[idiot900]

I'm a doctor. During medical school and residency, I was taught in good faith that "only as much as necessary" opioid was OK to give and wouldn't create dependence - it was only an "excess" of opioid that would cause a problem. So under the banner of reducing the suffering of our patients, and a mandate to reduce patient-reported pain scores, opioids flowed relatively freely.

Now we know that was a terrible idea with devastating consequences. But we didn't know better and truly thought we were doing right by our patients. It's hard to imagine a programmer without medical training could be blamed.

[bpaddock]

The problem is things have gone to far the other way now. Those with Chronic Pain are now committing suicide (as did my wife) when they are let to suffer.

The CDC itself stated in April of 2019:

"CDC Advises Against Misapplication of the Guideline for Prescribing Opioids for Chronic Pain Some policies, practices attributed to the Guideline are inconsistent with its recommendations"

Sadly the medical community is not getting that message due to this mater now becoming political.

https://www.cdc.gov/media/releases/2019/s0424-advises-misapp...

[sonofhans]

I’m so sorry about your wife.

[conanbatt]

Incredible that this is another comment of yours that manifests the answer I gave you in this topic.

Providers are under the microscope for opioids now, so why risk it, it's not their pain. Medicine is a rough field.

[bpaddock]

We posted at the same time, see my comment above yours about the documentary Pain Warriors.

Dr Mark Ibsen is one of the five stories. He lost everything for helping those with Chronic Pain. Five of his patients killed themselves when he was no longer able to prescribe. The medical board said he was over prescribing, that blood is on the boards hands. The arbitrator/judge in the case said that Mark did not do anything wrong, yet The System destroyed him.

Yes it is a rough field. I see it every single day in advocating for those that the Medical Establishment has forsaken.

There are bad doctors, there are bad people writing medical software as this thread explains. They need dealt with.

[bpaddock]

Pain Warriors documentary about Chronic Pain and medical establishment teaser is on my YouTube channel. Read the reviews of those that have seen the full movie previews.

https://www.youtube.com/watch?v=TN3T7lfab7Y

[jessaustin]

My condolences for your loss. My grandfather did the same, for the same reason.

[JshWright]

> Now we know that was a terrible idea with devastating consequences.

Practice Fusion knew that at the time. Internal emails released as part of the legal process make it clear that this feature was designed to get previously "opioid naive" patient (people not previously prescribed opioids) hooked on extended release opioids. This was specifically done to address the falling rates of ERO prescriptions, which the pharma company described as being due to "political reasons".

[pnw_hazor]

US negligence law encourages physicians to follow "the medical standard of care." This means doing what they are taught in medical school shields MDs from liability until the standard of care changes. The law discourages MDs from deviating from "standard" practice because doing so removes the "standard of care" liability shield.

The software developers are not protected by the "standard of care" shield. The software developers, like just about every other profession are held to a higher standard than MDs, namely "ordinary care" or "reasonable care".

Is a software company taking reasonable care to avoid harm when it builds a software feature that secretly encourages doctors to issue dangerous prescriptions? I don't know -- doesn't sound like it to me. Though there are probably a few plaintiff's attorneys willing to find out how a jury thinks about it.

[jessaustin]

Going through medical school and years of post-doc training makes physicians less responsible than people with no medical knowledge whatsoever? Yikes! If this is true, I hope the AMA lobbyists who bribed that turd onto the books were paid well for their evil deeds...

It's probably also not great for patients with rare diseases, that physicians are penalized for trying to solve problems no physician has solved before.

[pnw_hazor]

Yep, if safer or more effective innovative techniques become known, US MDs are not expected to practice them until those innovations become accepted as the standard of care. Other industries/professions don't get that break.

[pimmen]

That would absolutely be a valid reason to build the service like that; the medical community thought that only an excess of opioids would be a problem, and it directly improves the numbers they're evaluated on. However, once the medical community gets wise to what an awful idea that was, I hope that when the software providers hear about this they try to figure out a way to mitigate the damage they're causing. This feature was added in 2016.

Though, I think we agree that you cannot make an ethical decision on which action you should take unless you have any idea of what the consequences of your actions will be.

[jaclaz]

> It's hard to imagine a programmer without medical training could be blamed.

Sure, but I would have expected that there would have been some perplexities by the actual doctors when they were presented these popups at each patient data access.