This is the third in a series of articles on
avoiding fraud and theft in healthcare professionals’ offices.
The article is meant for medical professionals including physicians,
dentists, home nursing and mental health professionals. If you have any
questions about this series, feel free to contact attorney Matthew L. Kinley, a
healthcare lawyer in Long Beach, California at 562.901-3050
Practices in California should be wary
of prescribing pain killers for their patients.
The Medical Board has told various audiences that they are reviewing
physicians who prescribe such medications, and will review patient files for
abuse.
There is good reason for the Medical
Board to be concerned: There has been great abuse by patients who utilize pain
killers. There has also been an epidemic
of deaths caused by such abuse. One
estimate has it that American physicians prescribe enough pain killers to
medicate every American around the clock for a month.
In order to avoid a visit by the
Medical Board, or to be prepared if they do visit, and to make sure that your painkiller practice
is beneficial for patients, physician offices should adopt protocols to make
sure that patients actually need the painkillers you prescribe. Such protocol will help keep prescribed drugs
making it on the black market.
Action Items to Protect Your Practice:
1. Carefully
document the patient chart. Carefully
explain the side effects of the prescription, and for long term use, the
potential detrimental effects of potential addiction.
2. Screen
and monitor for substance abuse and mental health problems.
3. Be
vigilant for scams and identity theft.
4. Prescribe
pain killers only after examining the patient.
California Business and Professions
Code provides some guidance. Section
2242 provides that it is
“unprofessional conduct” to prescribe or furnishing dangerous drugs without
an appropriate prior examination and a medical indication.
5. Only prescribe painkillers after other treatments
have not been effective for pain.
6. Use legally required form. California Healt & Safety Code section 11162.1 provides standards
for prescription forms for controlled substances.
Limit the
number of pills prescribed.
7. The
quantity prescribed should be based on the expected length of pain.California
Health Safety Code section 11158 provides for limits on number of pills
(“may dispense directly to an ultimate user a controlled substance
classified in Schedule II in an amount not to exceed a 72-hour supply for the
patient in accordance with directions for use given by the dispensing
practitioner only where the patient is not expected to require any additional
amount of the controlled substance beyond the 72 hours. )
8. Using
patient-provider agreements combined with urine drug tests for people using
painkillers long term.
9. Talking with patients about safely using,
storing and disposing of prescription of painkillers. (www.cdc.gov/homeandrecrationalsafety/poisoning/preventiontips.htm)
10. Check the prescription monitoring programs with the California Attorney
General.