Primary Care Physicians Have Burden for Educating Patients
The legal requirements for prescribing controlled substances that have been enacted in many states during the past decade have presented a steep learning curve for doctors, particularly primary care physicians.
These physicians have shouldered the burden for educating patients about the new regulatory environment. Still, many patients stymied by the rules don't abide by these agreements, putting physicians' practices in jeopardy and potentially putting drugs on the street. Should primary care doctors dismiss these patients?
What constitutes chronic prescribing?
The definition of chronic prescribing of controlled substances takes on different meanings in different jurisdictions. Most agree that prescribing the ongoing availability of controlled substances beyond 90 days constitutes chronic prescribing. Increasingly, states expect those who prescribe controlled substances in a chronic manner to have signed prescribing agreements with patients that are documented in medical records.
Albeit on a learning trajectory, practices have shown that they are capable of process improvement in this area.[1] But the learning curve has been toughest for patients, even though efforts have been made to educate them about this new regulatory environment. Most sample agreements[2]require the patient to agree to stipulations such as this example phraseology: "I will not request or accept controlled substance medications from any other physician or individual while I am receiving such medications from this office.
