Very Confused

Author: docnusum

Posted: Sun Dec 11, 2011 1:42 pm

travispnorton wrote:
The bottom line is that individual medical professionals have individual views on how and how long suboxone should be prescribed. I would suggest talking to your doctor about his insistence that you taper off of Suboxone on his time schedule and let him know how you feel about it, your views, and your thoughts/feelings. I hear all the time that Dr’s are greedy, money hungry, etc and want the "extra slot" afforded to them by dropping patients….I think that’s bullshit, personally, as keeping stable long-term patients generates almost identical income as picking up new patients would. Looking for a new Dr if you simply aren’t happy is also an option, when you do you should ask what the Dr’s typical practice is regarding tapering timelines, if you want long-term to indefinite maintenance, ask the Dr what his/her views are about it UP FRONT to see how they might mesh with your ideas, that way you’ve lessened the likelihood of surprises down the road.

-Travis

GREAT POST….!!!

What’s often not considered is that providers are as varied in their thoughts and practices as their patients.
There is no "one size fits all."

Just because a provider doesn’t agree with YOUR plan or tailor their practice of medicine the way YOU think they should doesn’t make them "idiotic," uncaring, uncompassionate, stupid, etc. This just means that its not a good fit. That provider’s practice style doesn’t mesh with your expectations and that you should probably continue searching for a provider that is on the same page as you. Neither is "right or wrong"… just don’t match.

Personally… I’d rather keep the same patients indefinately than get new ones. This would mean that they are all stable and "know the ropes" and less suprises for me. Problem would be that this would also mean that none of them successfully tapered off and lived drug free. To some providers… that would be considered a treatment failure.

So in our practice…. we attempt (not force) tapers at regular intervals (3mo, 9mo, 18mo) and I document the results in the EMR. Patients know this from the beginning… and we have found that it can serve as a indicator to the "outside observers" that we aren’t simply "handing out drugs to addicts" and that even WE have hope for progression towards a drug free lifestyle for the patients. As far as we are concerned… if you come in on 16mgs… and at yr 2 is down to 8/4/2 mgs… then you are getting significantly better…

Again…. providers are as varied in their thoughts and practices as their patients.