The recent JAMA for Internal Medicine study regarding the success of Florida’s initiative. The study cites a 1.4% decline in the aggregate amount of prescribed opioid medicatins.As an objective professional in both teaching the Florida Pain Management Law and Regulations for the past five years , and consulting with numerous pain physicians and clinics in evaluating their patient’s compliance with the Pulido Coates Pain Patient Compliance Protocol and Scale, I have determined that while the Florida legislation has reduced the number of illegal pill mills, the Legislation has rather increased patient NONCOMPLIANCE in even the finest of legitimate pain management clinics and prescriber. In essence, patients are duping the docs! The average clinic level of non compliance including all 5 scale levels we scored in 3200 administrations using the PPCP-S is 60% NON COMPLIANCE. We routinely ask each physician medical director before we begin assessing their patient’s compliance how they think their facility rates as to compliance. The response is almost universally even among the most cautious physician, “my patients are 90-95% compliant”. Upon showing empiricle evidence of the easily scored PPCP-S, which is a billable procedure, that even many of their most perceived compliant patients are non compliant, the physicians are shocked.
It is one thing to close down a Pill Mill or make access difficult in pharmacies; its a totally different nightmare to know 60% of non-malignant chronic pain patients are either not educated or diagnosed properly, or the patient has become accustomed and skilled to serve to their reptilian pleasure seeker mentality. Its high time to protect the physician AND their patients from patient non compliance. its just the right and good thing to do.