Lafayette doctor defends pharmacies for flagging docs

A Lafayette pain management doctor speaks in favor of pharmacies and the decision to deny certain prescriptions.

Posted: May. 30, 2018 6:45 PM

LAFAYETTE, Ind. (WLFI) — News 18 is digging deeper into why some pharmacies have stopped filling prescriptions for Lafayette Pain Management Doctor Robert Bigler.

Lafayette Pain Management Dr. Edward Kowlowitz said he appreciates pharmacies for being an extra check on the system. He hopes to help people understand the process.

Pharmacies may have a drive thru, but they don't work like McDonald's.


"It's very different than going to a server at McDonald's and being expected to being served a happy meal with a smile," said Kowlowitz. "They have a responsibility."

They also have a liability. Pharmacies could get in federal trouble for filling prescriptions irresponsibly. That's why we are starting to see pharmacies flagging certain doctors.

"We need to view the pharmacist as an ally as a member of the healthcare delivery team rather than an adversary," said Dr. Kowlowitz.

Kowlowitz isn't worried pharmacies will start denying his prescriptions. He is confident in his decisions to prescribe pain pills.

"A knowledgeable, well trained physician should have the ability to use opioids when all other definitive care has been given to a patient but they're still suffering from pain that limits their functionality,"said Kowlowitz. "You know, having said that, the least amount of of opioid that should accomplish that should be given."

We still don't know why pharmacies like CVS and Walmart have stopped filling Lafayette Dr. Robert Bigler's pain prescriptions. However, we did find some context online. This prescriber checkup website published by Pro-Publica lists the state's top prescribers for each pain medication. Dr. Bigler is the top prescriber in the state for several different pain medications for Medicare claims. 

"What a patient wants isn't necessarily what they should get or what's best for them," said Dr. Kowlowitz. 

Although Kowlowitz helped create the CDC and state guidelines, when it comes to the number of times he checks up on a patient he's more conservative than most.

"The guidelines are that they are evaluated at least every 3 to 4 months," said Kowlowitz. "I think that patients that are on a significant amount of opioids are best monitored on a monthly basis."

If they aren't willing to be seen that often he said they need to find another pain provider. 

"Do you ever fear that they'll turn to the streets?" asked News 18's Kayla Sullivan. 

"I do," responded Kowlowitz. "But we can't be paralyzed by that fear and give people what they want but what's not good for them."

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