FUDIN and GUDIN Serve Up Medical-Legal Pain Cases!
Who would’ve predicted that an MD from Northern Jersey and a PharmD from Upstate NY, their names separated by just one letter, and unbeknownst to each other for years, each developed independent passions for treating pain without crossing paths for more than a decade?
Most recently, Dr. Gudin and I both learned that each of us have participated as legal expert witnesses in various [overlapping] case examples that could have incredible learning and “defensive medicine” implications for pain practitioners and other providers/pharmacists nationwide. We decided over a relaxing break from teaching on a sunny afternoon in Phoenix that we will finally join forces, team up, and provide monthly vignettes on assorted pain cases that should prove helpful to anyone treating pain, from the prescriber to the dispensing pharmacist, in some cases the nurses administering drugs, and perhaps even non-clinician caregivers. This specialty blog promises to be quite interactive with clinicians and patients alike. Who knows, maybe we’ll engage some attorneys.
Big fish story? Not really…
The FUDIN-GUDIN team, both editors for Practical Pain Management, originally learned of each other many years ago when Fudin was receiving emails and other communications to lecture and consult at various venues. At the same time, it seems that MD counterpart Gudin was encountering the same requests. Both learned of each other’s existence but still hadn’t met. One day, Fudin shows up for an Advisory Board meeting in North Carolina, attempts to check into the hotel and is told “we have no reservation for you”. Baffled, Fudin asked the receptionist to double check. She tells Fudin, “We have a reservation for a Dr. Jeffrey Gudin, but none for Dr. Jeffrey Fudin”. Fudin politely points out that there is in fact a Dr. Gudin, but has no idea if Gudin is scheduled to attend. Then the receptionist comically states, “Oh, look here – there are two reservations for Gudin, and none for Fudin”. As the last words fell off her lips, Gudin shows up behind Fudin, taps him on the shoulder, and that was the beginning of their very first live encounter.
We hope this will be the inauguration of some great educational opportunities. In fact, next year we have a surprise session planned at PainWeek in Las Vegas where we plan a FUDIN-GUDIN debate. Stay tuned for that, and enjoy the upcoming blogs. See you soon here at the PAINFULLY LEGAL blog.
I have no idea how many US pain sufferers take, or have taken, opioids to relieve their pain over long periods, like for a year or more. Could somebody please provide a number like that and the source?
I echo the congratulations and admiration for the importance of your individual contributions. As the newly formed Dynamic Duo you are poised to rescue Gotham at a time when both patients and prescribers are assumed to be guilty until proven innocent. These are difficult times when competent, compassionate health professionals are scrutinized by politicians or law enforcement agents who lack such training and aptitude.
Kimberly,
Thank you for your kind words and I’m happy James P. Murphy, M.D. is helping you with your chronic pain. I may need to see him soon, I don’t know yet, my doctor is a nice guy and I hope he continues to help me with my never ending chronic pain. Maybe he will read this, I don’t know.
The doctor I see now said start titrating down, taking 5 mgs off every 7 days. So this past summer I cut my medication to less than half of what I use to take. I found it still works at a lower dose so this surprised me . I listened to my doctor now I’m doing just as good as before on a much lower dose.
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Taking away opioid medications that help those in chronic intractable pain live a somewhat normal life is equal to ,
1. Taking away antibiotics from those with a serious infection.
2. Taking away blood pressure medication from those with out of control blood pressure.
3. Taking away blood thinners for those with heart problems.
4. Taking away cholesterol medication from those with high levels of cholesterol.
5. Taking away insulin from those with diabetes.
6. Taking away Viagra from those with , well you know.
7. Taking away Dilantin from those that have a seizure disorder.
8. Taking away Prilosec ,Zantac from those with chronic heartburn.
9. Taking away Ambien from those with insomnia,,, really cruel.
10. Taking away Kaopectate from those to treat sudden diarrhea,,, more cruel
NEED I GO ON ,,, PEOPLE IN CHRONIC PAIN CAN ADD TO THIS LIST IF YOU LIKE.
MUST PEOPLE TRULY SUFFER EACH DAY FROM NEVER ENDING CHRONIC PAIN.
I PRAY NOT.
CAN ALL OF US JUST PLEASE GET ALONG .
Let me congratulate both of you on this endeavor. It is a sham however that treatment of people with such a severe disabling condition has to be premised on multiple legal questions BEFORE the medical encounter can ensue.
I do have one legally based question: Is it possible to determine that a physician is “overprescribing” medication but to do so without ANY input from the patient. The medical record reflects the fact that the patient is doing well. The patient has a history of many years on a stable dose and has not shown any aberrant behavior. The regulators, state and federal both decide that the doctor is “overprescribing, apparently based only on the quantity of pills being prescribed.
Is it reasonable, and more importantly legal, to make a determination of overprescribing without any input from the patient that they are having problems with the medication?
Just throwing a scenario into the pot for both of you to mull over.
I am pleased for both of you and also for those of us who support the appropriate management of pain. The knowledge and experience each of you possesses will lead to a more in-depth understanding of therapies and potential outcomes. Congratulations on the new collaboration.
I am New to the Group Kentucky Pain Care Action Network, I am Pleased at The Information Provided there, and Glad these two Doctors Have Met and Pleased to Have Such Concern For The Patients Rights and the Support found Here I am Happy that you Both are tryin to help People like me thanks for all you are doing.
The treatment of chronic pain is complicated , even though we have data supporting the use of opioid therapy for certain individuals that suffer from chronic pain. The media scrutiny information of overdose deaths caused by people abusing opioids making it seem like any and all prescribing of opiates by experienced doctors is wrong no matter what.
In the past decade the treatment of chronic pain has taken a swing in a negative direction for those abusing the privilege of opioid therapy. We must come to a understanding and make ordinary people and groups like FED UP ! understand no one person suffering in chronic pain must continue to live a life with paralyzing pain.
Living with chronic pain can be frustrating, this can lead to personality changes making pain sufferers feel left out and alone in pain. Chronic pain sufferers need to learn to comply with your doctor and not be so demanding . In my experience with Opioid Therapy over the past 20 years it has helped me a great deal. This past summer I decided to step back and take a look at where I was with my therapy after all these years. After being treated by 4 different pain specialist over the years things where getting out of balance. I was able to titrate down to the lowest dose possible and it still be effective on my chronic pain and indeed I was able to make a huge decrease in dosage . There is a fine line of who opioid therapy may help. There may be individuals who may benefit from opioid therapy and others its just not for. Bottom line is we must have availability to opioid therapy for those who can truly benefit. Leaving people to suffer in chronic pain is inexcusable.
Mark, I believe what you are saying is true, Though I am still not satisfied with my therapeutic level, I have learned to be more patient with the doctors and pharmacists who ARE trying their best to make sure chronic pain patients get the help they need. I was fortunate enough to come across a wonderful pain doctor, James P. Murphy, M.D., who actually cares about the patients he treats, He even talks to you like you’re a real patient and not an addict. I consider myself incredible lucky to have come across his office on only my fifth attempt at trying to locate someone to handle my pain issues.
I understand what you mean about the opioid therapy perhaps not being for everyone. If you can’t play by the rules, you are out. Yes, even at Murphy’s, there are rules and there are consequences. I think Drs. like Murphy, Fudin and Gudin are all that stand between us and NO pain relief in this new opioid-phobic world we are forced to live in and what it holds for us in the future.
***** SEPTEMBER IS PAIN AWARENESS MONTH ******
“Opposition to Kentucky HB 1-Reform HB 217 aka “Pill Mill Bill”
https://www.facebook.com/pages/Opposition-to-Kentucky-HB-1-Reform-HB-217-aka-Pill-Mill-Bill/595049517218134
I have been a pain patient for 20 years and in the past year my family doctor because of the opioid crisis has had send me to a pain center it was the only pain center in the state of Iowa that would take me they said because I was on such a high dose of oxyContin and oxycodone they have cut my pain medicine in half I go through monthly withdrawal and at this dosage I am in terrible pain for longer periods of time can you please tell me how to Contact this Dr. Murphy I have no other doctors that will see me
Fabulous, I will share this with an attorney friend who did a YouTube interview with me. Ironically, I also have a degree as Legal Nurse Consultant in Paralegal Studies and was an expert witness during my nursing career. Now, as you know, I still advocate, write, and educate. I look forward to what the two of you have to offer clinicians that will ultimately affect the patient. There is value in collaboration.
Congratulations to you both! I’ve known Drs. Fudin and Gudin for many years and they are exceptional people and dedicated practitioners in every sense of the word! I look forward to reading this exciting blog and perhaps contributing to it now and then.