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.