I find it difficult to believe that there are MD's out there that are dispensing Duragesic in the manner discussed in this article. My pain management doctor here in Paramus, NJ started me out with oral pills and slowly weaned me up to the patch. I personally feel that I should be at a higher dose, but I leave those decisions to the professionals. My suggestion for anyone that is looking for a Pain Management physician is to look for a board certified MD trained at a recognized institution (i.e.; Cleveland Clinic).