
Show HN All US doctors ordered by their opioid prescription count - ransom1538
https://www.opendoctor.io/opioid/highest/?hn
======
droithomme
OK, so am I reading this chart correctly? The top guy issues over 21,000 new
opioid prescriptions per year. Not pills, but new, and presumably refill,
prescriptions. So that's about 58 prescriptions per day of the year or 84
prescriptions signed per work day. Which is 10.5 per hour. So he spends on
average 6 minutes evaluating each case before deciding a new or continuing
opioid script is an appropriate treatment.

~~~
rexicus
I believe he can have PAs under him writing prescriptions in his name also.
For chronic pain I assume there's not much to evaluate but click "approve" in
some medical information system.

------
epmatsw
Is that unexpected? Seems like it makes sense that doctors who specialize in
pain management would make up a huge share of painkiller prescriptions. And
oncologists make up a huge share of chemo prescriptions, etc. etc.

------
mitchellst
well, yeah.

There are doctors who, for example, treat your kidneys. They never need to
prescribe opioids.

There are doctors who perform surgeries, and prescribe a week of pain killers
for recovery.

There are doctors who manage chronic pain. (Often anesthesiologists by
specialty, hence that list is all pain management specialists and
anesthesiologists.)

How is this surprising? Frankly, if the numbers are accurate (5% prescribe
60%), I'm tempted to think it's not concentrated enough-- sounds like docs of
type 1 and 2 should knock it off.

But, what is this number "opioid prescriptions?" Is a script for 1 week of
meds a 1:1 unit with a script for a month or 3 months? If you're using
medicaid/medicare/insurance payer data, then probably, meaning these numbers
do not reliably proxy amount of drugs or number of people receiving them.

By all means, we need to pay attention to the problems with opioids. But
context-free clickbait numbers are a really bad place to start.

------
pavement
Astonishingly, nearly every member on this list rates at between 10K and 20K
claims a piece, multiplied by nearly 9,000 individual prescribing doctors.

So, a large city, and within that city, nine thousand sold-out stadiums, where
attendants hold tickets to the prescription opioid show, and at least one
doctor from this list is on stage.

Unfortunately, we don't have volume per claim, which is probably sensitive and
confidential patient information on some level.

    
    
      EDIT: HN's patented "*hug of death*" is killing this site already...

------
notadoc
Gee whiz, you mean pain management doctors, surgeons, oncologists, and
anesthesiologists are prescribing pain killers? Wow what a shocker!

This is stupid, and irrelevant.

If you're unfortunate enough to need surgery, have a painful injury, suffer
from chronic pain or a severe pain condition, you should just 'deal' with it,
right? The politicians, internet commenters, and media know better than your
specialized doctor anyway, right?

------
metaphorm
I'd love to see an analysis that finds a good way to try and discover
inappropriate prescriptions. Doctors deserve some benefit-of-the-doubt for
this stuff because these are legal medications that treat common symptoms.
What is the most useful way to discover when a doctor is making too many
prescriptions or not screening their patients for appropriateness of
prescription?

------
J5892
The top doctor on the list prescribes 20% more opioids than the next highest,
and these are his specialties:

* Counseling

* Pastoral Counseling

------
LeeHwang
The stigma of opioids is going to painful for patients. My wisdom teeth were
removed, and my surgeon did not want to prescribe any. I was in pain for a
couple days before I screamed at them and something that worked. It was a very
unpleasant experience.

~~~
notadoc
The only result of the nonstop political and media onslaught against doctors,
painkillers, and the imaginary opioid 'problem' is more patients in pain (like
yourself), and more nonsensical political intervention in doctor/patient
relationships with more cumbersome rules regarding prescriptions.

Doctors and their patients have literally nothing to do with drug addicts.
Drug addiction is not a new problem.

------
jdenning
This seems quite close to doxxing in my opinion. Flagged.

Edit: If there's a goal other than shaming these doctors and making it easy
for people to harass them, please let me know , and I'll gladly remove my
flag.

~~~
LyndsySimon
> If there's a goal other than shaming these doctors and making it easy for
> people to harass them, please let me know , and I'll gladly remove my flag.

Well, if you're a patient who has been denied an opioid prescription from your
current doctor, this list would likely be a great starting point to finding a
doctor who is more pliable... :)

