The Drawbacks

I went out for beers last night with a buddy of mine who’s a physician in Twin Falls, the neighboring larger town with the referral hospital.  Doing that and the conversation that we had led me to think this morning about the two worst things about my job (for me in particular).  Number 1 is I often feel like I can’t drink alcohol.  Number 2 is managing chronic pain.  I’ll elaborate briefly though, these don’t require much more than that.

Not drinking alcohol. This isn’t that huge of a problem I guess.  I gave up my brief stint of drinking regularly to excess quite some time ago.  In the meantime however I do very much enjoy a hoppy beer or a glass of wine. I often feel like I’m limited in my ability to do that however because of the nature of my job.  Even last night I met my friend for a beer about 6 hours after finishing a C-section.  The patient’s doing fine, she didn’t need my attention, but the possibility of something going wrong still exists and after two beers I would then have to dump this problem on the doctor on-call.  More commonly I feel the weight of my next OB patient’s looming due day on my consciousness.  I think “She could go into labor anytime, I’d hate to miss her delivery just for a glass of beer.”  Which is both for the financial impact of missing a delivery, but that’s also my favorite part of the job.  So what I’ve been doing is if I have a patient coming due, I generally will only have a glass of wine on Friday nights which is the night that I turn my work phone off and sign out.  But “women coming due” can be a fairly long time period and if you have 2 within a month’s time, it at times doesn’t leave me much window.  At the end of the day, it’s not really about actually having the drink because I might not drink much more then I do anyway, but it’s about the lack of control over my time and my lifestyle.   If I weren’t a physician I’d probably have a small glass of wine every night for the health benefits.  I still collect wine and will continue to do so, I just have to pick my times to actually imbibe them. 

Number 2 is a huge problem in this country.  Upwards of 20% of people in this country have used prescription pain medications for “non-medical” reasons.  Upwards of 9.5% of 12th graders in this country reported using Vicodin without a prescription in the last year.  It has gotten to the point that it’s often hard to tell the real chronic pain patient that is responsible from those selling/abusing them.  The street value of narcotics (last I did research into this)  is around $1 per milligram of drug and it’s not uncommon for a pain patient to get in the neighborhood of 1800 mg per month!  That’s not even on the high end, that’s pretty typical.  So if your doctor ever seems reluctant to give you prescription pain medications, that’s why.  I have a policy of not writing narcotic pain prescriptions for new patients.  That cuts down on the drugs seekers quickly because word gets out.  Some doctors pass them out like candy, why come to me if there is someone else that the “pill popper” community knows will probably give you some, but I do still get a patient that comes in and first visit needs a refill of their $2000 street value of prescription pain pills.  That conversation often goes poorly.  It’s sucky.

Published in: on March 23, 2010 at 1:38 pm  Comments (1)