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Aether2000

algosdoc
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Today Pinellas County in Florida, despite the most restrictive ordinances anywhere in the country for prescribing opioids, has elected to begin filing civil lawsuits against manufacturers, distributors, and prescribers of opioids to recapture the county paid cost of addiction treatment, counseling, medical examiner and lab costs in cases of autopsy due to opioid overdose, and an array of other related costs. They are specifically including "doctors that prescribe opioids" in the targeting and have now issued a request for proposals by regional law firms to go after the monetary assets of physicians. They plan to begin "data mining" to discover who is prescribing opioids. That is the end of opioid prescribing for me, even low amounts of opioids.
 
absolutely crazy.will trickle other places as well
 
Today Pinellas County in Florida, despite the most restrictive ordinances anywhere in the country for prescribing opioids, has elected to begin filing civil lawsuits against manufacturers, distributors, and prescribers of opioids to recapture the county paid cost of addiction treatment, counseling, medical examiner and lab costs in cases of autopsy due to opioid overdose, and an array of other related costs. They are specifically including "doctors that prescribe opioids" in the targeting and have now issued a request for proposals by regional law firms to go after the monetary assets of physicians. They plan to begin "data mining" to discover who is prescribing opioids. That is the end of opioid prescribing for me, even low amounts of opioids.
As obnoxious as this is, practically speaking, I doubt it will affect you. The risk of lawsuits has always been there from patients and their families. The county is probably looking mostly at pill mill type practices. Back in the day, docs were dispensing narcs for cash and it was a massive problem, not sure about nowadays.

But, I'm with you, we don't need this kind of pressure. It's not like the rest of our society is rallying to support the medical profession vs insurance, etc. I'm tempted to drop my DEA.
 
Their justification is that when the ordinances were implemented, the pill mills were eliminated and indeed there was a 2/3 drop in the number of docs treating pain (pill mills) and a marked reduction in those needing treatment for opioids. But the problem with drug addiction has once again spiked (probably due to heroin), but at this juncture the county doesn't care what the source is- they are going after everyone associated with opioid prescribing including "doctors prescribing opioids". In addition, they are banding together with some surrounding counties to file civil lawsuits against any entity associated with prescription opioids.

The county is seeking "damages that any monetary award could be based on are costs related to first responders and law enforcement; medical treatment and personnel; department of health, fire rescue, medical examiner and costs of prosecution and jail.
Additional damages could be based on costs related to building and maintaining treatment facilities, treatment programs for employees or the community at large, related social services, including combating a rise in homelessness due to addiction, and public education. Other damages include the effect on children who are removed from the home because their parents are addicted, which places a burden on the foster care system, and babies born addicted."
 
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They are going to have to prove that physicians operated outside the standard of care. Due to our paranoia, this might seem like a slam dunk for investigators but it will be very difficult.
 
Of course it depends on whether that practitioner has made reasonable wean attempts and/or has not initiated/escalated opioid regimen (s) without due cause.
 
Standards of care and specific prescribing practices are medical board or peer review issues. Criminal complaints may also involve standards of care. But what the county is doing is something entirely different: They want money, and will pursue civil damages against pharmacies, doctors, manufacturers, and distributors using the civil litigation system. There are several such lawsuits around the country that have been filed thus far but none have gone through the courts yet. What the county is doing is going after civil damages, and the standard of care is irrelevant. This could tie up doctors in court for a decade with legal fees. Its a new ballgame.
 
what does the tv station have to say?
 
Today Pinellas County in Florida, despite the most restrictive ordinances anywhere in the country for prescribing opioids, has elected to begin filing civil lawsuits against manufacturers, distributors, and prescribers of opioids to recapture the county paid cost of addiction treatment, counseling, medical examiner and lab costs in cases of autopsy due to opioid overdose, and an array of other related costs. They are specifically including "doctors that prescribe opioids" in the targeting and have now issued a request for proposals by regional law firms to go after the monetary assets of physicians. They plan to begin "data mining" to discover who is prescribing opioids. That is the end of opioid prescribing for me, even low amounts of opioids.

Somewhere it is a step in the right direction. This will not and should not affect most physicians on this board who are practising ethically.

I really think that even if PCP’s / FP - NP combinations reduce their opioid prescriptions by 30- 50 % , try conservative management delaying initiating opioids, over the next few years lot of these patients can be weaned to a manageable dose.

Maybe it will scare them.
 
At the risk of sounding like a broken record, it's now about self preservation. No lives will be lost absent COT for non-malignant pain. I personally don't even believe that the quality of anyone's life will suffer. However, your life may be ruined if you continue to have it as part of your practice. Erase opioids from the menu board.
 
this is being brought up in a legal manner, unfortunately. standard of care, evidence, medical decision making, risk/benefit analysis are all thrown out the window.

steve, the article you posted was spot on, but it was before the Oct 31st meeting, which is what "authorized" the action of civil suits against anyone involved with opioids.

Let's Talk Solutions: The Opioid Crisis in Pinellas County
Description
Let's Talk Solutions: The Opioid Crisis in Pinellas County

The TBHC Advocacy Committee is happy to present an informative, solution driven event, pertaining to the impact of the Opioid crisis in Pinellas County. The panel format will feature community based expert presenters, along with audience driven participation. The event will culminate with a facilitated activity which will result in tangible actions and strategies that can be applied to combatting this issue in our local community. Please plan to join us for a morning of conversation, action planning and networking. Our community needs you!!

**Light Refreshments will be served



The panel for the event includes:

*Representative Kathleen Peters, Florida House of Representatives

*Sheriff Bob Gualtieri, Pinellas County Sheriff

*Reta Newman, Director, Pinellas County Forensics Lab

*Jon Essenburg, Operation PAR, VP of Medication Assisted Treatment Services

*Rochae Zwicharowski, Recovery Advocate
yes, none on the panel are physicians or pain advocates. nicely unbalanced...

it seems an increasingly common ploy, but essentially serves to make a bunch of lawyers boat loads of money. the doctor part is "new".
 
Excerpts from StatNews
‘This is just the beginning’: Scope of opioid lawsuits widens to include hospital accreditor

Now local officials in West Virginia — the state with the nation’s highest drug death rate — have taken aim at a different target: the medical experts who recommended their use. This past week the cities and towns of Huntington, Charleston, Kenova, and Ceredo filed a class-action lawsuit against the Joint Commission, the influential nonprofit that both inspects hospitals’ performance and sets practice standards for their physicians. Hospitals must abide by the group’s standards, on opioids or anything else, in order to get reimbursed for care provided to Medicaid and Medicare patients.

The lawsuit claims the nonprofit — responsible for accrediting more than 20,000 health organizations nationwide — has spread “misinformation” about the risks of opioid addiction dating back to the early 2000s, including in published materials underwritten by opioid manufacturers.

And experts say the lawsuit could pave the way for many other municipalities to follow in West Virginia’s footsteps.

“Opioids are killing a generation of West Virginians,” Ceredo Mayor Paul Billups told STAT. “It’s had a tremendous impact. It appears that a number of medical providers were relying on directives from the Joint Commission that caused an increase on the number of opioids on the market.”

The lawsuit centers on the Joint Commission’s pain management standards, first issued in 2001, and the alleged cozy financial ties the nonprofit had with pharmaceutical firms. According to the lawsuit, the nonprofit produced materials that downplayed the evidence “that addiction is a significant issue when persons are given opioids for pain control.” It also says that similar materials claimed that patients who used opioids rarely became addicted, even though that was underpinned by scant evidence.

And those standards were developed in collaboration with the very drug makers positioned to profit from them, the suit alleges. Dr. Gary Franklin, a neurology professor at the University of Washington and vice president of state regulatory affairs for the advocacy group Physicians for Responsible Opioid Prescribing, said the research supporting the original standards was “developed in collaboration with University of Wisconsin” pain researchers who accepted drug company funding while pushing the industry’s agenda.

Industry involvement also went beyond the standards. In the early 2000s, pharmaceutical firms — including Purdue Pharma, maker of OxyContin — underwrote educational Joint Commission programing and paid for its own events to train hospital physicians about the accreditation standards, the lawsuit said. Even after the Food and Drug Administration warned Purdue in 2003 about overstating OxyContin’s effectiveness in ads, the Joint Commission kept producing materials that urged doctors to treat patients until they were “free from pain.” According to the lawsuit, the pattern continued for years, leading to the promotion of pain as the “fifth vital sign” in articles, as well as published education materials funded by Janssen Pharmaceuticals, maker of Duragesic, a skin patch that contains fentanyl.

The Joint Commission declined STAT’s request for an interview, but a spokesperson said in a statement that the nonprofit is “deeply troubled by a lawsuit that contains blatantly false accusations that have been thoroughly debunked.”
 
Today Pinellas County in Florida, despite the most restrictive ordinances anywhere in the country for prescribing opioids, has elected to begin filing civil lawsuits against manufacturers, distributors, and prescribers of opioids to recapture the county paid cost of addiction treatment, counseling, medical examiner and lab costs in cases of autopsy due to opioid overdose, and an array of other related costs. They are specifically including "doctors that prescribe opioids" in the targeting and have now issued a request for proposals by regional law firms to go after the monetary assets of physicians. They plan to begin "data mining" to discover who is prescribing opioids. That is the end of opioid prescribing for me, even low amounts of opioids.
This could be applied to other types of practice. Hate me for writing this but it is a direct result of the inability of the medical community to self regulate. Time to lawyer up.
 
Today Pinellas County in Florida, despite the most restrictive ordinances anywhere in the country for prescribing opioids, has elected to begin filing civil lawsuits against manufacturers, distributors, and prescribers of opioids to recapture the county paid cost of addiction treatment, counseling, medical examiner and lab costs in cases of autopsy due to opioid overdose, and an array of other related costs. They are specifically including "doctors that prescribe opioids" in the targeting and have now issued a request for proposals by regional law firms to go after the monetary assets of physicians. They plan to begin "data mining" to discover who is prescribing opioids. That is the end of opioid prescribing for me, even low amounts of opioids.

Got a link to the lawsuit article?
 
Prescribing any opioid no matter what the class now paints a target on your back if you are a physician prescribing for pain. Addiction treatment seems to get a bye for now. I will continue to prescribe buprenorphine and Suboxone for addiction but will eliminate all opioids for pain including Tramadol and Nucynta.
 
Can the county file civil suits against criminals for "harming the county"? It seems like they'd have better cases against convicted white collar criminals than docs.
 
oh how I wish ampapbh were still around...

why?

they don't have to prove much, just that opioids cause harm and can lead to addiction, and that you as a doctor gave someone a drug that could cause harm and lead to addiction. the preponderance of evidence is on their side.

so you did it in good faith? so what?

so you followed standards of medical care? they don't care, this doesn't involve standards of medical care. this is a civil suit. for the lawyers, an open and shut case. the only thing to decide is how much money to squeeze out of the doctor.

Civil Cases
(this is federal court, but you get the jist)
Civil Cases
A federal civil case involves a legal dispute between two or more parties. A civil action begins when a party to a dispute files a complaint, and pays a filing fee required by statute. A plaintiff who is unable to pay the fee may file a request to proceed in forma pauperis. If the request is granted, the fee is waived.

The Process
To begin a civil lawsuit in federal court, the plaintiff files a complaint with the court and “serves” a copy of the complaint on the defendant. The complaint describes the plaintiff’s damages or injury, explains how the defendant caused the harm, shows that the court has jurisdiction, and asks the court to order relief. A plaintiff may seek money to compensate for the damages, or may ask the court to order the defendant to stop the conduct that is causing the harm. The court may also order other types of relief, such as a declaration of the legal rights of the plaintiff in a particular situation.

Case Preparation
There may be “discovery,” where the litigants must provide information to each other about the case, such as the identity of witnesses and copies of any documents related to the case. The purpose of discovery is to prepare for trial by requiring the litigants to assemble their evidence and prepare to call witnesses. Each side also may file requests, or “motions,” with the court seeking rulings on the discovery of evidence, or on the procedures to be followed at trial.

Discovery may include a deposition, requiring a witness to answer questions about the case before the trial. The witness answers questions from the lawyer under oath, in the presence of a court reporter, who produces a word-for-word account called a transcript.

Settling Differences
To avoid the expense and delay of having a trial, judges encourage the litigants to try to reach an agreement resolving their dispute. The courts encourage the use of mediation, arbitration, and other forms of alternative dispute resolution, designed to produce a resolution of a dispute without the need for trial or other court proceedings. As a result, litigants often agree to a “settlement.” Absent a settlement, the court will schedule a trial. In a wide variety of civil cases, either side is entitled under the Constitution to request a jury trial. If the parties waive their right to a jury, then a judge without a jury will hear the case.

Trial Process
By applying rules of evidence, the judge determines which information may be presented in the courtroom. So that witnesses speak from their own knowledge and do not change their story based on what they hear another witness say, they are kept out of the courtroom until they testify. A court reporter keeps a record of the trial proceedings, and a deputy clerk of court keeps a record of each person who testifies and any documents, photographs, or other items introduced into evidence.

The opposing attorney may object if a question it invites the witness to say something that is not based on the witness’s personal knowledge, is unfairly prejudicial, or is irrelevant to the case. Generally, the judge either overrules or sustains – allows – the objection. If the objection is sustained, the witness does not answer the question, and the attorney must move on to his next question. The court reporter records the objections so that a court of appeals can review the arguments later if necessary.

Closing
After evidence is heard, each side gives a closing argument. In a jury trial, the judge will explain the law that is relevant to the case and the decisions the jury needs to make. The jury generally is asked to determine whether the defendant is responsible for harming the plaintiff in some way, and then to determine the amount of damages that the defendant will be required to pay. If the case is tried before a judge without a jury, known as a “bench” trial, the judge will decide these issues or order some kind of relief to the prevailing party. In a civil case, the plaintiff must convince the jury by a “preponderance of the evidence” (i.e., that it is more likely than not) that the defendant is responsible for the harm the plaintiff has suffered.
 
oh how I wish ampapbh were still around...

why?

they don't have to prove much, just that opioids cause harm and can lead to addiction, and that you as a doctor gave someone a drug that could cause harm and lead to addiction. the preponderance of evidence is on their side.

so you did it in good faith? so what?

so you followed standards of medical care? they don't care, this doesn't involve standards of medical care. this is a civil suit. for the lawyers, an open and shut case. the only thing to decide is how much money to squeeze out of the doctor.

Civil Cases
(this is federal court, but you get the jist)

Got any actual cases where they went after a legit doc that prescribed lower narcotic doses, did urine testing and monitored patients well?

I only see cases where the docs were doing egregious levels of prescribing and often for cash benefit or owned their own pharmacy like the one in Alabama. Never seen a case against a doc that wasn't egregious in any of the cases I've read in the news.
 
Got any actual cases where they went after a legit doc that prescribed lower narcotic doses, did urine testing and monitored patients well?

I only see cases where the docs were doing egregious levels of prescribing and often for cash benefit or owned their own pharmacy like the one in Alabama. Never seen a case against a doc that wasn't egregious in any of the cases I've read in the news.
The problem for good doctors is the cost of defending oneself from litigation. At the very least your insurance premiums will rise. Might ask your insurance company if they cover civil litigation of this type. BTW there will eventually be a backlash.
 
Got any actual cases where they went after a legit doc that prescribed lower narcotic doses, did urine testing and monitored patients well?

I only see cases where the docs were doing egregious levels of prescribing and often for cash benefit or owned their own pharmacy like the one in Alabama. Never seen a case against a doc that wasn't egregious in any of the cases I've read in the news.
What algos said was that this governmental agency will be the first to try civil suits against doctors. It will a be new paradigm.
 
What algos said was that this governmental agency will be the first to try civil suits against doctors. It will a be new paradigm.

Maybe but I dont see any actual evidence that regular physicians who monitor patient's close with urine drug screens and prescription monitoring programs ever getting charged.

Its always the cash for play guys or ridiculous Oxycontin prescribers who are at the top of the ProPublica database for their state.
 
lol..."fearmongering". Yeah, right. When you have spent 2 hours watching the videos of the Boards of Commissioner meetings, then you would see their resolve to move forward with this. This is a quote from the county attorney on how they will proceed with an action: “Any of you I name as a defendant, I believe you have harmed Pinellas County in a certain way (that would be spelled out in the causes of action), and then there would be a claim for damages.” She also gleefully talks about how doctors were brought into these civil suits in Chicago. She also claims the American Academy of Pain Medicine is simply a front for drug manufacturers.
 
lol..."fearmongering". Yeah, right. When you have spent 2 hours watching the videos of the Boards of Commissioner meetings, then you would see their resolve to move forward with this. This is a quote from the county attorney on how they will proceed with an action: “Any of you I name as a defendant, I believe you have harmed Pinellas County in a certain way (that would be spelled out in the causes of action), and then there would be a claim for damages.” She also gleefully talks about how doctors were brought into these civil suits in Chicago. She also claims the American Academy of Pain Medicine is simply a front for drug manufacturers.

So a county attorney had a stupid idea? And it involved suing someone? Personally knowing a county attorney, somehow this is unsurprising to me.

Since this is supposedly going to be civil in nature, isn't this the kind of thing umbrella insurance would help with?
 
Maybe but I dont see any actual evidence that regular physicians who monitor patient's close with urine drug screens and prescription monitoring programs ever getting charged.

Its always the cash for play guys or ridiculous Oxycontin prescribers who are at the top of the ProPublica database for their state.
you see, you are thinking of how the DEA and various DOH works.

think how a district attorney thinks... or worse yet, a regular lawyer looking for money.

insurance will not get involved. this has nothing to do with malpractice, they will argue. this has to do with drug "dealing" when one knows that these drugs could be dangerous.

im sorry algos... retiring or moving out of Pinellas County any time soon?
 
So a county attorney had a stupid idea? And it involved suing someone? Personally knowing a county attorney, somehow this is unsurprising to me.

Since this is supposedly going to be civil in nature, isn't this the kind of thing umbrella insurance would help with?
I believe this would come under malpractice insurance.
 
I will check with the medical malpractice carrier to see if it would be covered. There will not be any charges of medical malpractice made by the county, but it is possible it would be covered. Apparently deliberations have carried on at the county commissioner levels for many months but there was nothing in the press about it until recently. The board of commissioners voted 7-0 to move forward in hiring a chief law firm to handle the many lawsuits they intend to file, and anticipate from 2-8 law firms will ultimately be involved given the number of targets. They also specifically discussed the county opioid prescribing ordinance for doctors that has been in force for several years and how to get around the implications that the county was complicit in opioid prescribing since they provided a safe harbor if prescribers paid a fee of $3,500 per office to the county. The county attorney argued since these are civil lawsuits, there should be a way around the county ordinance in order to sue doctors.

Additionally, there are numerous other entities pursuing similar litigation including Sarasota, Del Rey Beach, St. Petersburg, Pasco County, Hillsboro County and a few other counties and municipalities in Florida.

The next step is the county tallying up their current costs for naloxone, NAS baby treatment, foster care, ambulance services, police services, court costs, incarceration costs, treatment facility costs, etc, and project all these into the future to arrive at a monetary damages value. Following that, they plan to allow open warfare on a contingency basis with multiple law firms choosing whatever targets or groups they want to pursue in the name of the county.

I know I am finished prescribing opioids, and am contemplating whether pain medicine itself has become too toxic to continue. What is surprising is that virtually none of the physicians in this county are aware any of this is happening. I have contacted the county medical society and am beginning to contact hospital medical staff offices to make them aware of the maelstrom that is swirling just beneath their feet. The county is resolute in pursuing these civil lawsuits.
 
I will check with the medical malpractice carrier to see if it would be covered. There will not be any charges of medical malpractice made by the county, but it is possible it would be covered. Apparently deliberations have carried on at the county commissioner levels for many months but there was nothing in the press about it until recently. The board of commissioners voted 7-0 to move forward in hiring a chief law firm to handle the many lawsuits they intend to file, and anticipate from 2-8 law firms will ultimately be involved given the number of targets. They also specifically discussed the county opioid prescribing ordinance for doctors that has been in force for several years and how to get around the implications that the county was complicit in opioid prescribing since they provided a safe harbor if prescribers paid a fee of $3,500 per office to the county. The county attorney argued since these are civil lawsuits, there should be a way around the county ordinance in order to sue doctors.

Additionally, there are numerous other entities pursuing similar litigation including Sarasota, Del Rey Beach, St. Petersburg, Pasco County, Hillsboro County and a few other counties and municipalities in Florida.

The next step is the county tallying up their current costs for naloxone, NAS baby treatment, foster care, ambulance services, police services, court costs, incarceration costs, treatment facility costs, etc, and project all these into the future to arrive at a monetary damages value. Following that, they plan to allow open warfare on a contingency basis with multiple law firms choosing whatever targets or groups they want to pursue in the name of the county.

I know I am finished prescribing opioids, and am contemplating whether pain medicine itself has become too toxic to continue. What is surprising is that virtually none of the physicians in this county are aware any of this is happening. I have contacted the county medical society and am beginning to contact hospital medical staff offices to make them aware of the maelstrom that is swirling just beneath their feet. The county is resolute in pursuing these civil lawsuits.

Live in Sarasota and practice in Bradenton. Can’t thank you enough for the heads up
 
retroactive? Or just future? They might as well go back 50 years to prosecute docs if this is the witch-hunt logic they follow.
 
That's exactly what this is. A complete witch hunt. If this is something they try, it would surely be escalated possibly to the heights of the Supreme courts. Just because they want to get their greedy little hands on everything you have, doesn't mean that they have the right to do so.
 
I will check with the medical malpractice carrier to see if it would be covered. There will not be any charges of medical malpractice made by the county, but it is possible it would be covered. Apparently deliberations have carried on at the county commissioner levels for many months but there was nothing in the press about it until recently. The board of commissioners voted 7-0 to move forward in hiring a chief law firm to handle the many lawsuits they intend to file, and anticipate from 2-8 law firms will ultimately be involved given the number of targets. They also specifically discussed the county opioid prescribing ordinance for doctors that has been in force for several years and how to get around the implications that the county was complicit in opioid prescribing since they provided a safe harbor if prescribers paid a fee of $3,500 per office to the county. The county attorney argued since these are civil lawsuits, there should be a way around the county ordinance in order to sue doctors.

Additionally, there are numerous other entities pursuing similar litigation including Sarasota, Del Rey Beach, St. Petersburg, Pasco County, Hillsboro County and a few other counties and municipalities in Florida.

The next step is the county tallying up their current costs for naloxone, NAS baby treatment, foster care, ambulance services, police services, court costs, incarceration costs, treatment facility costs, etc, and project all these into the future to arrive at a monetary damages value. Following that, they plan to allow open warfare on a contingency basis with multiple law firms choosing whatever targets or groups they want to pursue in the name of the county.

I know I am finished prescribing opioids, and am contemplating whether pain medicine itself has become too toxic to continue. What is surprising is that virtually none of the physicians in this county are aware any of this is happening. I have contacted the county medical society and am beginning to contact hospital medical staff offices to make them aware of the maelstrom that is swirling just beneath their feet. The county is resolute in pursuing these civil lawsuits.
Have you thought about contacting the pain societies?
 
you see, you are thinking of how the DEA and various DOH works.

think how a district attorney thinks... or worse yet, a regular lawyer looking for money.

insurance will not get involved. this has nothing to do with malpractice, they will argue. this has to do with drug "dealing" when one knows that these drugs could be dangerous.

im sorry algos... retiring or moving out of Pinellas County any time soon?

The only thing I can found out of that area in terms of charges against a pain physician is this one:

Grand jury blames Pinellas Park pain doctor for deaths of three people

Cash for opioids with over 6 million in cash at his residence alone.

Also it seems like they have opened up the area for new pain clinics:

Pinellas ends ban on new pain clinics

I see nothing in the press or anywhere else discussing lawsuits against people who follow normal opiate prescribing protocols.

I will wait to see what happens before I listen to the sky is falling crowd on this issue.
 
The information came directly from the Oct 24 and 31 2017 videos of the Pinellas County Commissioners meeting. Now, read my lips- THIS HAS NOTHING TO DO WITH QUALITY OF CARE. It is not a charge of malpractice. It is a civil suit blamed on you because you prescribe opioids that cause death and addiction to our society. The county has to prove only that you prescribe opioids, a known danger to society. The county is allowing the law groups total discretion on who to sue. Lawyers go for the deepest pockets and pain physicians have on the average made a far higher salary than most other physicians over the past 15 years. They have quite deep pockets and therefore are targets.
 
The information came directly from the Oct 24 and 31 2017 videos of the Pinellas County Commissioners meeting. Now, read my lips- THIS HAS NOTHING TO DO WITH QUALITY OF CARE. It is not a charge of malpractice. It is a civil suit blamed on you because you prescribe opioids that cause death and addiction to our society. The county has to prove only that you prescribe opioids, a known danger to society. The county is allowing the law groups total discretion on who to sue. Lawyers go for the deepest pockets and pain physicians have on the average made a far higher salary than most other physicians over the past 15 years. They have quite deep pockets and therefore are targets.

better run for the hills

I hear belize has nice weather this time of the year
 
The information came directly from the Oct 24 and 31 2017 videos of the Pinellas County Commissioners meeting. Now, read my lips- THIS HAS NOTHING TO DO WITH QUALITY OF CARE. It is not a charge of malpractice. It is a civil suit blamed on you because you prescribe opioids that cause death and addiction to our society. The county has to prove only that you prescribe opioids, a known danger to society. The county is allowing the law groups total discretion on who to sue. Lawyers go for the deepest pockets and pain physicians have on the average made a far higher salary than most other physicians over the past 15 years. They have quite deep pockets and therefore are targets.

I think you need your Lamictal old man. Next we're going to go after airline pilots because everybody knows planes have crashed. These guys are still flying playing at some point that plays in the crash and all those people are going to die I figure each death and one of those is worth 5 million.
 
It is actually really no different than a class action lawsuit. Your little post card comes in the mail and you check yes I bought product X. Then the lawyers take their 50% cut and then you get a check in the mail to compensate you for your purchase of the product, not by being injured by it.
 
I think you need your Lamictal old man. Next we're going to go after airline pilots because everybody knows planes have crashed. These guys are still flying playing at some point that plays in the crash and all those people are going to die I figure each death and one of those is worth 5 million.
There are two kinds of docs in the USA, the ones that have been defendants and the rest. Those of us that have seen American “justice” up close and personal know how miserable litigation can be for a defendant no matter how innocent of wrongdoing.
 
It is actually really no different than a class action lawsuit. Your little post card comes in the mail and you check yes I bought product X. Then the lawyers take their 50% cut and then you get a check in the mail to compensate you for your purchase of the product, not by being injured by it.
I think it must come under malpractice, even if the county wants to think of it differently. The prescriptions were written as part of a professional medical service.

Part of the reason I left Florida was the hyperactive legal community. I grew up there and my father was a general surgeon. There has always been a "war" between lawyers and doctors in the various branches of govt. Every few years, something comes up that is shocking and horrifying and it always dies down. After a while you become numb to it, even though the adversarial climate remains a thorn in your side.

County lawyers don't have an advantage over any other frivolous plaintiff. They are not part of the judiciary. In fact they are at a disadvantage, working within a bureaucracy. They will have to go through the normal contracting process to retain the cheapest law firm. And somewhere along the line, they are accountable to voters, who don't generally despise doctors. Just like anyone else who files a suit, a judge will determine if the county even has standing to file a case like this. I've never heard of a doc being sued by a govt for an "epidemic". No matter how confident or cocky they are now, a judge will probably pour ice cold water on this kind of case before it even gets warm.

If the county were to actually follow through with their threats and the judiciary is in on it, the whole system will run out of steam and money quickly because the population does not want their tax dollars spent on attacking community docs.

Not to diminish your concerns, but just keep in mind this is the "Florida Way". There need to be more docs involved in public/govt service. It would be awesome if you ran for elected office to fight against this kind of thing.
 
its going to be hilarious when, in florida, you can get sued and lose $$$ over prescribing opioids, but you can prescribe THC legally...
 
Apparently that is the case 🙂. The county said the traditional competetive bidding process doesnt apply and they are seeking large firms with deep pockets and significant civil suit experience. It should be interesting going forward.
 
Today Pinellas County in Florida, despite the most restrictive ordinances anywhere in the country for prescribing opioids, has elected to begin filing civil lawsuits against manufacturers, distributors, and prescribers of opioids to recapture the county paid cost of addiction treatment, counseling, medical examiner and lab costs in cases of autopsy due to opioid overdose, and an array of other related costs. They are specifically including "doctors that prescribe opioids" in the targeting and have now issued a request for proposals by regional law firms to go after the monetary assets of physicians. They plan to begin "data mining" to discover who is prescribing opioids. That is the end of opioid prescribing for me, even low amounts of opioids.
We'll have to watch this closely and see where it goes, but my guess is that they'll go after the drug companies and pharmacy chains and won't affect us (legitimate prescribers) too much personally. Otherwise, the lawyers could sue and win again any shop that's ever sold alcohol, guns, every drug store that's ever sold cigarettes. And they can sue every pharmacy out of existence for the deaths from GI bleeds, and McDonalds for all the heart attacks caused and the peanut companies for all the kids killed by peanut allergies. Yes, they can try and they will, but we still have shops that sell alcohol, guns, cigarettes, peanuts and burgers, don't we?

That being said, if the trend does start to make headway, great! It's just another excuse for me to dial back my opiate prescribing, maybe eventually to zero. My work life would be so, so, so much easier. I've always wanted an opiate-free pain practice. Please, give me an excuse to take that step!

But ultimately, if they're going to go this far, that means they're moving to a total ban on opiates, if they're going to be able to sue and destroy anyone for ever having prescribed opiates even for legitimate medical use. And while they're at it, they can sue and ruin the DEA, FDA and federal government themselves since it's those entities that has labeled these drugs as having legitimate medical use in the first place.

But as spineless as our government is, I seriously doubt they'll ever ban opiates or allow lawyers to sue every legitimate prescriber out of business. Hell, they can't even tie their own farking shoes without backing off at the first whiff of blowback! I can't even imagine the earthquake of blowback they'd face if they decide to be the one's taking opiates away from the whole nation. I say let them try and the'll see exactly what they face every day, and likely they'll collapse like house of cards. But if they succeed, then great! My life will be so easy, to be able to say, "Sorry, the strongest thing I can prescribe you is naproxen, flexeril and a squirt of depomedrol in your back. Dontcha know, opiates have been banned? Awe, shucks!"
 
I think you need your Lamictal old man. Next we're going to go after airline pilots because everybody knows planes have crashed. These guys are still flying playing at some point that plays in the crash and all those people are going to die I figure each death and one of those is worth 5 million.
I don't think he needs any lamictal. He's just sick and farking tired of prescribing opiates and is looking for every angle and excuse to stop prescribing them, because it's a pain in the arse, that's all. I don't blame him and I'll be right behind him, when it's feasible for me.
 
We'll have to watch this closely and see where it goes, but my guess is that they'll go after the drug companies and pharmacy chains and won't affect us (legitimate prescribers) too much personally. Otherwise, the lawyers could sue and win again any shop that's ever sold alcohol, guns, every drug store that's ever sold cigarettes. And they can sue every pharmacy out of existence for the deaths from GI bleeds, and McDonalds for all the heart attacks caused and the peanut companies for all the kids killed by peanut allergies. Yes, they can try and they will, but we still have shops that sell alcohol, guns, cigarettes, peanuts and burgers, don't we?

That being said, if the trend does start to make headway, great! It's just another excuse for me to dial back my opiate prescribing, maybe eventually to zero. My work life would be so, so, so much easier. I've always wanted an opiate-free pain practice. Please, give me an excuse to take that step!

But ultimately, if they're going to go this far, that means they're moving to a total ban on opiates, if they're going to be able to sue and destroy anyone for ever having prescribed opiates even for legitimate medical use. And while they're at it, they can sue and ruin the DEA, FDA and federal government themselves since it's those entities that has labeled these drugs as having legitimate medical use in the first place.

But as spineless as our government is, I seriously doubt they'll ever ban opiates or allow lawyers to sue every legitimate prescriber out of business. Hell, they can't even tie their own farking shoes without backing off at the first whiff of blowback! I can't even imagine the earthquake of blowback they'd face if they decide to be the one's taking opiates away from the whole nation. I say let them try and the'll see exactly what they face every day, and likely they'll collapse like house of cards. But if they succeed, then great! My life will be so easy, to be able to say, "Sorry, the strongest thing I can prescribe you is naproxen, flexeril and a squirt of depomedrol in your back. Dontcha know, opiates have been banned? Awe, shucks!"

It won't happen. The outrage would be insane from patients.
 
I don't think he needs any lamictal. He's just sick and farking tired of prescribing opiates and is looking for every angle and excuse to stop prescribing them, because it's a pain in the arse, that's all. I don't blame him and I'll be right behind him, when it's feasible for me.

He can quit pain anytime he wants or just openly state he is an "opioid free practice" who will only do the procedures on patients and then send them back to PCPs for opioid management.

The problem for him would be his competition would crush him in the area because they would manage the meds as well. So the PCPs and surgeons would just refer to his competition.

That is why he won't put his money where his mouth is.

Why not just openly declare to all referral physicians that you are an opioid free practice and be done with it? No one is forcing him to prescribe.
 
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