I get what you are saying here.. but do you specialize in terminal patients, or patients with extreme pain management needs?
If not, that is probably your answer.
..going ooc/serious a bit. I *do* in fact have patients fitting that bill. I am not usually involved with opiates, for threefold reasons:
- most of the routine prescriptions are handled by my minions
- I'm not comfortable with opioid management here. I get the feeling that they fear NSAIDs too much, and they prescribe too strong opiates, too early. So I'm not happy starting the heavy stuff in routine scenarios.
- In cases of severe, difficult to manage pain, I prefer to defer the actual management to pain units and/or palliative care. It's not that I *can't*, but its not something I do routinedly (whereas it IS something they do routinedly)
My field is blood disorders, specially malignant blood disorders (eg, leukemia, lymphoma, plasma cell dyscrasias). This means prescribing a range of expensive and specialized medications, often chronic in nature. So I don't really lack for pharma reps from which I could request stuff. I have never, however, requested a lap dance, because I keep a strict divide of business and pleasure. Also 90% of those reps are men, so it's not something I'd particularily like either. In that scenario I'd rather stick with biros