It’s a sad truth of life that not enough doctors are coming through their training and entering general practice. The result is towns and cities find themselves without primary healthcare, an accelerating problem as older doctors retire. How much time does it take to distinguish between the genuine patients who need drugs like tramadol to get a better quality of life, and the drug abusers who want to get high or the dealers looking for product to sell on the streets. Patients come to doctors because they cannot cope. The few doctors struggle to cope because so many people are in pain and need help. There is an alarming rate of prescription medication abuse in the U.S. and the physicians don’t have the time to make a proper diagnosis. That means an instant prescription of tramadol instead of a more holistic approach. In a perfect world, the physician would look at the patient as a person losing mobility, under threat at work because the lifting and carrying is too difficult, friendships and marriage under pressure because this is all too stressful to manage.