These questions will precipitate an investigation. These investigations will significantly undermine physicians prescribing practices. And it will be America s rural communities that suffer most. Rural physicians are often subject to more scrutiny. Urban physicians have more ready access to the latest information concerning pain management.
Urban physicians have better access to pain specialists.
Therefore urban physicians are more confident in their ability to defend their use of a controlled substance. It s very safe to say that every hospice in the country has had a request for help to die from at least one of its patients, not just Oregon hospices. When Sen. Nickles introduced the Pain Relief Promotion Act in the Senate, he indicated that a dynamic was created whereby some doctors underutilized controlled substances for pain. Hospices report that such instances were isolated and, most often, readily corrected. While we do not know that the letter from Mr. Constantine was the cause, the timing is suspicious.