Many readers of this material are current or former patients of mine, and as such they have already experienced the misery of rolling stimulant shortages, shifting co-pays, unresponsive byzantine insurers whose live employees know less than their automatons. They have endured the rolled eyes and the helpless shrugs of pharmacists as they troll the city for their medicines. They have seen their doctors retire without replacement as more and more stimulant prescribers fall prey to fees that are never raised and new bureaucratic tasks that never end.
It about to get worse, at least in New York State.
In August 2013 the “tough” centrist” Cuomo administration began demanding that every doctor who prescribes any controlled substance to anyone (opiates, tranquilizers and stimulants) must go online to the PMP (prescription monitoring program) to prevent multiple prescriptions from different doctors. It adds five distracted un-therapeutic minutes to every visit, effectively lowering fees yet again.
Now, coming in March of 2015, all prescriptions are supposed to be electronically submitted. All prescriptions, including stimulants, must be electronically transmitted to one pharmacy at a time. No more written scripts at all. You used to print them yourself. Then they made you get preprinted ones from them. Now they’re just going to stop printing them. No written scripts. Period.
I am planning for retirement.
Whosoever devised this plan has no idea what it is like to run a psychiatric practice that caters to busy successful people who also happen to take stimulants. I’m not going into all the ways I feel that these computer based intrusions into my work impair me, (what if my Internet goes down; that never happens to you, does it? Am I supposed to stop working for the day?) but I will say this: It’s already more than difficult to find prescribers who are comfortable with and knowledgeable about stimulants, let alone willing to prescribe them at all.
Watch with me as it gets so much worse.
Our Practice Plans; Brooklyn Bound
These business-related regulatory, insurance, record keeping and IT challenges are the very reason why so few doctors who take insurance provide anything more than basic prescribing, and why there are so few of even those. For the past ten years we have had two equal offices; one in Greenpoint and another at various locations in downtown Manhattan.
Simple economics is moving us towards consolidating our offices in one location, Greenpoint, and this shift will take place very gradually over the next 6 months to a year. For the time being we will continue accepting new patients in both locations; by new year we will most likely be taking new work only in our Brooklyn office, and sometime in the spring I will move one of my Manhattan days to Brooklyn.