PAINKILLER LAW BLOG: Fear, Dread and a Warm Welcome – Here Comes Zohydro

How can a drug about to hit the market be feared, dreaded, welcomed and deemed medically necessary, all at the same time? It’s complicated, so if the new “super painkiller” Zohydro had human feelings, it would definitely be in the midst of an identity crisis. In this post I’ll talk about the Zohydro kerfuffle, and why it’s more proof that in most cases, “blame” for prescription drug addiction lies with the drugs themselves, not the doctors who’ve prescribed them.

First, what is a “kerfuffle?” It’s a brouhaha. Commotion. Turmoil. Uproar. Hubbub. I learned the word from The Onion. Second, why the kerfuffle over Zohydro? Because Zohydro, a new opioid painkiller approved by the FDA and slated for market entry soon, is ten times more powerful than Oxycontin or Vicodin, and it contains no abuse-deterrent formulations. This has policymakers and even some medical societies worried that the drug will – well, how to say it gently? – kill or injure a lot of people who will be using it. Though the drug is slated to be used as a painkiller of last resort for patients who cannot get relief from other medication, its potency and its emergence on the market in an era of high rates of addiction, overdose and death from opioid painkillers are indeed cause for concern.

Last year, an FDA panel opposed approving Zohydro; the FDA itself then went against its panel’s recommendation and green-lighted the drug. The drug’s approval has been the subject of controversy ever since, and this week U.S. Senator Charles Schumer (D – N.Y.) asked the Dept. of Health and Human Services to reverse the FDA’s decision. Good luck, Chuck; the Congressmen from Big Pharma likely have a different view.

The controversy swirling around Zohydro got me thinking about doctors who prescribe opioid painkillers, and of law enforcement efforts to “do something” about the prescription drug crisis. To me, at the core of the Zohydro debate is the widespread belief that the drug’s mere availability will further aggravate an already serious public health problem. Is the worry that doctors, however cautiously, may be prescribing it? Or is it that Zohydro will exist at all? My answer is that people are worried about Zohydro’s very existence. To date, media reports haven’t much discussed the role doctors may play in prescribing the drug; reports instead have focused on how Zohydro’s very presence in the market will automatically impact the prescription drug crisis.

Isn’t this a powerful indicator that the problem could be the drug itself? After all, doctors would be directed to follow protocols, guidelines, safety measures and other steps in assessing patients’ eligibility and need for the drug, its effectiveness, and any problems that might arise in treatment. If that part of the discussion is so irrelevant in the minds of Zohydro critics, then doesn’t it stand to reason that doctors ordinarily aren’t the problem? Yes, it does, in case you’re on the fence about that one. I have long believed that in all but the extraordinary, outlier case, prescribers aren’t the problem so much as the drugs they’re prescribing are. The Zohydro kerfuffle is but one more piece of evidence that aggressively targeting legitimate doctors is the wrong way to go, especially when the same law enforcement agents who self-righteously kick in office doors and hold slanderous press conferences refuse to look past their own noses for the real roots of the problem.

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PAINKILLER LAW: Old Habits Die Hard, but Die They Must

The unmistakeable, tectonic shift in the medical establishment’s thinking about opioid prescribing continues to reverberate across the country. The medical community and law enforcement are starting to be of one mind, with the CDC‘s recent game-changer of a statement that too many doctors prescribe too many opioids to too many patients for too many things. As I have been writing, medical providers and insurance carriers and risk managers and medical malpractice lawyers need to change with the changing science, or get run over by the oncoming train of opioid-prescribing reform. Today’s post is a case in point of who could get pulverized.

NPR has reported that according to recent studies, many primary care doctors prescribe opioids for back pain when the accepted normal beginning course of treatment should be ibuprofen and physical therapy. The studies cite a number of possible reasons for tossing aside other treatments in favor of narcotics: Economics, insurance-reimbursement pressures facing doctors, online ratings by patients and the need to keep patients happy (or face online criticism and fewer referrals), and other factors. The studies note that with 1 in 10 primary care visits scheduled because of patient back pain, that’s a lot of opioids being prescribed when they shouldn’t be.

Medical providers who even a few months ago would have treated with opioids now need to wake up and smell the coffee, Mrs. Bueller. It’s no longer sufficient justification in light of the CDC’s new position on opioid prescription rates. As it is written:

“You want to be able to say, ‘When the science changed, so did I.’”

I wrote that two posts ago; I just wanted you to think I was quoting Scripture. I will continue to urge providers and the professionals who support and defend them to immediately and thoroughly evaluate all aspects of their opioid prescribing, in light of the CDC’s new position – which has since been cited favorably by the AMA. Any professional association, medical society or advocacy group that tells you times haven’t changed is not keeping up with current events, and may as well be directing you to stand on the train track and not move, no matter what. Stay up to speed, seek help in evaluating your practice or the advice you give your insureds or clients, and modify accordingly — today.

info@painkillerlaw.com MEISTER LAW OFFICES 213.293.3737

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PAINKILLER LAW: Opioid Prescribers! The CDC Just Warned You, and Gave You a Defense.

Today’s Los Angeles Times reports that Dr. Tom Frieden, head of the national Centers for Disease Control, condemns widespread prescribing of opioid/narcotic painkillers as dangerous and inappropriate. But if you read his remarks, he’s not only warning opioid prescribers, he’s giving them a ready defense against an accusation. Any medical provider who writes for opioids needs to pay attention or risk DEA, law enforcement and Medical Board wrath – criminal prosecution, conviction and imprisonment for drug dealing or homicide, and loss of license. MD’s, DO’s, PA’s, NP’s – now or never, take heed!

Frieden said two things which jumped out at me. First, here’s his bottom-line take on the U.S. epidemic of prescription drug abuse:

“These are dangerous medications, and they should be reserved for situations like severe cancer pain. In many other situations, the risks far outweigh the benefits. Prescribing an opiate may be condemning a patient to lifelong addiction and life-threatening complications.”

That’s the warning. The scientific evidence and widespread belief developing across the country are that these drugs should never have been recommended or made available to treat chronic pain. In the face of mounting evidence of the medical inadvisability of treating chronic pain (however that’s defined for each patient) with highly addictive, powerful narcotics, any provider who continues to prescribe high rates of these medications takes an ever-increasing chance of being accused of “operating outside the accepted standard of practice” or “prescribing without a legitimate medical purpose.” And as I’ve explained in this blog’s posts, if in the view of the DEA or a prosecutor you are “prescribing without a legitimate medical purpose” but you’re still prescribing like crazy, then you’re just dealing drugs. So the lesson from the CDC is to know what you’re doing, in light of the evolving prevailing science, or don’t do it. The CDC’s warning will have a big ripple effect, I’m sure, and that wouldn’t be such a bad thing, as long as ethical medical providers aren’t unfairly targeted for investigation and prosecution.

But Dr. Frieden also gave medical providers a powerful defense, a compelling argument to make in the face of criminal or administrative investigation. Here’s what he said:

“When I went to medical school, the one thing they told me about pain was if you give a patient in pain an opiate painkiller, they will not become addicted. And that was completely wrong.”

That’s a great argument, a legitimate defense, for a medical provider who faces official scrutiny over their narcotic prescription-writing. Today’s providers were all trained to treat pain as “the fifth vital sign,” and to take patient complaints about pain very seriously and respond accordingly. But if what you were taught about pain medication way back when is newly shown to have been wrong, then up until now, what crime did you commit by following accepted and scientifically validated medical practice? None, to my mind. The science changes, and with it, your obligation to keep up with the news and not put patients at risk. But who can righteously accuse you of having willfully neglected patient safety in the past, just because you followed what you were taught and what was at the time the prevailing state of medical knowledge?

The response by pain management medical providers or anyone who writes scrips for chronic pain has to be: (a) know the law, know the science, know what’s changing and stay in line with it, and (b) consider scaling back a pain practice unless even from the most skeptical perspective, you’re doing everything right. This may mean reforming your business model, it may impact income, it may mean a big change in how you’re currently practicing medicine. But a new business model sure beats an indictment or the initiation of license revocation proceedings if you insist on sticking with old ways in the face of new, possible life-saving information about patient safety.

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PAINKILLER LAW: When Crime’s All You Look For, You See Too Many Criminals

If you wake up every morning, strap on a badge and gun and go fight the War on Drugs, you come to view the world in a certain way. If your goal for each workday is to go in peace and not come back in pieces, your perspective on society, people, crime and your role in combating evil are invariably shaped by your experience. That’s why it’s a mistake for the DEA to bring its ordinary approach against drug crime to the issue of prescription drug abuse. But that is just what the agency is doing. It is basically treating like a criminal any healthcare professional who shows up on its radar.

At the recent joint conference sponsored by the California Medical Board and Board of Pharmacy, I heard the DEA speak about rampant drug diversion, pharmacists’ widespread complicity in prescription drug abuse, doctors wantonly prescribing outside the standard of care, drug dealers in white coats, and the DEA’s determination to crack down. The problem is, no one can quantify the degree of “complicity” by the nation’s pharmacists, or durably judge when a provider is prescribing outside the standard of care. The DEA says it’s happening, and its agents are the ones with the guns, and so, well, it must be happening.

The sense of things that I had coming into the conference was unfortunately not at all changed by what I heard there. The DEA’s talk was dominated by war stories of pharmaceutical distributors selling Oxy out the back door, of pharmacists ordering more than they need and keeping lousy records of where it all went, of doctors making megabucks writing scrips for no reason, and patients visiting websites devoted to the celebration of hallucinogens. Seriously, that’s what the speaker talked about. That’s clearly not the entire scope of the issue, and those characterizations don’t fairly define all medical providers or pharmacists or patients. None the less, the DEA is bringing its habitual mindset to a new class of cases and investigations – and a new “target” population – and that’s the wrong approach.

Clearly, the DEA is in reaction mode, just as Medical Boards nationwide are, and it’s being blamed for missing the early signs of what became a prescription drug abuse crisis. In reaction to the blame, the DEA is redirecting the pressure onto doctors, pharmacists and others who the DEA thinks are responsible for whatever the agency is supposed to be trying to stop. And what exactly is to be stopped? Who should decide whether a patient needs the drugs he or she is given: The prescriber, or the federal agent? If a doctor prescribes a lot of pills to a lot of patients, does it mean he or she is operating a pill mill? If a pharmacist fills prescriptions, is the pharmacist automatically part of the problem? And if the meaning of “outside the standard of care” can’t even be succinctly articulated in the law, how are law enforcement agents to know where the line is, BEFORE they decide a practitioner or pharmacist is dirty?

These are the questions all of us must vigilantly continue asking, persistently and if need be peskily, in this latest iteration of the War on Drugs. There is no easy answer, no matter what the DEA might think.

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VOICE OF REASON VS. CALL TO ARMS: THE CALIF. MEDICAL/PHARMACY BOARDS’ CONFERENCE ON PRESCRIPTION DRUG ABUSE

Recently I attended a conference sponsored by the California Medical Board and Board of Pharmacy. I think I was the only criminal defense lawyer in the room. The two-day event was entitled, “Joint Forum to Promote Appropriate Prescribing and Dispensing,” and was supposed to help healthcare providers and pharmacists know the law of controlled substance prescriptions, so they could follow the law and care for patients better. But that didn’t happen. Instead, during a Q and A with high-ranking Board officials on a panel, one attendee put it perfectly: The Boards are in “punitive” mode, “waiting to pounce” on prescribers and providers. That really was the unmistakable and highly regrettable message of the conference. In this post and several to follow, I’ll explain.

The voice of reason was heard briefly in the conference’s opening session. It belonged to the White House Office of National Drug Control Policy, better known as the Drug Czar. The speaker from the Office listed ways to screen for potential abuse, advice for effective patient monitoring, relevant CME, and other tools doctors could use in caring for patients while helping to curb abuse.

The speaker’s final suggestion was the most interesting, to me: He advised providers to regularly prescribe naloxone, the “anti-overdose” drug that has helped save the lives of accidental opiate overdose patients around the country. Great idea! But there’s also a downside, which I pointed out to the speaker: In today’s aggressive enforcement environment, the DEA and Medical Board might view writing for naloxone as prima facie evidence of excessive opioid prescribing. After all, if a doctor felt a patient was at risk of overdosing, why did the doctor write the opioid scrip at all? And why did a pharmacist fill it? What I fear, and what the official acknowledged could be a real issue, is that a provider’s or pharmacist’s act of patient protection could be used against them in a federal or state criminal investigation. That, to put it technically, would be totally uncool. And unfair. And inadvisable as policy and practice.

When the Drug Czar’s office had concluded its remarks, the DEA assumed the microphone. With that transition, the voice of reason gave way to a one-sided call to arms against the very professions represented by the conference’s attendees. More on this in the next post.

info@painkillerlaw.com MEISTER LAW OFFICES 213.293.3737

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PAINKILLER LAW: D.E.A. WINS TODAY; PATIENTS WILL LOSE TOMORROW

The FDA today concluded its highly watched two-day meeting on prescription drug abuse, notably – and erroneously, in PAINKILLER LAW’s opinion – endorsing a hardline proposal from the D.E.A. If the D.E.A. gets its way, and hydrocodone is reclassified as a Schedule II drug, patients will lose, and access to needed medication will be callously impeded.

The D.E.A has been pushing for this change, and the FDA panel by a close vote of 19 to 10 may be mistakenly coming around to the the D.E.A.’s position. Advocating similar change is a prominent doctors’ group, Physicians for Responsible Opioid Prescribing (PROP). But the coincidental joining of these two forces – cops and docs – doesn’t make the idea any more credible. This proposal if implemented could rigidly and with unreasonable orthodoxy deny thousands of legitimate pain patients access to the medicine they need. PROP and the D.E.A. in this instance seem to trust no one but themselves to decide for everyone else what medicine should be taken and for how long.

A direct and intended consequence of the D.E.A. proposal is that only MD’s could prescribe even Vicodin from now on. That means if you had dental surgery coming up, and your dentist told you it was going to be a tough recovery, he or she wouldn’t be able to give you even a few days’ worth of Vicodin for head-splitting midnight pain. You’d have to get that from your MD, after the pain was already knocking you over, or you’d have to get to the E.R. in the middle of the night to seek some relief. Why must the D.E.A. presume that ordinary citizens can’t be trusted to not become addicted to opioids even though they’re only given a three-day dose for acute pain?

This also means that if you see a physician’s assistant for your medical care, that person would no longer be able to write for certain pain medications, at all, ever. Is that reasonable? Is the D.E.A. making a competency judgment about licensed professionals? Is the agency dismissing the state legislatures and medical boards that have determined the legitimacy and licensing standards for PA’s in every state in the Union? Does the D.E.A. not care that frequently, PA’s serve patients in medically underserved communities? Did the D.E.A. not get the memo: That legislative support for PA practice often stems from the precise policy goal of getting qualified healthcare providers to those communities who need them most but have them least?

The best course is for the FDA to reject the D.E.A’s proposal. Expect the D.E.A., possibly PROP, and others to in good faith continue to pursue ultimately unsound idea. And remember that no amount of good intentions makes a bad idea better.

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PAINKILLER LAW: FDA and I Call For Abuse-Deterrent Drug Agents

The FDA today called upon pharmaceutical researchers to develop formulations of opioids that would bring pain relief while reducing the possibility of addiction. The FDA refers to “abuse-deterrent” drug agents in the chemical sense. I join the FDA in calling for abuse-deterrent drug agents, only the kind of agents I’m talking about wear badges, drive fast in unmarked cars, and show up heavily armed.

The FDA should be commended for its balanced approach, in which it seeks both the development of less addictive drugs, and the need to get real pain relief to patients. What concerns me is that in investigating healthcare providers who write Schedule II-V prescriptions, typically law enforcement agents including the DEA and state Medical Boards emphasize “case clearing” over balance, hard and fast over nuance, and black and white over shades of gray. Whereas the FDA’s January 9 statement expresses its extreme concern “about the inappropriate use of prescription opioids,” the FDA doesn’t define “inappropriate.” Left to the determination of the DEA, which has been accused of being late to the party on addressing prescription drug abuse, and left to state Medical Boards, which have been accused of bailing on the party altogether, the definition of “inappropriate” could be bent, twisted, contorted, and most dangerously, broadened to encompass practices and procedures which a better informed or more detached observer would never contemplate. But when the warrant is signed or the cuffs slapped on, it’s too late for a healthcare provider to say, “Let’s slow down, back up, look at this from the beginning, and then discuss.”

That is why every healthcare provider, risk manager, medical group manager and professional needs to know the black-letter federal and state law of Schedule II-V prescriptions, and the nuances and subtleties of how the law is interpreted, what influences and impacts the agencies charged with “cracking down” on supposedly corrupt providers, and what you can do now, today, to ensure patient safety and the protection of your practice. This is why PAINKILLER LAW exists. Don’t let yourself fall victim to the subjective and loosey-goosey way law enforcement agencies and Medical Boards are defining “inappropriate,” “overprescribing,” “gross negligence,” or other concepts whose interpretation could be fraught with peril for even the most honest and ethical MD, osteopath, or physician’s assistant. Let us help you verify, achieve and maintain full compliance with the laws that well-intentioned but hopelessly biased drug agents are ever more aggressively attempting to enforce.

PAINKILLER LAW – It’s good preventative medicine.

info@painkillerlaw.com 213.293.3737 MEISTER LAW OFFICES

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PAINKILLER LAW: HEALER BEWARE — MEDICAL BOARDS’ 2013 WISH LIST

2012 has seen the nation’s Medical Boards come under relentless scrutiny for allegedly dropping the ball on regulating healthcare providers who write prescriptions for opioids and other potentially addictive drugs.  2013 will see the Boards react in full.  We all know that when a Medical Board gets hit with criticism by Legislator A or Media Outlet B, the Board reflexively lashes out at Doctor C.   For you as a healthcare provider to know how to protect yourself from biased and careless official investigation, you need to know what your regulatory overseer is thinking, and how you could be at risk no matter how ethically and safely you do your job.  Here’s what is on Medical Boards’ “wish lists” nationwide for 2013:

1)  Criminal investigations, in addition to administrative inquiries, for any patient overdose death.  An excellent recent LA Times article roundly criticized the California Medical Board for what the paper viewed as lax oversight of doctors who lose patients to prescription drug overdoses.  The Medical Board’s first reaction will be to raise the stakes by initiating a more clearly criminal inquiry against a healthcare provider when any patient fatality is even partly attributable to prescription drugs.  The Board is out to vindicate itself.  Providers who underestimate the Board’s desire for vindication are operating at their own peril.

2)  Tightening up communication between coroners’ offices and Medical Boards.  It’s good policy for coroners to immediately notify Medical Boards whenever a death is attributed even partly to prescription drugs.  The danger, though, is what Medical Boards will do with the information as new reporting requirements become operative.  In the hands of Medical Boards desperate to rebuild their tarnished reputations, this could easily become a 1-800-WHO TO TARGET NEXT hotline.  That’s not what these new reporting laws intend, but I’m confident it will be their effect.

 

3)  Finding criminal and administrative liability when a provider gives prescription drugs to an addict.   Wait a minute:  Isn’t it permissible under federal and state law to prescribe controlled substances to an addicted person?  Yes.  In fact, doesn’t the law of many states expressly prohibit discipline against healthcare providers who do this?  Yes again.  But in the recent LA Times article cited above, a Medical Board investigator said that a patient’s death was “the inevitable result” of giving narcotics to an addict.  That sounds like a new theory of liability to me.  Take it from a defense lawyer:  An incorrect interpretation of the law does not always stop police from acting.  Healer beware.

I will have more to say on these particular topics, as well as what I think 2013 will bring for the broader issue of prescription drug abuse.  For now, take heed and make sure you’re in compliance with all the federal and state laws governing prescription painkillers and other drugs.  Remember that PAINKILLER LAW is here to help you.

info@painkillerlaw.com              213.293.3737               Meister Law Offices

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PAINKILLER LAW: WARM BLANKET, COLD TRAIL

“The Warm Blanket” is how many opioid users describe the feeling of being under the drugs’ influence.  Orally or injected, and regardless of the reason(s) the drugs may be taken, this description has been documented across the user spectrum.  PAINKILLER LAW’s position on prescription drug abuse is that even if a patient or an addicted person – or an addicted patient – needs the warm blanket, that does not necessarily mean criminal or civil liability should rest with a prescribing healthcare provider.  In other words, in all but the most extreme cases, the blanket is warm, but the trail back to the ultimate question of “why?” is appropriately cold.

And speaking of “cold,” I don’t mean to sound cold or heartless saying that.  Grieving parents of deceased addicted children need comfort, not a lecture.  None the less, it is true that healthcare providers are generally NOT to blame for prescription drug abuse.  Here’s an example:

This past Thanksgiving Day in Minneapolis, two teens broke into a man’s home to steal prescription medication.  They weren’t looking for iPads or a flatscreen TV or even cash; they wanted pills.  The homeowner shot both teens dead.  For reasons not yet fully disclosed by police, he’s being charged with murder.  But my focus is the teen burglars.

Let’s assume the teens were addicted to prescription pills, let’s say opioids.  They committed the crime to feed their habit one way or another, either by planning to ingest the drugs themselves, or by selling them to buy other drugs for personal use.  Let’s further assume that the teens were first prescribed opioids by a legitimate healthcare provider.  They became addicted over time; to not feed the habit now would bring on the days-long agony of withdrawal.

Who is liable for the burglary?  The teens; they did it.  Who, if anyone, is liable for the act of killing them?  The homeowner, if he can’t claim self-defense, which you’d expect he’d be able to do.  But if the homeowner is charged, can he defend himself by blaming the doctor who prescribed the opiates to the teens?  Is there a causative link between the prescriptions, and addiction-fueled criminal behavior, sufficient to excuse the homeowner from killing them?  Should the healthcare provider be sued by the teens’ parents for wrongful death at the hands of the homeowner?  Should the healthcare provider’s act of prescribing be criminalized, independent of the burglary or murder case?  Should the very act of having written scrips for these teens end up with a doctor, or osteopath, or physician’s assistant, or nurse practitioner, stripped of their license and doing hard time?  Would a healthcare provider still be liable if the teens had not committed a crime?

There are already some states, like Florida, which criminalize “overprescription,” if anyone can define it, and I’d challenge you to come up with a durable, scientific and constitutional definition.  Then there’s my state, California, whose law conveniently doesn’t define “overprescribing” but whose law enforcement agencies still try and charge it.  And there’s a national law enforcement drumbeat to “do something” about prescription drug abuse by targeting legitimate healthcare providers writing reasonable prescriptions for approved drugs.

What are your answers to the questions above?  My answer to all of them is an emphatic “no.”  And even if reasonable people can disagree, that only means the issues are too complicated for law enforcement agencies to handle prescription drug abuse as though this were a straightforward issue with an easy remedy.  As the old saying goes, “For every complex problem, there’s a simple solution, and it’s wrong.”

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PAINKILLER LAW: “That’s DOCTOR Po-Po to You!”

Doctor – a physician or surgeon.

Po-Po – slang for “police.”    

 

Generally speaking, law enforcement agents haven’t gone to medical school, and healthcare providers don’t raid your house.  But today across the country,  worlds are colliding.  With law enforcement agencies from the DEA to Medical Boards to local departments nationwide feeling the heat to “crack down” on practitioners who write painkiller prescriptions, we’re seeing medical judgment scrutinized and applied by agents and police officers with no medical training.  This is a very dangerous development.  The current investigative and enforcement environment should worry any healthcare provider who writes for Schedule II through V pain medication, no matter how ethical and scrupulous and appropriate the provider and the prescriptions may be.

In California, for example, you can be investigated for and accused of “overprescribing” opioids.  The thing is, there’s no definition – statutory, case law, regulatory, even clinical – of “overprescribing.”  How to determine what constitutes it, and whether it’s occurred?  That’s a work in progress, and in a “crack down” setting, you’d better hope that your practice and career aren’t the guinea pig on which Doctor Po-Po, the badge wielding agent who thinks he or she knows medicine as well as you, is experimenting.

The investigative, accusatory and discipline processes do not provide the slightest reassurance about fairness, due process, or lack of bias.  Who gets to decide whether to investigate?  The Medical Board.  Who decides whether to formally accuse?  The Medical Board.  Who initiates the disciplinary hearing?  The Medical Board.  Who presents evidence at the hearing, in other words, who’s effectively the prosecutor?  The Medical Board.  And who determines whether a practitioner suffers discipline, including licensing sanctions – in other words, who’s the judge?  You guessed it – the Medical Board.  If you’re not scared yet, then respectfully, it’s time for B-12 injection or at least a double espresso.

Were you a common [accused] criminal, you’d be constitutionally entitled to the separation of powers that comes with a criminal prosecution.  One person prosecutes, another defends, and a court or jury judges.  Not so with your medical license and career.  Your fate could be in the hands of the same people who’ve invested the time to go after you, who are under pressure to “do something,” who know they will look like idiots if they rule against themselves at a hearing, and who will be excoriated by a legislative budget or oversight committee for being too “soft” on disciplinary targets.

There are ways to help prevent yourself and your practice from becoming trapped in this swirling vortex of bureaucratic persecution.  First, make sure you are in compliance with the laws and standards, both written and unwritten, both objective and subjective, both mandatory and discretionary, of prescribing painkillers.  There are lots of ways to do this, but you need expert help to cover them all and incorporate them wisely into your practice, your office procedures, and your staff directives.

Second, if you ever find yourself under investigation, if a subpoena arrives, or if someone carrying a badge shows up at your office and asks to have a friendly conversation about how you supposedly screwed up, do the following four things, in order:

1)   Be smart.    2)   Be courteous.    3)   Be quiet.    4)   Call Painkiller Law right away, for guidance, reassurance, advice and help.

Painkiller Law:  Criminal Law Compliance for Healthcare Providers, is a service of the Meister Law Offices.  Call us today for a free consultation on verifying, achieving and maintaining compliance with the federal and state criminal laws which govern controlled substance pain medication.  It’s good preventative medicine.

213.293.3737     info@painkillerlaw.com

 

 

 

 

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