5 Pain Management Physicians Discuss Patient Contracts

Five pain management physicians discuss the role of patient contracts in prescribing narcotics.

Marc E. Lynch, DO, medical director, Casa Colina Surgery Center (Chino, Calif.): We have always used contracts in my practice from day one. Any patient that requires the use of opioids must participate in the contract. It has gone through many iterations and is copied by many primary care physicians in this area. It provides education as well as guidelines and is a vital part of any pain management office.

Ronald DeMeo, MD, MBA, board-certified anesthesiologist and pain-management specialist, Meridian Spine & Interventional Pain Medicine (Coral Gables, Fla.): Everyone signs an opioid contract. I don't call it a contact because it's not a legally binding document, but it's more of an understanding of what the practice is all about. It really weeds out the one who are here just for narcotics. It sets the tone right from the very beginning.

Timothy Spencer, DO, Saginaw (Mich.) Valley Neurosurgery: Yes, we use patient contracts. We believe they provide the physicians of patients prescribed narcotics with more control.

Meeru Sathi-Welsch, MD, Long Island Neuroscience Specialists (East Patchogue, N.Y.): All my patients sign opioid agreements, not contracts, before I give them prescriptions for narcotics. These state that patient agrees to use one pharmacy and get all narcotics from me. If they deviate from this agreement, I have written proof that they broke their agreement after being informed that they should not do this and I can then stop prescribing opioids to them.

Uzma Parvez, MD, Elite Pain Management (Union, N.J.): We always have patients sign an opioid/narcotic agreement with our office. It's useful when I have to discharge a patient on the basis of non-compliance. Other than that I periodically discuss it and remind patients verbally.  

This is an ongoing series which will feature five pain management physicians' responses to questions about the specialty.

Next week's question is: What other specialists do you consult with and what do those consultations add to patient care?

Submit responses to taryn@beckershealthcare.com before Mar. 27.

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