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It Is Our Duty

By A.J. Mencias, MD

On 7/26/17, one of my best friends and partners, Dr. Todd Austin Graham, was murdered by the husband of one his patients over an argument about prescribing pain medications to the patient. Dr. Graham had only had a couple of visits with the patient. He had only begun the treatment process.  The husband became agitated about Dr. Graham not prescribing pain medications to the patient. As Dr. Graham was entering his car outside our building, the husband shot him twice instantly killing him. The husband then went to his best friend’s home and committed suicide.

Since this day I have altered everything about how we manage pain in my patients. We have addressed these issues with our anesthesiologists. We have pushed for the development of regional block programs and acute pain services at our surgical facilities.  We frequently use pain catheters postoperatively. We encourage regional blocks preoperatively for postoperative pain control.   We have our patients sign a pain control contract with us when treatment begins, and we focus on educating them about the downfalls of opioid addiction.  We also limit the amount of pills prescribed and the strength of medication prescribed.  We have been truly successful in this endeavor.  It is very rare for my office to prescribe oxycodone or hydrocodone to our patients .

Our community has responded aggressively to improve the prescribing patterns of our local physicians.  Insurance networks also have begun regulating and monitoring these issues more closely.  The murder of Todd Graham has changed our community forever.  In addition, Congress has passed a bill in his namesake helping the national cause.  His death has changed many lives in many ways.  Our group has become closer and our patient care has improved.   This senseless death is just a sign that our world is different and teaches us that we must all take ownership of this problem.  The changes that we made in my practice have been successful in decreasing the amount of opioids my patients consume after surgery.  Our pain control satisfaction scores have increased.  Patients are consuming less narcotics.  We should all be making  changes to help the opioid crisis. It is one of our essential duties as physicians and surgeons.

A.J. Mencias, M.D. 
South Bend Orthopaedics and Sports Medicine

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