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Understanding Suspicion in the Emergency Room continued...

ER doctors have one useful tool, though. Currently, 34 states have prescription drug monitoring programs that allow doctors to check a patient’s prescription history online. “I can look up a patient and see all the prescriptions that have been filled for controlled substances,” says Blumstein, who practices in North Carolina. Doctors can use the database to corroborate a patient’s story. Or they might see patterns that warn them to probe further for drug abuse, for example, prescriptions from numerous physicians that have been filled at multiple pharmacies.

“It is an unbelievably great tool for physicians,” says Eduardo Fraifeld, MD, president of the American Academy of Pain Medicine.

But ER doctors also rely on instincts, Blumstein says. “It’s all perception. It’s the whole gut impression that the health-care providers get about you.”

So how can a patient with chronic pain convince the ER staff that his or her complaints are legitimate? Here are a few tips from the pain experts:

1. Make sure that you have a regular physician who treats your chronic pain.

That’s a relationship that all chronic pain patients should establish before they ever set foot in an emergency room, Blumstein says. But many people don’t have a doctor, he says, “and it looks really bad from a doctor’s point of view when a patient comes in and says, ‘Oh, I have this terrible chronic pain,’ and the doctor says, ‘Who’s taking care of this terrible chronic pain?’ and the patient says, ‘Oh, I don’t have a doctor.’”

“Before you get into a situation where there’s an exacerbation of your condition, make sure you have a regular doctor treating you,” he says.

2. Show that you’ve tried to contact your regular doctor before you go to the ER.

If you’ve been in pain for five days and have not alerted your doctor, the ER staff will question how bad your pain really is, Blumstein says. Even if the pain struck just that day, make an effort to contact your regular doctor first, he suggests.

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