Physician gets fined for tapering off?

[Chrish]

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Portsmouth doctor reprimanded for treatment of chronic pain patient

CONCORD — A Portsmouth doctor has been reprimanded and fined by the New Hampshire Board of Medicine after he cut back a chronic pain patient’s prescription opioid painkillers — and

www.unionleader.com

Pretty f-ed up scenario. I thought boards are there to protect us healthcare professionals.

So does this mean everything is state dependent and they can screw you over for whatever reason?

 

[awval999]

The boards are there to protect the public, not the healthcare workers.

 

[Sine Cura]

Lol @ cutting the TDD from 280 mg oxycodone a day to 240 mg/day ("by 40 mg"). What agony.

Never taper. Just leave people on this **** for life because of "quality of life" issues.

Edit: Here's an example of someone in California who had a "clean" license for decades but they finally dropped the hammer on him

https://www2.mbc.ca.gov/BreezePDL/document.aspx?path=%5cDIDOCS%5c20191022%5cDMRAAAHL2%5c&did=AAAHL191022213252120.DID

"failed to taper to lowest effective dose"

"prescribed oxycodone 80 mg #120 30ds and oxycodone HCL 10mg #120/30 days in an unsafe quantity"

Prescribers can get hit for excessive prescribing and pharmacists can get hit for excessive furnishing (seems like the board of medicine determined there was zero justification for holy trinities or multiple sedative-hypnotics like alprazolam + zolpidem), so either get the message or get disciplined.

 

[mentos]

Lol @ cutting the TDD from 280 mg oxycodone a day to 240 mg/day ("by 40 mg"). What agony.

Never taper. Just leave people on this **** for life because of "quality of life" issues.

Edit: Here's an example of someone in California who had a "clean" license for decades but they finally dropped the hammer on him

https://www2.mbc.ca.gov/BreezePDL/document.aspx?path=%5cDIDOCS%5c20191022%5cDMRAAAHL2%5c&did=AAAHL191022213252120.DID

"failed to taper to lowest effective dose"

"prescribed oxycodone 80 mg #120 30ds and oxycodone HCL 10mg #120/30 days in an unsafe quantity"

Prescribers can get hit for excessive prescribing and pharmacists can get hit for excessive furnishing (seems like the board of medicine determined there was zero justification for holy trinities or multiple sedative-hypnotics like alprazolam + zolpidem), so either get the message or get disciplined.

280mg oxy per day wtf. My pharmacy only stocks 5mg tabs, I can't imagine dispensing 1680 tabs per month!

 

[Chrish]

“It just sends the right message to physicians in New Hampshire that the guidelines are just that — guidelines — and not hard and fast rules,”



Previously I have never considered this but let's say if you refuse to fill a script for someone and that individual asks for your license number with the intention of filing a complaint with the board, what are you supposed to tell them? I would think you wouldn't be required to provide that info.

 

[footfairy]

“It just sends the right message to physicians in New Hampshire that the guidelines are just that — guidelines — and not hard and fast rules,”



Previously I have never considered this but let's say if you refuse to fill a script for someone and that individual asks for your license number with the intention of filing a complaint with the board, what are you supposed to tell them? I would think you wouldn't be required to provide that info.

In my state the PIC's license Is required to be visible at each entrance of the pharmacy and is searchable online as public record. Additionally the pharmacy and pharmacy staff licenses are to be visibly displayed within the pharmacy. Not providing your name/license number could only strengthen actions against you.

 

[Chrish]

Yeah it makes sense.

This incidence reminds me of this:

Alaska BoP: "you guys aren't real doctors. Stop refusing opioid prescriptions"

Board advises pharmacists: 'Patients first' over 'refusals to fill' opioid prescriptions This is extremely scary. These buffoons don't seem to realize that "valid" prescriptions are what got us into this mess of an opioid crisis. I'm writing a strongly worded letter as we speak to admonish...

forums.studentdoctor.net

Pathetic that boards have been given such power. I feel bad for this doctor. Only thing I can think of is he shouldn't have continued the same dosage for 5 years. He should have laid down the tapering plan from the beginning and patient could have gone somewhere else.

 

[owlegrad]

I thought boards are there to protect us healthcare professionals.

Why did you think that? It is literally the exact opposite - boards exist to protect the public from us.

Here is a fascinating example of a case where the supreme court decided that the a BOD overstepped its authority: https://www.bizjournals.com/triad/n...-court-rules-against-n-c-dental-board-in.html

You can decide for yourself if you agree with the ruling (I don't) but the larger point is that boards must act to protect the public and if they are seen as acting to protect their profession instead that the board members are held personally accountable for that.

 

[Chrish]

Why did you think that? It is literally the exact opposite - boards exist to protect the public from us.

Here is a fascinating example of a case where the supreme court decided that the a BOD overstepped its authority: https://www.bizjournals.com/triad/n...-court-rules-against-n-c-dental-board-in.html

You can decide for yourself if you agree with the ruling (I don't) but the larger point is that boards must act to protect the public and if they are seen as acting to protect their profession instead that the board members are held personally accountable for that.

By protecting, I meant taking our side when it comes to dealing with opioid issues. Especially when DEA clearly allows use of professional judgement in this situation.

If there is a med error then I certainly expect them to side with patient.

 

[rxkrafted]

It sounds like a good deal to me if I were the doctor. Pay only $1000 bucks and 12 hours of education to get rid of the patient who is a liability and problematic.

 

[owlegrad]

It sounds like a good deal to me if I were the doctor. Pay only $1000 bucks and 12 hours of education to get rid of the patient who is a liability and problematic.

Why should the doctor have to pay anything to get rid of a problem patient?

 

[owlegrad]

By protecting, I meant taking our side when it comes to dealing with opioid issues. Especially when DEA clearly allows use of professional judgement in this situation.

If there is a med error then I certainly expect them to side with patient.

Oh I actually do agree with you on that point. Doctors are clearly damned if they do, damned if they don’t. Either the DEA or the BOM will get them for over or under prescribing.

 

[rxkrafted]

Why should the doctor have to pay anything to get rid of a problem patient?

They don't but if I were in his shoes, that's how I would have taken it to feel better about the situation lol.

 

[APN-59 rph]

I don't know about doctoring boards.....but from all accounts Phcy boards are in the pocket of the chains....The guy on the bottom with the license get hammered....quite a few for dope violations too....you will never win..best to pay up and shuffle on....

 

[Xarelto-10]

Portsmouth doctor reprimanded for treatment of chronic pain patient

CONCORD — A Portsmouth doctor has been reprimanded and fined by the New Hampshire Board of Medicine after he cut back a chronic pain patient’s prescription opioid painkillers — and

www.unionleader.com

Pretty f-ed up scenario. I thought boards are there to protect us healthcare professionals.

So does this mean everything is state dependent and they can screw you over for whatever reason?

Incorrect. The Boards are there to primarily protect the PUBLIC, not you.

 

[confettiflyer]

Incorrect. The Boards are there to MAKE IT LOOK LIKE THEY ARE protectING the PUBLIC, not you.

fixed your post


Sent from my iPhone using SDN

 

[Xarelto-10]

fixed your post

How did you do that ?

 

[JustFillIt]

I think they call this - Damned if you do, damned if you don’t...

It really shows that, I’m many cases, lawsuits are almost a matter of chance. None of us ever know when we will become the subject of a frivolous lawsuit.

 

[Chrish]

Must admit this is the time I have heard of someone getting into trouble for not prescribing opioid.

 

[Wickett]

Hard to judge without knowing all the details. It looks like the prescriber went along with and continued to give the patient a crazily high dose, then suddenly got concerned about the daily morphine equivalent limits. Still think it's a bit ridiculous he got fined, but he helped create that monster.

 

[grumpyRph]

Hard to judge without knowing all the details. It looks like the prescriber went along with and continued to give the patient a crazily high dose, then suddenly got concerned about the daily morphine equivalent limits. Still think it's a bit ridiculous he got fined, but he helped create that monster.

lol yes my thoughts exactly . They really should’ve rewarded him a grand .

 

[Sine Cura]

280mg oxy per day wtf. My pharmacy only stocks 5mg tabs, I can't imagine dispensing 1680 tabs per month!

That was the total daily oxycodone across OxyContin (80 mg) and IR (30 mg)

 

[Sine Cura]

As far as people complaining and asking for my license #... my name is on the wall. Why would I care.

As far as the actual decision against the NH doctor, if you look at the decision more closely they also claimed he violated Med 502.05(d), which states for prescribing opioids for chronic pain, "Prescribe for the lowest effective dose for a limited [emphasis mine] duration"

Also it seems they had a problem with the tapers being abrupt and/or arbitrary ("Utilize a written treatment agreement that is included in the medical record, and specifies conduct that triggers the discontinuation or tapering of opioids") and lack of proper referral for the pt's mental problems.

LOL

Med 502.05: Section Med 502.05 - Chronic Pain, N.H. Code Admin. R. Med 502.05 | Casetext

 

[BenJammin]

Portsmouth doctor reprimanded for treatment of chronic pain patient

CONCORD — A Portsmouth doctor has been reprimanded and fined by the New Hampshire Board of Medicine after he cut back a chronic pain patient’s prescription opioid painkillers — and

www.unionleader.com

Pretty f-ed up scenario. I thought boards are there to protect us healthcare professionals.

So does this mean everything is state dependent and they can screw you over for whatever reason?

What dumb university taught you that?

 

[BidingMyTime]

What dumb university taught you that?

Yes, whenever I hear someone say something so totally against logic and reality, I assume it's a new school, and want to know which one so I can make sure to warn my boss in case s/he considers hiring anyone from that school.

 

[Sine Cura]

The way people denigrate others on these forums (love that anonymity right) they would get their ass beat in the parking lot unless you are > 6'3" 250 lbs like Ceti

 

[Bakin’ Bacon]

“It just sends the right message to physicians in New Hampshire that the guidelines are just that — guidelines — and not hard and fast rules,”



Previously I have never considered this but let's say if you refuse to fill a script for someone and that individual asks for your license number with the intention of filing a complaint with the board, what are you supposed to tell them? I would think you wouldn't be required to provide that info.

You’re under no legal obligation to provide that info. You’re just required to identify yourself as the “pharmacist” so they won’t confuse you with a “technician” or “cashier”. The patient is free to acquire whatever information that is displayed publicly (pharmacy’s license#, address, etc.).

 

[Sine Cura]

Funny how "patients" are "on" > 300 MME/day of their "chronic pain" opioids yet suddenly they stop taking it (based on PDMP) and they are still alive and functioning?

Doesn't pain management have the right to discharge known abusers and/or sellers?

 

[BidingMyTime]

You’re under no legal obligation to provide that info. You’re just required to identify yourself as the “pharmacist” so they won’t confuse you with a “technician” or “cashier”. The patient is free to acquire whatever information that is displayed publicly (pharmacy’s license#, address, etc.).

It may depend on the state, in IL it is absolutely required to give ones names (it's required to have ID pin or lanyard on at all times identifying oneself.) I'd be surprised if there is any state where the pharmacist could legally just say they were the pharmacist and not give their name.

 

[Splenda88]

Physicians are in a tough spot... I just don't and won't prescribe opioids in outpatient settings, period.

Patients are even trafficking Viagra now, making physicians hesitant to prescribe it.