Orthopedic Trauma Patients: ‘Doctor Shopping’ and Increased Narcotics Use

Brent J. Morris, M.D. Shoulder and Elbow Surgery Fellowship Texas Orthopaedic Hospital in affiliation with the University of Texas Houston Health Science Center, Houston, TexasMedicalResearch.com Interview with:
Brent J. Morris, M.D.
Shoulder and Elbow Surgery Fellowship
Texas Orthopaedic Hospital in affiliation with the University of Texas Houston Health Science Center, Houston, Texas


MedicalResearch.com: What are the main findings of the study?



Dr. Morris: There are concerns that an increasing percentage of patients are receiving narcotics by “doctor shopping” or seeking narcotics from multiple providers. One in five of our postoperative orthopedic trauma patients received narcotics from one or more additional providers other than the treating surgeon.

Patients that doctor-shopped postoperatively had a significant increase in narcotic prescriptions, duration of narcotics, and morphine equivalent dose per day.

MedicalResearch.com: Were any of the findings unexpected?


Dr. Morris: The prevalence of postoperative doctor shopping was surprising, and unfortunately, this number likely underestimates the true extent of postoperative doctor shopping.

MedicalResearch.com: What should clinicians and patients take away from your report?


Dr. Morris: This study highlights the importance of counseling our patients in the postoperative period about narcotic use. The treating surgeon is responsible for pain control in the immediate postoperative period, and additional narcotics should not be sought from multiple providers without alerting the treating surgeon. Pain control in the postoperative period is very important, especially in patients with traumatic injuries; however, there needs to be better awareness among patients and providers to ensure that patients do not engage in doctor shopping.

MedicalResearch.com:  What recommendations do you have for future research as a result of this study?

Dr. Morris: We now recognize that a high percentage of patients doctor shop postoperatively and research should be focused on combating postoperative doctor shopping and quantifying the impact of narcotic use on clinical outcomes and patient satisfaction.

Citation:

The American Academy of Orthopaedic Surgeons Meeting 2014
Narcotic Use and Postoperative Doctor Shopping in the Orthopaedic Trauma

Brent J. Morris, MD, Nashville, Tennessee
Justin Zumsteg, MD, Nashville, Tennessee
Kristin Archer, PhD, Nashville, Tennessee
Brian Cash, BS, Nashville, Tennessee
Hassan R. Mir, MD, Nashville, Tennessee