A Doctor’s Appointment Can Feel Like Criminal Court for Pain Patients
/By Crystal Lindell
This week I had an appointment where I was worried that I would have to submit to a urine drug test. And if anything went wrong, it could ruin my life.
It wasn’t a criminal court date or a meeting with a probation officer. It was with my doctor.
Every six months, I have to see the doctor who prescribes my opioid pain medication for a check-in. I’m actually very lucky that I only have to see him twice a year, because many patients are required to go in much more frequently.
But those two appointments each year cause me so much stress that I have trouble functioning. There is always the fear that if something doesn’t go according to plan, my opioid prescriptions could be cut off. And when a doctor has that much power over you, it’s rational to worry about how things will go.
So, in the weeks leading up to the appointment, I stress about everything that could go wrong.
Chief among my worries is that I haven’t had health insurance since 2022, so now a lot of my previous medical bills are in collections. Mind you, even when I had insurance, a lot of my medical bills went to a collections agency because, between co-pays and deductibles, the bills were in the thousands of dollars.
I always worry that this be the visit when my doctor finally cuts me off from care because of unpaid bills. Or maybe it will be the front-desk receptionist who confronts me about the overdue bills. What do I do if they refuse to see me as a patient because I am late paying? While it’s a decision that would fully be within their rights, it would ruin my life.
I have good reason to fear this. In 2008, I got an HPV vaccine from a doctor, and the shot came with a $150 co-pay. I had just finished paying thousands of dollars in medical bills for my gall bladder removal surgery, so I was having trouble paying for the vaccine.
And then, out of the blue, I got a letter from that doctor’s office saying that they were cutting off my care because of the unpaid bill. And I was no longer allowed to get care at any of the doctors in that hospital system.
I was shocked and sad, and also thankful that I was moving out of the area soon. But the experience scared me and left me constantly worried that even small unpaid medical bills could result in a doctor abandoning me.
Money isn’t the only stress factor when it comes to these appointments. There is also the chance of a urine drug test going wrong. While my doctor has not ordered one in a while, it’s always a possibility.
Now, you might assume that since I take my medications as prescribed, there should be nothing to worry about when it comes to peeing in a cup. But if anything does go wrong, I could lose access to the medications that I need to function. Like if there’s a false result on the screening, which happens more often than you might think.
So, I stress.
A lot of people assume that drug tests only look for non-prescribed or illicit substances. That what they are really looking for is cocaine and heroin. But the tests go far beyond that, and they are constantly adding substances to check for. While they have never tested for kratom in the past, I have no idea if it will suddenly be added to the screening, and what would happen if I tested positive for it.
The real reason most doctors order drug tests is they want to make sure you are taking your opioid medication as prescribed. If the medication isn’t found in your urine, that means you might be selling or diverting it.
Again, not a problem for me. But still, the act of being forced to pee in a cup for the sole purpose of policing my compliance with the doctor is always going to feel punitive.
All of these worries are rolling around in my brain when the day of the appointment arrives. I have to wake up earlier than normal to shower and make the drive to the doctor’s office. It’s almost two hours each way because he works at the closest university hospital, and my complex medical needs require more than a local primary care doctor can handle.
My body hates waking up early, and my chronic pain often flares up in rebellion if I don’t get enough sleep. So, I have to ease into functioning while waiting for my pain medication to kick in.
All of this stress is compounded by the fact that on the day of this particular appointment it was snowing, with a mix of rain and sleet hitting the ground in just the right way to make all the roads extremely icy.
I knew this was going to make driving difficult, but I also knew that if I canceled my appointment, I risked not being able to get my next pain medication refill. So I prepared myself for an extremely treacherous drive and planned to leave a full hour early
Before I was set to leave, my fiancé went to the local Casey’s gas station to fill up the car for me. When he came back he sounded like he had been to war: “You can’t drive to your appointment in this weather! People were literally spinning out in the Casey’s parking lot!”
Ugh. Fine. I decided to suck it up and call my doctor’s office to see what my options were because I knew the weather was too bad to drive.
I assumed that I would need to completely reschedule, because he’s usually booked out for months. But when I called, the receptionist said that in the notes my doctor had said that I could do the appointment virtually if needed.
I once heard that wearing different colored socks brings good luck, and thus I have done this many times throughout my life on stressful days. And this time, it actually worked!
I was able to do a very easy telehealth call, from the comfort of my own home! Everything went extremely well. He told me that he had seen the weather, and that I had made the right call to stay off the roads that day. I had spent all that time stressing for nothing.
But it shouldn’t take a pair of mismatched socks to get compassionate care. Millions of chronic pain patients are constantly stuck navigating these types of appointments because of the war on opioids. Unfortunately, many of them end up living the things that I feared.
Of course, in six months’ time, I will have to go to his office again, and I’m sure I’ll go through all the same stress before that appointment too. Hopefully by then I’ll have some sort of health insurance, and ideally it will be a clear summer day..
Until then, I’m just happy that my doctor decided to rule in my favor. In an ideal world, a doctor’s appointment shouldn’t feel like a verdict.
