board where you live.

Hope you have better luck next time around.

Stinker

The Hippocratic Oath
(Modern Version)

I SWEAR in the presence of the Almighty and before my family, my teachers and my peers that according to my ability and judgment I will keep this Oath and Stipulation.

TO RECKON all who have taught me this art equally dear to me as my parents and in the same spirit and dedication to impart a knowledge of the art of medicine to others. I will continue with diligence to keep abreast of advances in medicine. I will treat without exception all who seek my ministrations, so long as the treatment of others is not compromised thereby, and I will seek the counsel of particularly skilled physicians where indicated for the benefit of my patient.

I WILL FOLLOW that method of treatment which according to my ability and judgment, I consider for the benefit of my patient and abstain from whatever is harmful or mischievous. I will neither prescribe nor administer a lethal dose of medicine to any patient even if asked nor counsel any such thing nor perform the utmost respect for every human life from fertilization to natural death and reject abortion that deliberately takes a unique human life.

WITH PURITY, HOLINESS AND BENEFICENCE I will pass my life and practice my art. Except for the prudent correction of an imminent danger, I will neither treat any patient nor carry out any research on any human being without the valid informed consent of the subject or the appropriate legal protector thereof, understanding that research must have as its purpose the furtherance of the health of that individual. Into whatever patient setting I enter, I will go for the benefit of the sick and will abstain from every voluntary act of mischief or corruption and further from the seduction of any patient.

WHATEVER IN CONNECTION with my professional practice or not in connection with it I may see or hear in the lives of my patients which ought not be spoken abroad, I will not divulge, reckoning that all such should be kept secret.

WHILE I CONTINUE to keep this Oath unviolated may it be granted to me to enjoy life and the practice of the art and science of medicine with the blessing of the Almighty and respected by my peers and society, but should I trespass and violate this Oath, may the reverse by my lot.

I am really mad! I didn't know Doctors could fire patients.

Doctors took an oath to help their patients. If a patient doesn't want to try a certain med than they should help them find a different treatment plan, to help them feel better. They are a Doctor that's what they get paid to do.

The risks and side effects for arthritis drugs are heavy, and should always be thought carefully thru.

I have never had this happen. But if I did, I would certainly complain to the board. They would than be investigated. Maybe they fired too many pateints and no one spoke up.

Robin

I am so mad too! I'm with another poster who said, "Who do these doctors think they are?".

If you read my new post (or my older one) about my doctor trying to pull my meds out from under me while I was doing well, you'll see I'm going through a similar experience.

You are SO fortunate that you were able to see your old rheumy who is semi-retired. I had a rheumy who treated me ever since I was 8 years old, and I thought the world of him. He was like a father to me. But he COMPLETELY retired last year, and left me with this crazy, new, young doctor, who I think wants to "see" me in a flare, honestly. I would give anything to go back to my original doctor.

Do I think these docs have incentives to put you on the expensive drugs pushed by the drug reps? Absolutely. And I think the newer, younger ones are the worst, because they are coming out of med schools that have basically been bought and paid for (and often taught by) pharmaceutical companies. It is a bad, bad situation.

RA is a crazy complicated disease and it really is like another post I saw - "throw something at it and see if it sticks" .... unfortunately that leaves alot of opportunity for the drug companies and some doctors.

My Rheumy kinda forced me to take ENBREL. I have since found out he was on a clinical trial team at a very respected Medical Center in Southern CA when ENBREL was being studied.

I took ENBREL for 9 months, ending in June 2006. Since then I have had atrial fib, pre-cancer of the endometrium requiring complete hysterectomy and examination of abdominal lymph nodes, severe anemia that required iron infusions, congestive heart failure, cardiomyopathy, Non-Hodgkins Lymphoma, cardio genic shock due to cardiac toxicity due to chemo drugs, pacemaker/defib installed (option #2 was heart transplant), then pericardium effusion due to lead wire poking through my heart wall, then had to have my gallbladder removed. Now I am trying to find a doctor who attribute the initial problems to the ENBREL.

If a doctor will only treat you with one medication, and that one medication is linked to many other serious side affects, then you could most likely report them to the state licensing board.

My current rheumy is not even sure that I have had NHL for years, and that all my problems relating to RA (I am fortunate and have few actual joint issues, but lots of internal organ issues) were actually the NHL. Would love to figure that one out...and then go after the doctors who diagnosed me with RA in 1996.

I am really mad, as I more or less allowed them to poison me all this time. Really makes me wonder why doctors are more interested in money than actually treating patients.

Good luck. Go with what your gut tells you.

fire a patient? thats a new one on me. ive never heard of that happening before. i spose am pretty lucky with my hospital, they have great doctors and nurses. im on enbriel, MTX, prednisoline (cnt spell) and as many pain killers as are needed. doctors should be there to be guide u through this, and prescribe the right medication for you not to follow some crappy program. thats what my first hospital did and now im stuck with permanant and on going damage to my joints and need replacements, its not right. thinking ov sueing. x

The only thing I have taken that helps some is percocet. I have bad pain in my back as well as my elbows which radiates down my arms. I need 2 hands to pick up a coffee cup. I have lung problems from RA so have to be careful of what I take. Lois

So if you are someone who can't afford Enbrel he would still fire you? This is totally STUPID and I agree you should report him to your local and or state medical board.