The state of Arizona now monitors
our narcotic prescribing habits and here are my numbers from Jul-Sep 2015,
which averages to some 768 patients seen. My numbers are in red and the state
average of my peers is in blue. Outside of those mentioned the other pain
relievers I prescribe are Flexeril, Ibuprofen, Tramadol and Tylenol with
codeine (T3), in that order from most to least, with Tramadol and T3’s being
very sparingly, in that order as well.
As for quantity of pills, the electronic
health record (EHR) defaults to 20 pills; more can be ordered but less is more
problematic than what it is worth, although sometimes 20 is just way to many so
I take on the task of writing for less, however, it is painful. That mentioned,
because if it were not so problematic I would write for less all the time thus
prescribing even less than recorded here.
Nonetheless, I would have to say my
narcotic prescribing habits are not over the top. Of the 768 patients 54 (7%) of
them received narcotics. Keep in mind, during the recorded period I have only
worked in the emergency department where pain, the only reason for pain
prescriptions, would be most acute. Of the 768 patients one (receives narcotics
from 5+ providers) got the upper hand. But then there is always one.
Interestingly, as noted at the
bottom of the form, I am NOT currently signed up for access to the Prescription
Drug Monitoring Program. And despite the reminder I will continue to NOT be
signed up, as I do NOT need that system to say, “No”. More important, for me, I
do NOT need that system to influence my prescribing habits and the evidence
shows I am doing just fine without it.