Do you know of a medical provider who has been summarily and without recourse dropped from a retail pharmacy‘s list of approved prescribers? I do. I know a lot of legitimate, caring professionals who are in this predicament, and know of many more nationwide feeling the unjust squeeze of tremendous, invisible power. Retail pharmacies, both independent and chain stores – let’s call them “Little Pharma” – are so scared of the DEA that they’re cutting off MD’s, DO’s, and PA’s without notice, without any specifics, and without any means of redress, all in a desperate attempt to try and keep the Feds off their backs. There’s a new blacklist in town, and it’s yet another kneejerk, excessive and unfair response to the problem of prescription drug abuse.

Typically, a medical provider gets a letter out of the blue and that…is…that. The pharmacy or its corporate attorney tells the provider that the pharmacy’s responsibility is patient safety first, and that it is obligated under federal and state law to make sure it doesn’t dispense scrips written by “problem” prescribers. But no details are offered, no specific instances of conduct or prescribing are cited, and no basis for the pharmacy’s decision, other than vague references to statutory language, is provided. You as a medical provider have been branded a problem. You don’t need to have been red-flagged, you don’t need to be under investigation, and you can’t do anything about it unless you decide to go public. Or you can sue, if you feel like devoting the next several years and all of your financial resources to fighting a major corporation, its mountains of money and its legions of lawyers.

On the surface, the pharmacy or its corporate counsel is in charge. But beneath the surface is where the true power is being invisibly, silently exercised. It’s beyond the reach of the legal process; it’s immune to the presumption of innocence, and it’s happening to people we know. Pharmacies are either being leaned on by federal agents to nix a certain provider from the pharmacy’s approved prescriber list, or the pharmacies are afraid of attracting attention by continuing to fill a provider’s scrips if, say, the provider is in the news in a less than flattering way. Fear quickly prevails: Years-long business relationships and friendships evaporate in the time it takes to generate a form letter; patients are needlessly harassed and embarrassed at pharmacy counters, and all the while, no one will say why. This is something out of McCarthyism; it’s something out of Franz Kafka. It’s government overreach is what it is, and it’s real.

What to do about it? I say stand up and fight back. We are, after all, Americans. The idea of government thinking it can push law-abiding citizens around is so at odds with everything in our national DNA, that eventually public objections will build sufficiently and law enforcement agencies will either voluntarily or under judicial compulsion have to take a giant chill pill. Let’s just hope that when that day comes, the pharmacy can still dispense to the government agent in need of a step back.

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