Drug seekers clogging system

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POCATELLO — Dr. Willis Parmlee, an emergency room physician at Portneuf Medical Center, said the majority of patients seen in his department legitimately need medical treatment, but a few are inappropriately clogging the system.

Parmlee said a small contingency of the people who come through PMC’s emergency room — maybe one to three a day — are simply seeking a new pain medication prescription.

“It’s what we call doctor shopping,” Parmlee said. “They can’t go to a private doctor, who would limit their prescription. So they use the emergency room, where we are consistently busy and they are not always recognized.”

Parmlee said many of these people have legitimate pain issues but abuse the medications. They move from urgent care location to urgent care location is their best bet to continue getting the medications they believe they need. He said many will alternate between hospitals in American Falls, Pocatello, Blackfoot and Idaho Falls, even using private urgent care facilities.

Crista Madsen, director of marketing and community relations for PMC, said the hospital has tracked about 60 people who have been through its emergency room roughly 100 times in the past year.

Parmlee said the computerized tracking system from which Madsen drew her data is also helping PMC figure out who these people are and address the real need.

“You don’t want people going without treatment,” Parmlee said. “But you also don’t want to perpetuate a drug problem.”

Parmlee said the emergency room is the medical safety net for society at large and must see each patient. It takes roughly 60 minutes to 90 minutes just to process a patient and begin to resolve his or her issue.

He said once they realize they have a person frequenting the emergency room for the same complaint of pain, they inform the hospital’s social services department.

Vivian Street, director of case management and social services at PMC, said her department meets with the patient and develops a case plan. That plan usually involves trying to assign them a single doctor to resolve the underlying issue of the patient’s pain.

“Each time a person comes to the emergency room, (he or she) will usually see a different person,” Street said. “If they have just one physician who sees them for their pain need, they are likely to get more appropriate treatment and pain management.”

Bingham Memorial Hospital sees its fair share of what they term “drug seekers,” said Jake Erickson, administrator for the Idaho Pain Group at Bingham Memorial.

“A lot of narcotics seekers look to find a pain management specialist because they are licensed to prescribe stronger and larger quantities of narcotics,” Erickson said.

When a patient frequents Bingham Memorial’s emergency room with complaints of pain, he will likely be referred to the Pain Group, which will do an extensive evaluation, Erickson said. The examination even includes a psychological evaluation.

“Often the drug seeker will be found out during that process,” Erickson said.

Between 75 and 90 new patients seek out the Pain Group monthly, and Erickson estimates 15 percent to 20 percent of them are drug seekers. However, he said the vast majority of drug seekers are experiencing a real pain problem that eventually gets resolved.

To further weed out the drug seekers, the Pain Group has a stiff list of rules that includes signing a contract not to seek narcotics from any other doctor. Erickson said anyone who is found to violate this rule is terminated from treatment at the center.

“Maybe 5 percent of the people who see us are actually (terminated) from the program,” Erickson said.

Erickson, Parmlee and Street all agreed that their job is not to persecute or even to prosecute the patient coming to them just to acquire narcotics.

“We try to remember that this behavior also represents an illness,” Parmlee said. “Like any other illness, it needs treatment.”

By Jimmy Hancock

jhancock@journalnet.com

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