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Doctor’s Lawsuit Targets Parents of Patient Who Overdosed

The U.S. Drug Enforcement Administration stripped Dr. Kevin Buckwalter of his ability to prescribe narcotics, citing the death of eight patients. Now Buckwalter claims a malpractice suit filed by the parents of Andrea Duncan, who died in 2005, is an abuse of the legal process.

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Dr. Kevin Buckwalter leaves his office in Henderson, Nev., at the end of the day on Sept. 30, 2008. (Steve Marcus/Las Vegas Sun) | See Las Vegas Sun's full investigation on Painful Painkillers.

The dramatic rise in prescription narcotics use—and the subsequent increase in overdose deaths—has led to a spate of lawsuits around the country targeting doctors for malpractice or running pill mills. But legal experts say the case of one family physician in Henderson, Nev., stands out.

Dr. Kevin Buckwalter has turned the tables, filing a lawsuit against the parents of a young woman who died from an overdose of narcotics that he prescribed.

Buckwalter's suit accuses John and Maggie DeBaun of abusing the legal process, intentionally inflicting emotional distress and interfering with his ability to do business by filing a medical malpractice case against him for the death of their daughter.

"I've never heard of such a lawsuit," said Stacey Tovino, a professor at the William S. Boyd School of Law at the University of Nevada, Las Vegas. Tovino and other Nevada legal experts said it appears to them that Buckwalter abused the legal process in an attempt to intimidate the DeBauns.

Buckwalter did not respond to a call for comment. His brother Bryce, who serves as his attorney, declined to comment about the lawsuit. In an email, he accused this reporter of harassment for attempting to contact his brother, said he would seek a restraining order and threatened to sue ProPublica.

Buckwalter has been a subject of controversy for several years. A 2008 Las Vegas Sun investigation, also by this reporter, highlighted the opinions of four pain-management specialists who reviewed Buckwalter's care of patients and said it appeared to be negligent.

Staci Voyda, a teenager addicted to prescription narcotics, wrote in her journal that she went to Buckwalter to get off drugs. But his treatment included ramping up her dosages of narcotics. She killed herself in August 2007, and family members say the drugs pushed her over the edge.

Another Buckwalter patient, 69-year-old Barbara Baile, was prescribed large doses of narcotics, which caused constipation so severe it ruptured her bowels. A subsequent infection killed her.

These are prescriptions for Xanax and morphine written by Dr.
Kevin Buckwalter for Andrea and Clint Duncan. (Sam Morris/Las Vegas Sun) | See <a href='http://www.lasvegassun.com/news/topics/painful_painkillers/' _cke_saved_href='http://www.lasvegassun.com/news/topics/painful_painkillers/' _cke_saved_href='http://www.lasvegassun.com/news/topics/painful_painkillers/'>Las Vegas Sun's full investigation on Painful Painkillers</a>.The DeBauns' daughter, Andrea Duncan, died in 2005 from intoxication with opiates and benzodiazepines, a class of drugs that includes Valium and Xanax. Four days earlier, her husband Clint, also a Buckwalter patient, had overdosed on prescription narcotics and died.

In a 2007 videotaped deposition for an unrelated lawsuit, Buckwalter described the treatment he provided Duncan. Under oath, Buckwalter said he did not examine Duncan on her first visit because he "did not have time," yet prescribed her 300 tablets of Xanax, an anti-anxiety medication, and the painkiller hydrocodone, a synthetic opiate.

The following year, the U.S. Drug Enforcement Administration and Nevada State Board of Medical Examiners stripped Buckwalter of his license to prescribe controlled substances. The DEA attributed at least eight overdose deaths to Buckwalter. The medical board blamed him for four cases of malpractice, including one in which the patient died. Buckwalter closed his practice.

Dallas lawyer Kay Van Wey, who specializes in pill mill cases, filed six lawsuits against Buckwalter on behalf of patients who died or were harmed. The DeBaun case was filed in April 2009, past the statute of limitations in Nevada. But Van Wey argued in the complaint that the deadline should be extended because Buckwalter allegedly concealed his negligence and altered medical records.

A judge didn't buy the argument and dismissed the case. Buckwalter claims in his lawsuit that the DeBauns sued to harass and annoy him.

Buckwalter has denied all of the allegations that he provided substandard care. His lawsuit against the medical board to get his prescribing privileges reinstated was unsuccessful.

Jeffrey Stempel, a professor at the UNLV law school, said that for the DeBauns' lawsuit to be considered an "abuse" of the legal process, there would have to be some ulterior motive other than seeking damages for their daughter's death.

Ann McGinley, another professor at the UNLV law school, said it takes more than simply filing a lawsuit to support a claim of intentional infliction of emotional distress. And given that Buckwalter lost his ability to prescribe controlled substances in 2008, it's difficult to see how the DeBauns interfered with Buckwalter's ability to conduct his business, she said.

McGinley said that if lawsuits like Buckwalter's became more common, they could have a chilling effect, discouraging patients from pursuing legitimate malpractice claims. "My concern is that other doctors will take this on as something that they will do regularly," she said.

Some opiates used to be prescribed for terminally ill patients only. The high potential for addiction and abuse has been known for years. Tolerance is built up very quickly and addiction ensues. If doctors weren’t so quick to write prescriptions for these drugs, they wouldn’t find themselves embroiled in legal battles.

And the Pharmaceutical companies giggle in the shadows, all the way to the bank!

Jackson-Findrxonline.com

Aug. 26, 2011, 10:13 a.m.

I remember reading people’s opinions, online, of the medicine vicodin before I took it and it scared me away from it. Then I finally decided to give it a try and it has been the best choice I have made. I have been on it for over 4 months and I feel great. I’m on 100 mg and I don’t have any side effects. When I first started I did notice that my hands would tremble but then it subsided. So honestly, don’t listen to all the negativity because what does not work for some works amazing for others. So go based on youself and not everyone else. It may be a blessing in diguise. The pill is not meant to make you be all happy go lucky and see “butterflies and roses,” its meant to help put the chemicals in your mind in balance so you can just be who you are and not overly depressed. I still get some sad times, but that is normal, that is life, and it’s up to people to take control to make a change. I did so by getting on this pill.

Those who can do.  Those who can’t do teach.  Those who do harm litigate.

What does the AMA say about this?  Has anybody of relevance filed amicus briefs or similar with the court?  I’m curious about the “ecosystem” that’s bound to be growing around the case.

This is nothing new or novel.  Incompetent doctors have been counter-suing for years now in an attempt to force a small settlement or intimidate patients from filing similar suits.  We had an aging chief neurosurgeon at a local hospital.  He had a terrible bedside manner and mistreated patients as well as staff and nurses.  Anyone who brought suit against him was immediately served with a counter suit.  To the point that local attorneys would not touch a case of malpractice by this man.  Yet, he was allowed to continue in his position, having caused needless suffering and pain to those around him until he retired.  This is just one more example of a healthcare system that is dysfunctional to the core.

Jackson:

Vicoden may work for you, but can be addictive.  If you are on vicodin for long periods of time you probably want to have your doctor check your kidneys to make sure they are not getting damaged.  I deal with worker’s comp claims and see tons of people on pain meds like vicoden.  Just because you are not having side effects that you notice, does not mean that the meds are not affecting your body.  Following up with the right doctors and making sure you get you kidneys checked on a regular basis can help catch any problems.

I don’t endorse frivolous lawsuits or suits against doctors for minor reasons but this guy deserves what he gets.  And if the DEA and state Medical Board got involved, then you know it was not some simple deal where he made a mistake and it unfortunately cost a life in just one instance.  If I were the parents who are suing, I would turn around and demand attorney fees for any defense of a counter suit, so I did have to pay out of my settlement or jury award, once it is all said and done. 

The thing about it is that his suit has no merit because we have the right to use the judicial system to resolve disputes.  That being said, really, his suit ought to be viewed simply as harassment.

Jackson wrote:  “...its meant to help put the chemicals in your mind in balance so you can just be who you are and not overly depressed.”
____________________________________________________

I’m fairly certain that Vicodin is not intended to be used as an anti-depressant.  I had severe neurological pain for several years and Vicodin basically kept me from killing myself.  But that was because of pain, not depression.  And when my problem was finally diagnosed and corrected, getting off the drug was quite a challenge including sleepless nights, jitters, anger and heart palpitations.  Vicodin should not be used unless it is for pain and a last resort.

Robert wrote: “The thing about it is that his suit has no merit because we have the right to use the judicial system to resolve disputes.  That being said, really, his suit ought to be viewed simply as harassment.”
__________________________________________________

That is true, but in reality “harassment” suits are filed all the time by parties who seek to intimidate those who have smaller pockets and are unaware of the arcane and often unjust rules that have been written into our current court system.  Believe me, I know from personal experience.  Not to mention the Rotary club, golf membership, old boy network that exists including ties between local doctors and attorneys.  Every day Americans, working class Americans are no match for a corrupted and wealth serving system.

WillHarper makes an excellent point.  There is an old canard we always heard when I was drafting healthcare regulations for DHHS and some medical association’s ox was about to be gored: “the government has no business interfering with the practice of medicine”.  Translation:  we are above the law.  This all-purpose bromide allows medical associations to raid the public coffers and evade accountability while continuing their longstanding tradition of doing a piss poor job of policing one another.  A friend once reminded me that good medicine isn’t rocket science and half of physicians practicing finished in the bottom half of their class.

Where is the AMA and the State doc’s association while all of this is going on? Those who oppose malpractice litigation claim that the State medical associations will protect us from bad medicine but it seems that all they do is rally the troops to stick behind their associates much as the police. There is a good project for ProPublica;look into the Medical Associations and see if they really police themselves!

Stephanie Palmer

Aug. 26, 2011, 2:01 p.m.

Given that the drug companies are advertising drugs that can cause “lymphoma and other types of cancers,” how do we know what’s going on here?  Maybe narcotics are a better way to go.  And no, I take no drugs ever. I’d rather deal with myself than put myself in the hands of big pharma.

Why is it that certain drug get such a bad rap as far as being “bad or unhealthy” yet the over prescribed psychotropics,which I know, are very dangerous, and have killed many, continue to be pushed?
People should have the right to choose, period!
The anti psychotics prescribed these days as
replacements for
drugs like xanax
and such cause
really unpleasant
and even deadly
side effects for
many, while the
drugs originally
intended for
certain
symptoms, work
well.
Not everyone is
an addict! And,
not everyone is
suicidal.
Stop dissing
certain drugs and pushing
others. Face it!
No drugs are healthy, in any case!

Formerly dangerous drug prescriber Dr. Buckwalter is an embarrassment to the profession! For him to say he was harrassed by a family grieving who wanted justice for their daughter is both stupid and arrogant, the lawsuit should be dismissed as soon as it gets in front of a judge.

Carolyn Thomas

Aug. 26, 2011, 2:31 p.m.

Jackson’s comment must have accidentally sneaked through the SPAM filter here - note the Jackson-Findrxonline.com handle.  Not a “real” patient taking Vicodin at all . . . .  and certainly not for depression.

Phil - An even better project for propublica would be a close look at the Joint Commission for the Accreditation of Healthcare Organizations, based in Chicago.  Most people would be surprised to know their state departments of health rarely inspect their hospitals except for patient anti-dumping complaints or anything sexy enough to attract the attention of the local media.  Hospitals are rated by a private accreditation organization that is reimbursed for its inspections by participating hospitals.

Just posting to follow the discussion

It seems to me that there is some shared responsibility for these deaths. The doctor shouldnot have given so many pills, but the people
who visited the doctor obviously didnt want Motrin or tylenol.

There are many chronic conditions which would put folks over the edge if it were not for ongoing pain control involving narcotic prescriptions!  Doctors who prescribe dangerous combinations of medications, or just too much of any one of these drugs, are only partially to blame for the overdose deaths.  Patients today are well-informed, having the same prescribing documents available to them as their physicians, and even without internet access usually these prescribing sheets are include with the medication to take home. In addition, pharmacists normally give coaching on taking medications and possible interactions, and answer any questions. Just because a medication makes you feel good at the moment doesn’t make it safe to take!  I’ve been on Percocet for over 8 years now and I realize that, past a certain point, the medication does not cure all pain.  I have to monitor the balance between tolerable pain levels and the amount of medication I take.  Maybe some people aren’t able to be so diligent, but without the Percocet I’d be a basket case!  These cases never seem to weigh the responsibility the patient has to wisely manage their own health care with prescriptions that are taken outside the hospital setting.  And then, some doctors are not diligent in their own practises both prescribing and educating patients.  We don’t need to rip the rug out from under the feet of patients who are doing well on controlled drugs, but it does sound like Dr Buckwalter stepped over the line.  And so did his patients.

Shyam Jha, MD, JD

Aug. 26, 2011, 10:52 p.m.

If patients take pain medications as prescribed, they would not have died. 

These patients appear to have committed suicide using medications that was prescribed to them.  They must have obtained these medications by prescription by going to the doctor and claiming that they were having pain.  No physician gives you pain medication without you seeking it.  Only surgeons write pain medications routinely, in a limited amount, to be taken if needed for (intolerable) pain, because it is predictable that patients will have pain after surgery. 
The physician does not go about knocking on your door giving you pain medication.
This physician’s prescription practices may have been questionable, but they are not directly causative of death.

This is clearly an abuse of the legal process, targeting doctors because they have liability insurance.  The manufacturers or sellers are never sued ... because they are protected by law.

I do not see makers or sellers of knives being sued ... or makers and sellers of guns being sued ... or the makers and sellers of good old rope ... because these can be obtained without prescription and are commonly used to commit suicide.  The jury would laugh at such a co-relation, and they would be laughed at if they did make such a co-relation.  but when it is a doctor ... and the medication is obtained by prescription ... and is used inappropriately ... that logic is ignored.

The potential of drug dependence is well known ... but that does not cause death.  Death is only caused when a person takes excessive dose of medication by choice, or by mistake, or by using different types of medications in combination ... in inappropriate doses.

The medical board or DEA may take action against doctors for inappropriate prescribing practices.  That is understandable.  But it is very unlikely that anyone will die if they took pain medications as was prescribed to them.

@Shyam Jha, MD, JD

It sounds as though you don’t think any wrongful death suit can be brought against a physician when a patient overdoses intentionally.

Do you think the physician bears any responsibility in determining if the patient is dangerously addicted or might be suicidal?

My understanding is that in the legal process this country there is a basis for determining negligence if a doctor does not adequately check the patient for such tendencies. 

You provide as evidence the fact that these patients would have had to seek out these medications, but we would assume the same about any suicidal person or addict wouldn’t we?  In fact the reason the medications are prescribed rather than freely dispensed are for this reason are they not? So that the doctor judges whether or not they will cause harm to the person’s health (mental or otherwise). Whether the patient might use them to intentionally over dose?


Also, being contacted by a reporter is not harassment. Something is clearly amiss with these siblings.

From the Las Vegas Sun article on Buckwalter:  “Baile died in April, a victim of one of the side effects of narcotics — severe constipation. Her death should have been prevented, experts said. Doctors who prescribe narcotics should know they can turn a person’s stool rock hard, blocking the bowels.

Barbara Baile’s husband of 50 years, Don Baile, sat in on every appointment she had with Buckwalter. He says his wife complained of constant constipation but the doctor never explained that the narcotics he was prescribing could cause the problem. Don Baile does not recall Buckwalter’s ever performing a physical examination of his wife. He says Buckwalter’s only action was writing on his prescription pad.

In February, having gone more than three weeks without a movement, her bowels ruptured. The damage was irreparable and after three months of agony she died of sepsis.

Buckwalter’s records don’t reflect that Barbara Baile was constipated. The experts said that any doctor should have known to manually remove Baile’s blockage or prescribe medications to clear out her system. Don Baile says Buckwalter only mentioned over-the-counter remedies.”

No action by the state medical board on this physician was taken and he is apparently still in practice.  Dr. Jha, with all due respect, this Nevada physician has quite a history.  Do you really think Dr. Buckwalter is representative of most practicing physicians and that he is competent?  Of course he has rights.  We all have rights, but people in positions of unique public trust have a special responsibility, as do the people we entrust with the responsibility to protect the public from potentially dangerous medical practitioners.  My sense is Dr. Buckwallter and everyone involved with reviewing his medical practice have let all of us down.

A neighbor of mine died several years ago froma combination of lortabs and xanax and whiskey.  He always told his doctor he was in “agonizing pain” though he would sell his medicine for cocaine. One night he took his cocaine with 10 xanax pills and a pint of whiskey and was found dead the next morning by his son.Now his son says this doctor gets urine drug tests on everyone and wont give more than a weeks supply and insists on seeing some patients every week.Perhaps he should have done this anyway but it seems to me that people should take responsibility for themselves

Hank Hudson

Aug. 27, 2011, 5 p.m.

Your doctor is not god….though he might act like it at times.  While he
has more information about your problem then you do, you must also
act as your own doctor, to a degree.  If things don’t seem right, get a
qualified second opinion.  Have someone help you on the internet to
see what kinds of reactions are “normal”—talk with your pharmacist,
talk to qualified alternative medicine providers, etc. 
You know your own body than does your doctor.  If some things don’t seem normal to you, do something proactively.  With all the other options available to us, we should be more accountable for our own health as best we can.

As a profession I find that doctors are the most arrogant of any profession.  They lie with impunity and do anything to prevent someone wrongfully harmed to sue.  They stick by each other and watch the costs of toxic treatments, toxic vaccinations, toxic scans and toxic drugs pile up.  They watch and do nothing when patients are suffering and dying at the hands of the medical industrial complex. 

My only hope is that the health insurance industry will go after the doctors and health care providers that are sucking the tit of the pharmaceutical companies, medical device manufacturers and the trillion dollar scanning industry. I hope they go after them with a vengeance and safe the remaining population from mass poisoning and safe their profits from extinction.

We all thought that health insurance companies were the problem and historically their behavior has been deplorable. But we have ignored the elephant in the room, big pharma and the doctors that support them. We may find an ally in the new requirements mandated by law of health insurers in this country. They can no longer kick sick patients out so they have to find another mechanism to bring down the high cost of health care and maintain their profits.

Lucretia Rossi

Aug. 27, 2011, 10:30 p.m.

For the first time, I’m kind of disappointed with ProPublica. While there are definitely doctors who are basically pill mills, there is also the aspect that now doctors are afraid to prescribe anything because if their patients abuse it, they are on the hook for it. Even if they prescribe an appropriate amount, and the patient overdoses by not following the prescription, the doctors get sued. Not to mention, the federal narcotics police treating legally-prescribing doctors (especially doctors specializing in pain management) like Columbian drug cartels. A few doctors are making it hard for all doctors. Also, it leaves people with severe chronic pain to suffer, because doctors are afraid to effectively manage pain for those who really need it, for fear of lawsuits or the federal government. There are definitely two sides to this issue, and only one side is being discussed here.

Lucrecia wrote: “There are definitely two sides to this issue, and only one side is being discussed here.”
_____________________________________________

I hear what you are saying and agree.  But the problem is not a specific drug, rather the way its use and side effects are monitored by the prescribing Dr.  As usual in the US, the real issue quickly becomes obscured.  As a population we are severely overmedicated.  Physicians know this.  Everyone knows this, but the for profit healthcare system has become a monster that must be fed.  Rather than working diligently to overcome patient’s chronic illness and complaints, many doctors quickly reach for the prescription pad and have you make another appt in a month.  It’s a win win for them and the parmaceutical companies, but does precious little to help the cause of the problem.  Believe me, I know, I’ve been down the rabbit hole and almost lost my life there.  If it hadn’t been for an intuitive and compassionate, naturopathic physician (Dr. Aimee Shunney in Santa Cruz, CA) I would not be alive today.

I too agree with Will and Lucretia.  I’ll even take it a step further and say that narcotics are the best product on the market for long-term chronic pain relief and although addictive they are the least toxic.  But low-profit margin drugs are not a part of the business model for big pharma therefore their focus is to get them banned.  They can make billions with blockbuster drugs for pain like Vioxx and kill thousands before an unsuspecting and uninformed patient population knows what hit them.  And with half the population believing Karl Rove’s screeching diatribe about frivolous lawsuits are a problem we take our focus off the real and fatal problem of toxic medical practices initiated and executed by the medical industrial complex with the help of doctors.  And the patient population is so enamored with doctors they will do anything they tell them.  You need a metal on metal hip replacement, sure doc.  You need a CT scan with excessive amounts of radiation because GE’s machine will malfunction and use excessive amounts of radiation on you.  Sure doc.  You need MRIs with gadolinium based contrasting agents that will cause a new man-made disease and likely kill you.  Sure doc, sign me up.  Here have some Vioxx and likely die from a heart attack.  Sure doc.  And how about some Levaquin and tear a tendon or two, you don’t need to walk again anyway.  Sure doc.

Interesting take from Peter above


“For him to say he was harrassed by a family grieving WHO WANTED JUSTICE FOR THEIR DAUGHTER is both stupid and arrogant, the lawsuit should be dismissed as soon as it gets in front of a judge.”

I do not support the abuse of drugs, however, it’s always interesting to me how, strangely enough, JUSTICE for the deceased apparently equates to MONEY for the family of the deceased.

Whatever happens, SUE FOR MONEY and then say its for JUSTICE for the victim.

The onslaught of lawsuits filed FOR JUSTICE when its obvious that “the victim” played a role in his/her demise by knowingly taking drugs in a manner and for a purpose not intended is revealing.  It also undermines the family claims of love for the deceased.  The family should have seen what was going down and done something but instead they want money to do what?  Take a vacation?  Buy a new car?

JUSTICE for the victim.  Is that accomplished by giving huge sums of money to surviving relatives?  Why is that the measure of justice we seek?

Jackson,

I have to agree that taking the right dosage for a short period of time, can be beneficial.  I think the point of the article is that too many doctors are grossly negligent in prescribing medication. Dr. Buckwalter’s lawsuit is frivolous, and should be thrown out.  I also think there should be no statute of limitations in a medical malpractice case. Doctors in general get special treatment under the law.

First, they have what is called a Pier Review Committee that usually conducted as a result of some hospital negligence.  IN other words, someone came into the hospital to get a kidney removed, the doctor removes the wrong one, the patient dies.  This committee finds out what went wrong i.e., doctor was drunk or on drugs, didn’t get enough sleep, has problems in his marriage, etc.  All of these sort of things can lead to mistakes that are covered up by the hospital.  The public NEVER gets to see the Pier Review, and doctors are not reported to the D.A. for prosecution for negligent homicide.  No the hospitals cover the doctors and hide behind this ridiculous privilege.

The second is tort reform that has successfully eliminated damages in malpractice lawsuits that and encourage doctors’ reckless behavior.

Wow Anne! Justice is when the party at fault is forced to pay for their mistakes and malpractice.  It’s a deterrent to prevent future malpractice claims and should be used to fullest extent of the law. Think of other innocent bystanders that pay and pay for the malpractice of these doctors.  Health insurance companies must pick up the cost of treating these victims that were harmed if they live.  Perhaps they have long term disability and have to use it or they have to go on social security as a result of injuries caused by doctors, drugs or medical devices. Now we have watered down lawsuits and ridiculous caps and it takes years for victims to see a penny of it.  Lives are ruined, families torn apart and malpractice is allowed to continue unabated.

We should call him the Halliburton doctor.

Very interesting discussion but did no one notice the article said Dr. Buckwalter DID NOT EXAMINE the patient because he was too busy, but did prescribe the medication. I agree we as consumers need to ask questions of our doctors, pahrmacists and read the enclosures of medications prescribed. But doctors often do a very poor job of educating patients on how to take the medication. I work in the medical field and see doctors prescribe without explaning the cautions or discussing with the patients possable side effects. Most patients when asked how they are taking medication are NOT TAKINF IT AS PRESCRIBED! Most especially with pain meds. Our office see several new patients each month seeking pain medication (WE ARE A PSYCHIATRIC OUTPATIENT CLINIC). They are doctor shopping looking for a Dr. Buckman. There are far too many of them out there making a profit at the expense of their patient’s health. Law suits are the most effective way to get their and the medical board’s attention. counter siuts are their right but judges don’t have to agree to try trhm and can still dismiss them.

Shyam Jha, MD, JD

Aug. 28, 2011, 10:13 p.m.

As about the constipation story.  Was there only one doctor in this world?  The patient and her husband knew that she has a problem ... they know that their doctor does not address that ... “after repeatedly raising this issue” ... common sense will dictate that you will raise this issue with your primary care provider, or seek another doctor, ... put yourself in their shoes ... would you go on being such a patient?  ... hey people have left my practice because they don’t like my name, or my accent.

I too have a story. 
A patient came to me who was being treated by another doctor.  I felt that she was on a dose of opioids that was unjustified, given her condition, ... and that her constipation was severe, ... she said she literally had to manually pull it out.  I spent quite some with her and her husband at the initial evaluation, explaining why she has constipation, developed a plan to reduce her medication, advised how to change diet, and food habits, the role of fibre, and rescue laxatives, and offered her a reduced dose of opioids.  Guess what ... she went back to her old doctor.

I have another story ... I have a template that asks patients relevant questions about important side effects, and I go over that with every patient.  This patient always answered that she has no constipation ... I phrased the question differently once ... “how many days between bowel movements”? She says “oh about two weeks”.  I asked her why she has been marking “no constipation” ... she said she has been like that for years, and did not know it was constipation.  Do you have to be taught this in school that going once in two weeks is not normal?.  This woman has gone through life, two marriages, kids and she thinks this is normal? I lost my cool ... anyway I developed a plan for her and she agreed to follow it, and on follow ups claimed that her bowels were regular ... I have no way of knowing if that was true ... your doctor can not help you if you lie. 

This is America ... you don’t like your doctor .... down the road there is another one. You are not married to your doctor. 
In fact I see some people like doctors so much that they go to four doctors in one month ... getting narcotics from every one of them.  I have to be on my toes to weed them out.

And as far as truth goes ... come law suit time .... patients forget what the doctor told them.  They will take the oath and say that they do not ever remember the doctor telling them that ... I have been in a law suit ... and I know it.

... before you take sides please understand ... there are two sides to every story ... at least two sides ... always.

Anyway, the biggest problem that I see in my practice is that people do not seem to understand ... no matter how much you tell them, that ... pain is your friend ... your alarm system, that warns you something is wrong ... when you take significant doses of pain medications then it may mask symptoms of potentially fatal problems ... then reaching for a pain pill will further mask the problem ... and place you on a downward spiral.  I suspect this too happens ... specially in the older population, the diabetic, and women ... for example these people will not have the classical chest pain if they are having a heart attack.  When younger people die from opioids ... it is almost always because of overdose, or reckless use of combination of drugs.

Jackson-Findrxonline.com…YOU DO NOT TAKE VICODIN FOR DEPRESSION!!!!!!
VICODIN IS A HIGHLY ADDICTIVE ANALGESIC. You stated your hands were trembling when you stopped…uhoh!!
VICODIN is not a treatment for depression. You feel good because you are high from the drug. DOH!

I was given Vicodin after a dental procedure, but I did not use it.  The same with other procedures that I’ve had.  You don’t HAVE to take the Vicodin if you don’t want to.  I prefer using something else like Tylenol even after being given the Vicodin.  It’s just a matter of choice and how much pain you want to deal with.  I’d rather deal with a little pain than take something that could harm me.  The only medications I take for pain is Tramadol for knee pain, and I do take Lorazapam to help me sleep, but not every day.  I think you have to be smart about what you put into your system, even if the doctor gives it to you.  Just my opinion….and what works for me may not work for someone else.

Carol wrote:  “Very interesting discussion but did no one notice the article said Dr. Buckwalter DID NOT EXAMINE the patient because he was too busy, but did prescribe the medication.”
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Carol caught another major problem with modern day doctor’s visits.  I suffered for ten years with horrible, neurological pain in my left arm and upper torso.  I must have seen 100 doctors in all.  Many specialists, surgeons and at least a half dozen primary care doctors, trying desperately to find out what was going on.  One of my major frustrations was trying to get a doctor to actually EXAMINE me.  They all wanted xrays, MRI results, blood tests, nerve tests results etc, but almost half either reluctantly examined the area after my asking them, or waved it off as unneccesary.  It was almost as if they were inclined NOT to examine me.  This despite my complaints of large knots and swelling under the skin.  It turns out that I had food allergies that were causing inflammation and large knots in my muscles.  One the of golf ball size knots was in my left Trapezius muscle and it was pressing against the brachial plexus bundle of nerves exiting my neck.  This was what was causing the terrible pain.  Once we identified the foods I was allergic to, with the help of Dr. Shunney, and avoided them, the knots and other symptoms went away. The terrible pain went away.  I would not have survived without strong pain medication all those years, but I fault the doctors who missed this, and especially those who wouldn’t listen or physically examine me.

Doctors way over-prescribe drugs like Vicodin. I sprained my ankle once and just went to the doctor to make sure it wasn’t broken because it wasn’t getting better. The doctor wanted to prescribe Vicodin, but I told her I’d just take Ibuprofen and ice it. When my back went out, another doctor gave me a prescription for 40 Vicodin pills (way too much). I only used 4 and saved the rest for if it happened again. Unfortunately, someone (realtor, handyman, roommate?) stole most of the rest out of my nightstand. Those pills are addictive and doctors who push them unecessarily should be prosecuted like drug dealers.

Tami, some people cannot function or have a life without pain killers like Vicodin.  If you have a choice between not functioning at all or taking pain meds even though you may become addicted what would you choose?  One size does not fit all. 

And to Shyam Jha, MD, JD, you appear to be an apologist for doctors.  I’m not sure if it is because you represent them against malpractice or because you are a doctor.  But there are serious problems with the current healthcare delivery system and many patients are being needlessly poisoned while doctors stand by and not only do nothing but encourage the poisoning.  I’m referring to gadolinium based contrasting agents, overdoses of radiation and toxic drugs like Vioxx and Levaquin to name a few medical malpractices that are harming the patient population.  Whilst doctors can’t know everything I do expect them to understand their orders and the prescription drugs they are prescribing and the risks of nuclear medicine.

Sharon, I do actually agree with you that some people need strong pain killers for certain conditions. I just think that Vicodin is dispensed a little too freely. Years ago, I would just be given Ibuprofen for a sprained ankle (I’m fairly accident prone), but now it seems the first course of action is Vicodin or other addictive drugs. It’s the same with antibiotics. You can get a prescription for those with every cough, even if it’s a viral infection. I just wish doctors would be more careful about what they prescribe.

We have a pendulum here in the U.S. that swings wildly one way or the other on many issues.  Child custody, for example, now its automatically assumed even with evidence to the contrary that the children are better off with mom.

We also have the pendulum regarding things like drug therapy.  Right now the Feds have decided to crack down on these painkilling drugs.  While I do not condone drug addiction and all the related problems, I’m afraid that now its going to be difficult or even impossible for people who need strong painkillers to survive intact mentally.

Our government is rarely looking out for our best interest, if they were we wouldn’t have LEGAL MOB LENDING aka Payday Loans.  I don’t trust the government anymore, I’m not one of those with my eyes squeezed shut I see the government appearing to be motivated one way when the truth is another.

Anne, I could not agree with you more.

I have suffered from depression for most of my life, and had a doctor once prescribe me wellbutrin.  This definitely was not the drug for me, and I would tell the doctor about the sleepless nights and suicidal thoughts that this drug was causing, and all the doctor did was just keep “uping” the dose.  The doctor’s who office was filled with wellbutrin paraphernalia, from the calenders on the wall, to the pencil holders to the “free” samples he gave me every visit.  The guy barely spoke to me aside from giving me the pills; it was his therapists and nurses who saw me.  I saw him for maybe 2 minutes a week, long enough for me to complain about the medicine and for him to disagree and increase the dosage.

It didn’t take long for me to see him for what he was and to stop going to his office, but this seems to be a huge problem in this country.  The relationships between the doctors and the pharmaceutical companies need greater regulation.

Bart - hope you eventually found a drug that works for you.  I too have suffered and taken numerous drugs.  The ones that helped me most were Prozac and (you’ll like this) Wellbutrin, in fact I’m taking it now.  I was taking Effexor and it did a good job keeping my mood level, no highs and extreme lows - trouble is it was making me fat and I have never been so.  Anyway, quit taking that 2 years ago and since then I’m back down to my normal weight.  Weight gain is a commons side effect with many, too bad.  Its’ not much to gain if you lose your depression but die of a stroke due to overweight.

Your two minutes with the doctor - If you look at your insurance claims - it probably says “medication management” for type of appointment.  Its basically to do what you’ve experienced, the days of Freudian exploration of your innermost self are past unless you happen to be a wealthy movie star.

Many of the doctors are required to see “x” number per hour by the terms of their being on staff, sad but true, its all insurance driven.  Insurance decides how much time we get and what medications we get.

BTW, the suicide you blame on Wellbutrin, I don’t know your circumstances but if you thought about suicide while taking it you may well have thought about it if you weren’t taking it.

I mean who but depressed people kill themselves?

Attorneys ambulance chase once a drug (for example Prozac) is successfully sued then the hunt is on for more people by the attorney.  Which strikes me as wrong, then there’s a profit motive that shouldn’t be there imo.

What works for one doesn’t for another.  And in my case and probably others - even if you do find something that works, over time it becomes less effective.

You can always look for another doctor, even though its “just” medication management it shouldn’t prohibit him from treating you with courtesy and not make you feel as though you’re on a stop watch exactly.  like drugs, not all doctors are agreeable with the individual.

good luck

One thing I left out which is worth considering, I attended group therapy and there were others like me who were taking prozac (it was very new then) and were seeing tremendous improvement.  It was the first one I ever took that actually made me feel as though I could deal with life.  Those of us helped were concerned as there was a call to ban Prozac because of suicides and I’m glad it didn’t happen because I know it helped a lot of people including me.  Its like I said, what works for one works for another.  And a “feeding frenzy” of lawsuits can develop once the word gets out somebody got a huge settlement from one drug manufacturer.  I mentioned it to my therapist (maybe you should get one because they will talk to you and spend longer) and she agreed with me that as in prozac the suicide numbers may very well have been the same with or without.  A certain number of people do kill themselves and if they happen to be taking a drug at the time, its likely to get the rap.  Doesn’t make sense - you could just as well say, well he had a balogna sandwich that day so it was the bologna..

I’m not trying to minimize anyone’s feelings of despair or whatever, its just some things to consider.  We humans have been known to do things because of money and I can well see that if its profitable to say “my whoever” died because of xyz drug then I can almost guarantee there will be people waiting in line.

I’m not nuts about pharmaceutical companies, I think they do overcharge sometimes, but in the end, we all pay anytime there’s a lawsuit, they just raise the prices.  So in essence the public is paying the settlement fee.

Doctor Kevorkian was a better man

Bwahaha 100 milligrams of vicodin will kill you as the this would be a unsafe daily dose of acetaminophen.  O spams bots.

Sharon - if you want the people responsible to pay fine.  But the people responsible in too many cases are not the police who end up shooting “their baby” its the parents who didn’t care enough about “their baby” to know where the hell he was at 3 in the morning.

Having failed to properly supervize their child they have no business collecting money that wouldn’t be necessary if they had done their job.

As of today Dr. Buckwalter’s summary suspension has been lifted the Nevada Medical Board said he was a good boy for taking classes on how to be a good doctor. Check the Las Vegas Sun by Steve Greene for the story ,Amazing that Javaid Anwar signed his report card .After 10 people died I hope Karma gets him soon .

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