What Happens to the Patients When the Doctor Quits?

What Happens to the Patients When the Doctor Quits?

When controversial Montana physician Mark Ibsen said he had enough and decided to leave his practice in Helena, Montana, it set off an issue in Montana’s capital city that is being raised around the country.

What happens to the pain patients he treats? It is a question being asked in communities around the nation.

Ibsen had been targeted by the Montana Board of Medical Examiners for overprescribing narcotic pain medication, but interestingly won the latest chapter in that dispute last June. Ibsen contended that he was simply treating more patients with pain medications because other doctors had stopped seeing the patients because of fear of scrutiny by federal and state officials.

He called those patients “narcotic refugees” in a blog he wrote for the National Pain Report.

His decision to step aside had economic and emotional causes, he said. The legal bills and what he saw as unrelenting legal and regulatory pressure had him come to the conclusion that he was done. Ibsen’s patients had trouble filling prescriptions at the big-chain pharmacies in Helena.

One of his most vocal supporters has been retired pharmacist Steve Ariens who has grown increasingly angry with what he sees as a civil rights issue–access to medication for chronic illness, particularly chronic pain. He wrote on this topic in late August for the National Pain Report. He comes about his passion quite normally; his wife suffers from chronic pain.

As news of Ibsen’s sudden decision to quit surfaced, Ariens sent the following to the National Pain Report which we have decided to publish.

So no other family has to deal with…

by Steve Ariens

How many times have we heard this phrase stated after the death of a loved one or group of one or more innocent people are killed or harmed?

It doesn’t matter if you are talking about a medication mistake where a two year old dies or where a four year old who had a cancerous kidney removed whose parents had trouble getting his pain medication filled.

It would seem that those who have lost a loved one to either drug overdoses or gun violence seem to become galvanized into groups against certain substances that their loved one died from and/or guns in general.

None of these groups seem to understand that they are dealing with people that have very serious mental health issues.  Particularly, with those who have lost a loved one to a substance they use/abused or died from seem to be the most driven to prevent such a situation from happening again.

Are the people dealing with self-guilt that they could not “save” their loved one from the mental health illness of an addictive personality? Try as they may, the loved one’s self destructive death spiral they were in is irreversible.  So they have to find something/someone to blame.  It can’t be that their family’s gene pool has a “defective gene” that has shown up as mental illness.

On the other hand, when a chronic pain patient ends up dying of their own hand, because they have been denied adequate pain management by a prescriber or a pharmacist, You seldom – if ever – hear the same resolve from their loved ones to never letting it happen again…

Most likely, you will hear s/he is no longer in pain… s/he is at rest now, and the loved ones go on about their lives.  Why is there not the same amount of anger about losing a loved one to a disease that there are treatments available? Just like there is for those with mental health?

Why is it allowed for their death certificate be stated as “drug related overdose”, knowing full and well that the loved one was basically “forced” to resolve their pain by ending their life?

There is increased discussion among healthcare professionals and health insurers about pts being more compliant with their medication(s) to treat their chronic disease issues. However, for some reason, that discussion is focused primarily on high blood pressure, elevated cholesterol and diabetes. With the exception of diabetic neuropathy, none of the disease they are focusing on has chronic pain associated with them. Also, none of them are subjective diseases (pain, anxiety, depression, ADD/ADHD, mental health)

The same disease states that are the common denominators behind a lot of our social troubles.

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Authored by: Ed Coghlan

There are 10 comments for this article
  1. Lee at 5:55 pm

    In Oklahoma a doctor must send notice that there leaving and give 30 days of pain Meds so you have time to get a new doctor my doctor changed his practice from pain management to no pain meds like xaxnax and loratabs I have been going in to withdrawal I’ve had a heatattck and this going g kill me makes my heart feel like I maybe going to have anyother heart attack the new doctor won’t give me any meds [edit] the dea scum bags

  2. Patti at 7:39 pm

    Welcome to the new Police State. It would be something else if we were seeing the crooks who brought down our economy in 2008 being investigated so thoroughly and forced to reform their practices, or a big crackdown on the rape culture permeating college campuses and the armed forces, or trying to find a way to help the mentally ill that our society chooses to throw away, or doing something about the glut of money going into our elections, promising corruption…any number of things! Every comparative report or compilation of numbers shows that prescription drug abuse causes the least amount of deaths than any other legally obtained substance, including alcohol, tobacco and guns. This is just a DEA power trip; an expansion of the over funded and ineffective war on drugs that everyone knows has been a complete and utter (not to mention costly) failure. The worst part is, putting restrictions on alcohol or tobacco to reduce the horrendous health hazards these substances are known to cause would inconvenience people who use them for pleasure, whereas those who rely on prescription medications of any kind – pain medication included – are doing so to keep themselves healthy and functional, as much as possible. People who take pain medicine for severe chronic pain still feel the pain, it never goes away, and certainly not to the extent they are getting “high” from their medication. It simply gives them a bit of relief so that they can push themselves to work through the pain. Punishing these people because of the addicts in the world will only hurt the pain patients – the addicts will simply move on to something else; either street drugs or alcohol, or a combination of both. In the meantime, a big sector of the population loses any semblance of a life with function and dignity, and the empathetic doctors who truly want to use their years of training to help people are ruined.

  3. marty at 4:11 am

    Powerful and true article. I was shocked and saddened to see that Dr. Ibsen finally had to throw in the towel. Good lord he went thru a lot to help people. I can’t help but wonder what has happened to a good portion of his patients. Lately I have done a lot of thinking about what would happen to me if I lost my doctor. I have always been so against suicide and thinking it was a cowards way out but some days I think I would be doing my family a favor. Especially my 22 year old son who has given up so many dreams to take care of me. I only take one pain drug every 4 hours and it barely dulls the pain , but without it I know I couldn’t go on anymore. I have been thru the nights of waking after 4 hours screaming for his help and with every step he helps me take I scream and cry. How fair is that to put him thru this every day with the pain getting worse and worse. I want to put the thoughts of suicide out of my head and so far I have but it’s always an option now and especially if I lost my doctor. God speed to all suffering from chronic pain and being denied help to help you survive another day.

  4. Ariela Marshall at 9:51 pm

    Pain Patients are not living the Quality of life they could. There is no more Patient/Doctor relationship when Doctors are so scared to Practice Medicine the way they know to do because the environment is to Dam Hostile, The Doctors have no choice, That is too bad because it leave patients in pain with less options and Physicians not treating Chronic Pain Patients. A Lose Loose Proposition,

  5. Rebekka at 9:14 pm

    You have two choices when it comes to pain. Fix it (not always possible) or treat it. You can’t just reject a patient. We wouldn’t do that to animals, let alone people.

  6. Katie at 7:53 pm

    I’m a mom, wife, and suffer from irretractable chronic pain. I was in my mid 20s and my doctor who had diagnosed me and started treating me would spend 10 minutes with me, write me a new px to try and send me on my way, he didn’t care that I was in tears and afraid and didn’t understand what was happening to me. He didn’t care I didn’t want his prescriptions, I was just another patient, no big deal, just a pay check.

    I have never been a refugee because I chose for Dr. Ibsen to take over my care, why? Because when I came into his business a few years ago with an 8 day migraine he spent 3 hours with me. Not because he wasn’t busy, but because he cared. He wanted me to start seeing the naturopath that was next door, he sent me to physical therapy, biofeedback, accupuncture, chiropractors, massage therapies. He wanted to know where my vitamin levels were, plus many other tests that can contribute to my pain and fatigue. We spent hours discussing my past so he could heal the traumas that could possibly be what weakened my immune system and allowed everything in my body to go haywire. Dr. Ibsen inspired me, he gave me strength when I thought I had none, he encouraged me and reminded me I am not my diagnosis. He helped me find my fight, for that I will forever be grateful.

    Before Mark I was scraping by, I was suicidal as I could barely take care of my family. It’s hard when you go from an active super mom, one of those Pinterest moms, to a mushy pained blob that hides in the bathroom to cry. Dr. Ibsen inspired me, he encouraged me to keep searching for new treatments, for new medications, I would bring stacks of information in and we would sort through them eliminating the ones he didn’t think would be worth it. I’ve worked with top doctors from all over the United States, I’ve traveled oversees for care, all with his approval and rooting me on. From the time I walked in the door to where I was at a week ago I would say I’ve made an 85% improvement, without Dr. Ibsen I probably wouldn’t be alive.

    The reality of pain is just that, we don’t get to die, we get to wake up every day only to feel guilt ridden because we can no longer take care of what we used to. We get to wonder if I’m this bad at 28 what is 58 going to be like; “Please don’t make me suffer that long”,but this is our lives, this is our reality. Every chronic pain patient is stripped of their pride, dignity, confidence, jobs, their lives and many give in, many cannot take the pain anymore and when their doctor is taken or can no longer take the pressure, that patients light just went grew a little darker. Many that do not have adequate support from home, friends and most importantly their doctor, life is bleak. How long are pain patients supposed to keep fighting before they have no fight?

    Right now I am terrified of what will happen to the patients of the amazing Dr. Mark Ibsen, but I am also afraid of what was happening to him. I’ve been a patient before there were many, I’ve seen how this has all affected him, I’ve seen his tears that come because he can’t help everyone and at the end of the day I 100% support his decision, I am not angry with him for he has done more for me than any other person. I am scared however, I am scared of how long my light will gleam. I’ve reached out to other doctors, they are booked months out or no longer seeing new patients in light of the Christensen case and do not want to risk their own lives to save others.

    What I am angry about is that somehow we have lost our rights! We have become statistics, we have been deemed drug seekers because we are backed in the corner. Insurance doesn’t cover alternatives, so what are the pain patients supposed to do? The ones who take their medications as they are supposed to, the ones who get up every day and fight no matter how bad they are feeling?

    What happened to the oath doctors took? How did we get to where we are at, Dr. Ibsen has been singled out, gone rouge, some may say, but he is abiding by the oath he took not treating patients based on people who’ve never encountered a pain patients advice for what treatment that person needs. What happened to our government, that we the people are no longer a priority? I would never wish any chronic illness that creates debilitating pain upon anyone,the pain that is unrelenting and only opioids help reduce. Reduce is the key word, if you ask any pain patient they will tell you even with the medication the pain is not gone, it has just made it bearable. My hope is that the political powers above us see what they are doing and how inhumane this is. Let doctors be doctors, let them treat their patients without fear. Allow our medical community to become one again.

    My best wishes are to Dr. Ibsen, he is a strong man, stronger than any I’ve ever met. He has advocated, he has risked his career for chronic pain patients, and all at a great cost. A cost no man should carry alone, yet the majority of the pain patients remain silent. There is only so much one person can handle and without the voice of every pain patient in the United States nothing will change.

    Again, thank you Dr. Ibsen

  7. Kim Miller at 5:33 pm

    I too followed the situation with Dr. Ibsen, thinking he won his case and all was going to be fine. I was shocked and saddened when I read on Steve Arien’s blog about Dr. Ibsen closing his doors. I was upset for the doctor, a hero in the pain community, and extremely worried about all the patients who now find themselves out of options, out of medical care, out of everything but pain.

    What will these people do? How many will end their pain in a permanent way? What is wrong with this entire picture? Who is a winner in this scenario? I see no winners. Now is a time for advocates and activists to join together and express our outrage at this situation!

    Now is a time for solidarity, not divisiveness! We should unite during pain awareness month, in honor of Dr. Ibsen and in support of his cast out patients in Montana. It has happened to me and could happen to any of us at any time again. We are 100 million strong!

  8. Mark Ibsen MD at 3:37 pm

    http://www.nbcmontana.com/blob/view/-/34959790/data/1/-/b5tr0v/-/christensen-court-doc-1.pdf

    Read page 7 of the indictment of Dr Christensen.
    This would strike fear into ANY physician who prescribes.
    That is why no one will.

    Ask yourself: if the medical board, a division of DOJ ( the attorney for the BOME is assistant attorney general)
    Restored his license, how can the County Attorney arrest him 10 days after he resumed his practice?
    And
    Charge him with 400 felonies( nice round number)?
    That is 36.7 felonies per patient.
    Sadly, 2 people died.
    At their own hand.
    And, after holding his records hostage for 17 months, they found 9 patients to “turn” on Dr C.
    Nine out of 4718 patient charts.
    What turned these patients’ stories, from “please help me Doctor”
    To
    “The doctor was trying to harm me”?

  9. Kim Miller at 12:32 pm

    I too followed the situation with Dr. Ibsen, thinking he won his case and all was going to be fine. I was shocked and saddened when I read on Steve Arien’s blog about Dr. Ibsen closing his doors. I was upset for the doctor, a hero in the pain community, and extremely worried about all the patients who now find themselves out of options, out of medical care, out of everything but pain.

    What will these people do? How many will end their pain in a permanent way? What is wrong with this entire picture? Who is a winner in this scenario? I see no winners. Now is a time for advocates and activists to join together and express our outrage at this situation!

    Now is a time for solidarity, not divisiveness! We should unite during pain awareness month, in honor of Dr. Ibsen and in support of his cast out patients in Montana. It has happened to me and could happen to any of us at any time again. We are 100 million strong! Let’s show our outrage and comment to this article. Are YOU fed up?

  10. Nancy at 10:02 am

    This is so sad. I have been following the case of Dr. Ibsen. So disheartening to see he has to leave his position. But I can certainly understand why.
    How will his patients find another prescriber? How many will end their lives?