I've turned down many patients for a refill who are on ambien and xanax 3 times a day including one Xanax ER a day. At best I'll offer a weaning schedule so that we don't stop them cold turkey. Many times they will refuse.
There is a doctor near where I practice who has switched to direct medicine or concierge medicine. Ever since the switch, we have had a flood of new patients who are all on the same meds. Without fail, every patient I have of his is on the same regimen. Ambien 10mg nightly, xanax 1mg tid, and xanax ER once daily. Sometimes a norco or muscle relaxer will be on their profile too.
I've noticed that this direct pay doctor will not fill anything but those meds for them and leave the DM II management with A1c of 13's up to me their new insurance taking primary care doctor. (me)
How do you guys/gals deal with this? I'm tempted to reach out to him and more or less be like bro…wtf is going on? I'm confused what my and your role is here.
On one hand I want to help their medical problems but on the other I find it hard when they have two different primary care doctors, one of which seems to only be treating anxiety or insomnia with high dose benzos. Since I do treat those disorders but not with benzos long term, these patients will flock to the cash pay doctors near me to get their fill.
Should I start refusing to see these types of patients to treat their diabetes, HLD, thyroid disorders, etc? What would you do?
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