Office Policy

The goal of HCPA is to improve quality of life and restore an individual's ability to perform acceptable levels of activities of daily life such as occupation, hobbies, sports, housecleaning, cooking, self-care, etc. Our program is an integrated, non-interventional pain management program. It is not a standalone facility to distribute controlled substances such as opiates including but not limited to: Vicodin, Loricet, Hydrocodone, Oxycodone, Percocet, Roxicet, OxyContin, Morphine Sulfate, Avinza, Kadian, Hydromorphone, Opana, Fentanyl patches, Dilaudid, etc. Although opiates do have a role in the management of chronic, nonmalignant pain, they may only be used after a thorough physical evaluation with an appropriate diagnosis and in moderate doses and may be prescribed as an integrated treatment plan with other modalities. High levels of opiates have not only been shown to lead to chronic abuse, dependency, tolerance, and addition but also to Hyperalgesic Syndrome. Hyperalgesic Syndrome is a condition caused by opiates. At high doses, opiates can actually increase pain, and paradoxically, the higher the dose, the lower the pain thresholds. Thus, patients may actually experience more pain with escalating doses.

This practice does not automatically renew opiates from another doctor. Very often, our initial telephone screenings will identify an individual whose dose of opiates is extremely high and may be counterproductive for the treatment of pain. There also may be the identification of chemical dependency, abuse, or addiction. In these cases, we may recommend the patients be referred to an inpatient facility specializing in substance abuse, or if the patient qualifies, we may offer the outpatient Suboxone Program at HCPA.

HOW TO BECOME A PATIENT AT HCPA

A patient needs to go through a step wise process in order to become a patient at HCPA.

The patient will be screened by one of our professionals over the phone to determine if he/she is an appropriate candidate for this program. If the patient is determined to be either a chronic pain patient and/or a Suboxone patient, we will ask that medical records and a pharmacy history be provided prior to the first visit. These usually include a year's worth of medical records from the previous physician and at least one progress note within the last thirty days.

Next, the patient is scheduled for an initial visit. At the first visit, a comprehensive history and physical examination will take place by Dr. Hayes. He will then develop a treatment plan. There is no guarantee that a specific drug including opiates will be prescribed or be part of your treatment plan at any time.

Dr. Hayes will then review your diagnoses and spend quite a bit of time discussing the nature of your ailments, pain issues, prognosis and the specifics on how the program will help the patient.

The doctor will discuss risk benefits of treatments and side effects of medications.

Appropriate referrals will be made to other specialists if necessary.

If a controlled substance is to be prescribed, you will be asked to sign a physician-patient agreement for controlled substances. The agreement is an 18 point directive specifically covering obligations of the patient to stay within the pain management program. These include drug screening and refill policies.


REFILL POLICY

No refills are given between office visits.

Emergency refills will only be given at an office visit with a 48 hour notice.

It is federal and state law that no more than thirty (30) days of a controlled substance be given to a patient at any given office visit. Three month prescriptions may be given for non-controlled substances, but no exceptions can be made for opiates.

A patient may not give or sell medications to another person under any circumstances. This may lead to the immediate termination of any further treatment.

If you receive a pain medication from HCPA, you may not use another physician for pain medication.

The patient should use only one pharmacy.

The use of illicit drugs including non-prescribed opiates is prohibited. This may lead to the immediate termination of any further treatment.


DRUG SCREENING

This office complies with federal guidelines. We perform random drug tests on ALL patients who receive opiates controlled under the DEA (Federal Drug Enforcement Agency). Our patients are very special, and we want to ensure the highest level of medical care without intrusion or challenge to personal integrity. However, in order to provide this level of care, we must comply with federal and state guidelines. Accordingly, we have instituted a drug testing program in accordance with these guidelines. The utmost courtesy and dignity will always be of paramount importance. It is quite non-invasive and is done in complete privacy. The specimens follow a chain of custody form and are sent out to a federal and state approved laboratory for evaluation.

Should you have additional questions, please call 610-757-1035.