no.
you should review each of the cases independently. do your due diligence as if it were a patient you were seeing for the first time.
confirm a definitive diagnosis, one that can be verified on, say MRI scan or lab work. check your urines, look at your PMPs, do UDS, etc. have them sign a new treatment agreement.
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with regards to Dr. Basch - an "integrative" family practitioner "specializing in pain management",. there are always 2 sides and these articles are all essentially an advertising blitz by Basch. the truth? here is the official documentation, and they paint a completely different picture.
Patient 1 - Methadone 20 mg three times daily, oxycodone 15 mg every 4 hours as needed (60 mg), Oxycodone 30 mg 1-2 tab up to maximum 6 per day (180 mg), and lorazepam 1-2 mg twice daily
patient had elevated QT interval in 2014. no dose change or follow up EKG. in fact, it was increased then decreased by 10 mg over time, and ultimately went up 10 mg "because P1 admitted to respondent that she had increased her methadone dose on her own by 10 mg". she states that she plans on tapering multiple times through the years, but apparently the notes are "cut and pasted" and "making it very difficult, if not impossible, to know what actions were taken when." "Patient-1 regularly breached her pain medication contract without apparent consequences"
Patient 2 - was hospitalized for severe constipation on fentanyl and hydrocodone, discharged on butrans and tramadol. she took over, never signed treatment agreement, allowed patient to alter her tramadol dose, kept calling butrans "suboxone", and apparently cut and pasted most of her notes, with no clear plan.
Patient 3 - DJD and osteoarthritis, took over patient on dilaudid and tramadol, temazepam and clonazepam and butalbutal. MME at that time 160. she added on fentanyl, so MME went up to 340. treatment agreement signed but had wrong age. patient then noted to miss 2 appointments and staff noted cognitive decline. she told patient to limit clonazepam, patient apparently "shrugged her concern off". Basch did not change prescription - clonazepam 4 times daily... she noted as early as 2014 that the medications don't seem to improve patients pain, but ultimately dosage went from 160 to 424 MED. at one point, there was a switch between fentanyl to OxyContin, but the board doesn't seem to know when that happened. she was also noted to continue to prescribe 2 benzos even though patient admitted to 2 drinks per day and was using alcohol for the pain. again, most of her notes were apparently cut and pasted.
Patient 4 - cervical radic and spondylolisthesis, she took over in 2015 when he was on 960 mg oxycodone per day with 30 mg temazepam. a pain specialist stated patient should be tapered 10% per month until on oxycodone 10 mg 4 times daily and OxyContin 80 mg 3 times daily. guess what - she didn't taper that way. 4 months later, he was down 15% but then she went back up on dosage - to 900 mg oxycodone a day. in 2016, he reported that he was running out because the prescriptions were running late. she noted he was getting 30 day supply every 28 days... but she gave him extra script as a buffer. all while continuing temazepam - and for 3 months increasing temazepam from 30 to 45 mg daily. at one point, she added ambien per the patient request on top of temazepam. med list stated OxyContin 40 mg every 6 to 8 hours as needed and OxyContin 80 mg every 4 hours but pharmacy script was 3 times daily - discrepancy between what is in her notes and the prescription.
ultimately, he did have neck surgery, she did taper him but only got to 630 MED not the 420 MED recommended by the pain specialist...
Patient 5 - well, more of the same. dilaudid 4 mg 6 times daily, oxymorphone 40 mg 6 times daily, 6 mg alprazolam, and 10 mg nortripyline. patient fell, no apparent concern, had bruise in his arm (? concern IVDA) and she did not investigate. he accidentally washed some pills, brought in the washed and partially whole pills. she gave refill script. at one point, the pharmacy gave out full prescription of drug on Feb 15 and again on Feb 21. she requested the pharmacy investigate, they did and confirmed the 2 prescriptions within 7 days, but she believed the patient instead and gave him a tide over prescription for morphine. she also at one point wrote for more pills so he could develop a reservoir in case the pharmacy gave him trouble. she did eventually taper a bit... her notes from initial visits in August 2015 discuss taper, which she finally started in Dec 2017, from MME 816 down to MME of 664....
apnews.com
www.kevinmd.com
www.ama-assn.org
