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Ortho: Trauma
What is your pain medicine policy?
It is our goal to provide each patient the right medicine, dosage, amount, and for the appropriate length of time required for the injury that is being treated under the care of the orthopaedic trauma service, in a timely manner. Narcotic medication presents issues challenging to staff such as serious side effects for the patients such as sedation, depression, impaired thinking, impaired breathing, itching, hives, all of which can be dangerous. Narcotics also contribute to problems with tolerance, dependence, abuse and addiction. Any of these issues can result in serious bad outcomes such as hospital admissions or even death. We enter the health care field to maintain the health and wellness of our patients and are governed by laws that protect you the patient, as well as the provider from problems associated with the administration of certain medicines. For this reason, we ask our patients to sign an agreement, with our staff regarding Narcotic Refill Policy, at your first visit to our clinic. If there are any questions or concerns please discuss these with the physician prior to signing the agreement. The items are taken very seriously by our office staff, resident physicians and attending physicians.

Medication Agreement:

* I agree to keep all of my scheduled appointments, or call to reschedule the appointments within 24 hours of the appointment time. I understand that no medication will be given if there was a “no show” appointment. The University policy also states that if I am more than 30 minutes late to an appointment I may have to reschedule for another time.
* I agree that I will only receive narcotic pain medicine from the University of Missouri Orthopaedic Trauma service for the condition that is on the chart at the present time. If there is a new condition for which I have chosen a different physician I will call this office to let them know of this new condition and any new medications. If there are multiple narcotic medications from different physicians without being notified, we will immediately discontinue medication prescribing and notify the pharmacy, the other physician and will not restart the narcotic.
* I understand that I cannot be seen at the Orthopaedic clinic without a scheduled appointment. If I run out of the pain medicine prescribed, I am still required to follow the 48-72 hour refill policy. If the pain that is being experienced is out of control, then I would need to be seen by the Emergency Room physician for evaluation and treatment.
* One pharmacy must be used for all prescriptions. This will be kept on file and all refills will be called to this pharmacy.
* You must discuss any changes of narcotic pain medicine with the physician at the office visit. It very important for you to notify the doctor about your pain so that the correct pain medicine can be prescribed for you. We will not change strengths or medicines over the telephone. Aspects of pain that should be communicated while you are in the office visit would include: intensity, duration, what causes the pain, what helps the pain other than medicine, what activities are you doing, how much medicine you are currently taking.
* I agree to take the prescribed amount of narcotic pain medicine. I have been instructed that by taking too much medicine or additional medicines can be harmful to my health, resulting in damage to my kidneys or liver. If the pain medicine is not working effectively, I will call and discuss the pain with my physician’s office.
* I am responsible for giving the Orthopaedic Trauma staff 48-72 hours to refill my prescription which means that I need to keep track of the number of pills that are left and call in advance to request a refill of the medicine to the pharmacy on record. The patient is required to call for their own pain medicine refills unless there is an extremely unusual circumstance preventing the patient from doing so. In this case, one person is designated as the spokesperson for the patient. I understand that it is not acceptable to call the office multiple times to get this task completed. Abusive behavior towards staff is not tolerated.
* Pain medicine requests involving regularly scheduled pain medicine should be made Monday-Friday 8am-4pm. If you are having a new problem, or worsened condition that needs to be evaluated prior to the office hours the following day then you would use the physician on call. However, if it is determined that this process is in any way being abused, the trauma staff can discontinue the use of pain medicines for you.
* There may come a time in this process that it isn’t clear why the pain response continues to be so great. At this time, our physicians may consult a Pain Specialist to evaluate your injury, pain medicine regimen and take over the care of this process. These individuals are specially trained to treat chronic pain issues with many different methods of therapy that prove beneficial to your treatment.

I have read the above agreement and agree to each statement as it is written. I understand that at any time, if I do not adhere to the guidelines of the above agreement, the Orthopaedic Trauma staff is not obligated to continue providing narcotic pain medication. I will also communicate with the Orthopaedic staff any characteristics of pain that may be beneficial in prescribing pain medicine.



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