[llrn7470]

I just got through an exhausting two hour appointment with my PM doctor. After trying anything but opioids for my pain, he has finally agreed that I should be on MS-IR and MS Contin for pain. This I am open to because I am going through enough Ultram to float the Navy without much relief. I guess it didn't hurt that my hubby and best friend (a CT surgeon) were there to help let this guy know that I am not functioning well despite being on and off Neurontin, now Lyrica and Cymbalta. Anyway, the big deal came when he showed me a mandatory pain contract. Now I have no problem with any part of the contract (bringing my bottles to all appointments, keeping all appointments, going to no other docs for medications, drug testing, etc). Here's the kicker. It gave them free reign to discuss my case with anyone that they wanted to. I guess that this would not be a problem for most patients, but I work as a Neuro ICU nurse in a large university hospital. The very people that they would talk to about me are people with whom I work. I do not want these people knowing about the medications that I am on. Now, obviously, I am not going back to work on all of these medications. But I thus far have been responding well to lumbar sympathetic blocks and have a shot of being one of the few who make it out of this. I refuse to have my personal medical history shared with every attending and resident that I work with before I return. I was livid and said I refused to sign that item on the contract. Essentially, per the university (which the PM works for and I am a "home hostage" insurance member) says clearly "no contract, no meds." He argued, but I pointed out the conflict of interest and I said that I have the same rights to privacy under HIPPA as any other patient. My friend pointed out that essentially the insurance puts a gun to my head with this contract, as in "sign it or else." In the end and after much discussion and ranting, I sort of ended up with a line item veto that said that I needed to give prior consent for each doctor with whom they wished to speak about my case. I pointed out that there would be such a bias should my boss and colleagues find out my drug list when I go back to work that I would be given every drug test under the stars, would be eyed at every narcotic count, and likely not get to work with certain patients who were on these medications even though I have done nothing wrong and never would. I take my license sooooo seriously. It's how I feed my family and I know that there typically is an automatic trust which people have in their nurses that comes with no other profession. I love my job and have worked hard to get where I am. I am currently in classes and graduate in December with my degree and go right into Nurse Practitioner classes. Do you think I am being paranoid or do you think that it is akin to blackmail saying that I can't get treatment without allowing anyone to get my medical record where I work???