With all the recent shocking changes in the U.S. health care system ranging from medical coding, billing, to the way insurance companies carry out business, it is important to take a minute and think carefully how lucky we are. Healthcare professionals are a highly prized commodity in the states as well as in any other country. The largest shortage in oncology per person suffering from cancer is in Russia. This creates some alarming issues that are increasingly making it more difficult for terminally ill and pain medication seeking patients to obtain the medications and treatment they seek. With recent legislation, a patient is to follow through four steps in order to receive pain medication that only lasts five days, which must be repeated every five days to continue the treatment. This has created a system that is bound to fail. The suicide rate has increased and rate at which patients continue clinging onto life while experiencing unbelievable levels of pain has gone past the breaking point. This legislation has increased felonies that are drug related pointing to caregivers providing medication to patients experiencing pain whom cannot adequately provide for themselves. There has been no record of drug abuse levels reducing since this has been in effect. Drug abusers and illegal use of these narcotics by non-approved persons will likely not be effected. The only people being harmed by this law are the patients. The process is as follows according to Dr. Clark.


“Every 5 days, the patient must go to the general practitioner (GP) who will refer them to an oncologist. Since there is a shortage of oncologists, the patient or their representative will then queue with a roomful of people who are terminally ill and if he or she manages to make it in to a consultation before closing time the oncologist will hopefully agree that pain management is required and send them back to the GP with a note of permission for the GP to write a prescription. “The GP will write the script but must get the head of the clinic to sign off on it as well. If the patient is in a hospital, the oncologist and head of the department must sign the script. It is only valid at one particular pharmacy and if it is out of stock they will miss out. If they fail to return the packaging or used fentanyl patches, the new script will not be dispensed. The script only covers a 5 day supply so every 5 days the process begins again.”


The recent law continues to send caring and willing healthcare providers to prison for doing what they see as compassionate care. Their ongoing defiance has made little change. The process has simplified and increased to 15 day doses that have to be refilled every 15 days rather than the previous 5. The shortage of oncologists required to screen the patients for the medications is another issue that has not been addressed yet. The wait time to receive a prescription continues to rise as more and more people are judicially forced to seek care the lawful way fearing prison time.


If you are a physician, healthcare provider of any sort, support staff, or a patient, think of the situation you are in currently and be thankful for how relatively simple we manage our healthcare here in the states versus many other countries. The heroic healthcare providers in Russia are paying for medication and comfort care in time.