I don't know if this is a industry standard or not but I had to go to the ER 5 times while on Pain Managment. Due the "contract" each and every time the ER personel said there hands werre tied and they could only do was what the PM doc on call said to do. They could not treat me any other way, admit me, or anything. All they could do was stabilize me and send me home. They did this 4 times until the last time when I was close to death. They gave me the correct medication, admitted me, got me off the dozen meds the PM doc had me on (for some reason they would not prescribe a one time dose of daluidid, which got the pain down and I could sleep) kept me for 5 days until the meds were out of my system and my heart was stable again then I got dischared. The point of this, the "contract" has other consiquences and liabilities that they do not tell you or maybe are not awhere of.