Prescriptions from Office Under Investigation

[drakegrad2011]

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A pain management clinic in the area was recently raided by the FBI and DEA but is now back open, (assuming the investigation will take time) is there any reason to fill their prescriptions? I lean towards a hard no on the prescriptions, but the other pharmacists I work with are okay continuing to fill our regular patient's prescriptions (not taking new patients) since their arguments is that the physician's DEA # is active and no action has been taken against their medical license in the state. I understand the point about not making the patient suffer and that we have been filling these prescriptions in the past, but I would think you would want to err on the side of caution and not fill from this office. Thoughts?

 

[Sine Cura]

If the patients do not want to suffer they can go to a less illegitimate practice

 

[johnpharm01]

What would the basis of denial be? I only use one rule is the prescription valid which entails multiple parts legal, therapeutic etc. Just because there was an investigation (hopefully your source of information is solid) does not mean the rxs are invalid. Denying them may cause patients to go without meds and suffer. I would recommend taking a second look at the rxs and fill unless there is a valid reason for denial.

 

[BigBoss]

We have a rule in this country that you're innocent until proven guilty. Until there's a conviction or the DEA is inactive, then there's no reason not to fill the RX. I'm sure you've read the story of the WAG RPh who refused to fill a misoprostol RX on moral grounds for a woman who needed to abort a failed miscarriage. She called corporate and the board, and may possibly sue. What you're doing may invite the same.

 

[CetiAlphaFive]

A pain management clinic in the area was recently raided by the FBI and DEA but is now back open, (assuming the investigation will take time) is there any reason to fill their prescriptions? I lean towards a hard no on the prescriptions, but the other pharmacists I work with are okay continuing to fill our regular patient's prescriptions (not taking new patients) since their arguments is that the physician's DEA # is active and no action has been taken against their medical license in the state. I understand the point about not making the patient suffer and that we have been filling these prescriptions in the past, but I would think you would want to err on the side of caution and not fill from this office. Thoughts?

The other pharmacists you work with aren't worth the Danskos they stand in or the paper their Bpharms were printed on.
Lol

You are absolutely correct.

If you work for a corporation, bring this issue up with management.

Walmart is good about putting blanket refusals on doctors like this.

 

[CetiAlphaFive]

We have a rule in this country that you're innocent until proven guilty. Until there's a conviction or the DEA is inactive, then there's no reason not to fill the RX. I'm sure you've read the story of the WAG RPh who refused to fill a misoprostol RX on moral grounds for a woman who needed to abort a failed miscarriage. She called corporate and the board, and may possibly sue. What you're doing may invite the same.

What does the criminal justice system have to do with pharmacists using caution and paying attention to prima facie evidence that a problem exists?

Walmart puts blanket refusals on doctors like this all the time.

 

[BigBoss]

I’m saying you shouldn’t refuse on the basis that the DEA conducted a raid, but you should refuse if through sound clinical judgment you believe the RX itself will cause more harm than good. If it’s the latter, then I have no problem.


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[CetiAlphaFive]

I’m saying you shouldn’t refuse on the basis that the DEA conducted a raid, but you should refuse if through sound clinical judgment you believe the RX itself will cause more harm than good. If it’s the latter, then I have no problem.Sent from my iPhone using Tapatalk

Agree to disagree, I guess.

For me, a DEA raid is enough evidence for a reasonable pharmacist to realize or suspect that there is a problematic pattern of prescribing.

Would you fill prescriptions for a patient that has been fired from pain management for testing dirty on UAs in the past?

 

[owlegrad]

Hmm. I think I agree with BigBoss on this one. "Innocent until proven guilty". Having said that I would certainly scrutinize their scripts A LOT harder after that and my gut feeling is that most or all of their scripts would probably fail any sort of "reasonability" test.

 

[wucool33]

We have a rule in this country that you're innocent until proven guilty. Until there's a conviction or the DEA is inactive, then there's no reason not to fill the RX. I'm sure you've read the story of the WAG RPh who refused to fill a misoprostol RX on moral grounds for a woman who needed to abort a failed miscarriage. She called corporate and the board, and may possibly sue. What you're doing may invite the same.

That is so wrong. I can’t even... Do you know how high the bar is for an office to even get raided? And it’s even more difficult for the DEA to take a doctor’s license away. I knew a legit pill mill that was finally raided after YEARS of compliant from the local pharmacies, but surprisingly it remained open. All the chains finally had to take that doctor’s DEA out of the system, because it was obvious the DEA wasn’t going to do anything about it.

 

[drakegrad2011]

Lots of good discussion here, I kinda of agree that if they were raided by the dea something definitely was going on, and this was on the news so the patients know it happened as well. Most seem to understand what’s going on and why it’s becoming difficult to fill their prescriptions.

 

[BigBoss]

Good points, but it’s getting harder and harder to keep using the “sorry, we’re out of stock” excuse all the time with the same patients.


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[Xarelto-10]

Innocent until proven guilty. But the fact that FBI/DEA paid a visit should be reasonable ground for a closer look at the scripts coming from that practice.

 

[zelman]

That is so wrong. I can’t even... Do you know how high the bar is for an office to even get raided? And it’s even more difficult for the DEA to take a doctor’s license away. I knew a legit pill mill that was finally raided after YEARS of compliant from the local pharmacies, but surprisingly it remained open. All the chains finally had to take that doctor’s DEA out of the system, because it was obvious the DEA wasn’t going to do anything about it.

So, you’re saying that your judgement on DEA licensure is better than the DEA’s? That seems a little absurd. If the DEA has scrutinized a provider and decided their practice meets DEA standards, what objection do you have?

 

[wucool33]

So, you’re saying that your judgement on DEA licensure is better than the DEA’s? That seems a little absurd. If the DEA has scrutinized a provider and decided their practice meets DEA standards, what objection do you have?

I have no idea what the DEA’s standards are. In the case I was talking about, literally every one in town knew that doctor’s patients are either illegitimate or weren’t been properly managed. I’m also talking about not a single pharmacy in town would take that doctor’s prescriptions... if I remembered correctly, his office was raided more than once.

 

[PharFromNormal]

Yes the law of the land is innocent until proven guilty. However, committing the foul must also come before being proven guilty. If we are always waiting until being proven guilty we are not being proactive in trying to reduce the fouls... or even worse trying to prevent ourselves from being implicated in the guilty verdict if we are complacent with the fouls.

Edit: additionally it’s not just the DEA that’s involved now for opioids. Civil lawsuits have been raised against pharmacies for their alleged role in a problem. Call it right, call it wrong, but there is still a cost on the business to legally defend itself whether right or wrong. It’s logical that a business would want to reduce its exposure to costly legal engagements if they can prevent them...

 

[Sabril]

If the patients do not want to suffer they can go to a less illegitimate practice

The DEA is not all prayers and puppies. They have a quota to meet and are not above (or even prefer?) using questionable means to meet it. That said if you look at the patients coming from these kinds of offices, they probably all have lower back pain and all are on ibuprofen, flexeril, alprazolam and 180 oxycodone. That should raise a red flag before you even hear about any raid.

 

[CynicalIntern]

I've never had the DEA raid an office that I wasn't already refusing 99% of the prescriptions for. Would I kick out a patient who I had been filling for that was in the 1%? No. Would I continue to refuse the other 99%? Yes.

If you were filling multiple scripts from that office daily, the fact that they were raided shouldn't change your mind - but you may want to re-evaluate your standards for controls to make sure you can justify if the DEA comes knocking.

 

[CUninja]

Independently of anything else, a provider who is being investigated and their Board has not taken action is writing legitimate prescriptions.

If there are other reasons to believe that the prescription is invalid such as a suspected forgery, the provider not meeting the required elements of a prescription or prescriptions which could reasonably lead to the patient's death, that is a different story.

By some people's logic in this thread, a pharmacist who is theoretically being investigated for an off duty DUI yet has not had action on their license taken by the board, should not be working. The license is valid until the state Board in question says it is not.

 

[BidingMyTime]

I guess I would need to know if this was an actual raid (I'm thinking not or they would have had their DEA licenses suspended), or was it just an investigation? It's not unusual for the DEA to investigate doctors, and I have see a couple of doctors get in trouble because of errors of judgement they made with one patient (patient selling drugs rather than taking them, and doctor wasn't doing appropriate urine checks.) If it appears to be errors in judgement (and let's be honest, everyone of us has made mistakes), then certainly prescriptions to should be carefully scrutinized, but there is no reason to deny legitimate patients their prescriptions.

 

[ldiot]

Good points, but it’s getting harder and harder to keep using the “sorry, we’re out of stock” excuse all the time with the same patients.


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Sorry out of stock? Grow some balls and tell them they you are no longer filling scripts from this office. Period. You don't need to give them any reason for it other than you are not comfortable with it. If they want to make a big deal out of it, shut them down. Trust me, it's a lot easier to do this than to have them calling you every day, coming in every month, complaining, etc.

I hate when pharmacists use the out of stock excuse, not only in this situation but others as well.

 

[grumpyRph]

Sorry out of stock? Grow some balls and tell them they you are no longer filling scripts from this office. Period. You don't need to give them any reason for it other than you are not comfortable with it. If they want to make a big deal out of it, shut them down. Trust me, it's a lot easier to do this than to have them calling you every day, coming in every month, complaining, etc.

I hate when pharmacists use the out of stock excuse, not only in this situation but others as well.

even our companies' policies don't want us to use the out of stock excuse.

isn't there some inherent satisfaction you get by refusing to fill shady people anyway?

 

[Slippers]

We have a rule in this country that you're innocent until proven guilty. Until there's a conviction or the DEA is inactive, then there's no reason not to fill the RX. I'm sure you've read the story of the WAG RPh who refused to fill a misoprostol RX on moral grounds for a woman who needed to abort a failed miscarriage. She called corporate and the board, and may possibly sue. What you're doing may invite the same.

If I am required to fill every opioid prescription as immediately as possible because delays in therapy by 1-2 days (i.e. for the patient to make an appointment with a different prescriber or for the pharmacy to contact the doctor's office to verify an Rx during normal business hours) means that the patient has the right to sue me, then I expect NOT to be held responsible for dispensing illegitimate prescriptions and idiots overdosing on pain meds used illegitimately. Pharmacists should have the right to ensure opioids are being used for a legitimate medical purpose. There's enough sketchy scripts going around for anyone who's worked in a pharmacy to be well aware that blanket opioid Rx acceptance would be a bad, bad thing.

I seriously hate the "I'm scared they will sue me" mentality. If you tell everyone who's questionable that you are 'out of stock' because you're afraid of being sued, this results in real patients who need medication not being able to get it. Is there any way you can contact the DEA to find out more about the issue? (i.e. was this a routine, minor investigation or something more major?) If there's reason for concern, just be up front and tell any customers from that MD 'sorry, our pharmacy doesn't take Rxs from this doctor because he is in trouble with the DEA.' We can fill it if you get a new Rx from [recommend local pain med MDs not under investigation].

 

[BigBoss]

If I am required to fill every opioid prescription as immediately as possible because delays in therapy by 1-2 days (i.e. for the patient to make an appointment with a different prescriber or for the pharmacy to contact the doctor's office to verify an Rx during normal business hours) means that the patient has the right to sue me, then I expect NOT to be held responsible for dispensing illegitimate prescriptions and idiots overdosing on pain meds used illegitimately. Pharmacists should have the right to ensure opioids are being used for a legitimate medical purpose. There's enough sketchy scripts going around for anyone who's worked in a pharmacy to be well aware that blanket opioid Rx acceptance would be a bad, bad thing.

I seriously hate the "I'm scared they will sue me" mentality. If you tell everyone who's questionable that you are 'out of stock' because you're afraid of being sued, this results in real patients who need medication not being able to get it. Is there any way you can contact the DEA to find out more about the issue? (i.e. was this a routine, minor investigation or something more major?) If there's reason for concern, just be up front and tell any customers from that MD 'sorry, our pharmacy doesn't take Rxs from this doctor because he is in trouble with the DEA.' We can fill it if you get a new Rx from [recommend local pain med MDs not under investigation].

There are flaws with the current RX confirmation process that lead to legitimate RXs being denied for patients who are in severe pain because of what a RPh hears in the news. Obviously you should check the legitimacy of an RX, however, your decision should be made based on the RX and the diagnosis, and not what you hear in the news. If the DEA hasn't revoked a provider's DEA number or hasn't convicted them, then how can you blanket deny all of their RXs? That's irrational and detrimental for a legitimate patient.

 

[Slippers]

If the DEA hasn't revoked a provider's DEA number or hasn't convicted them, then how can you blanket deny all of their RXs?

I would want more information as to what the issue was with the DEA. If the doctor's office was 'raided,' then this sounds like this doctor was doing something wrong, even if the doctor has not been convicted yet. Does 'innocent until proven guilty' extend to pharmacists who dispense prescriptions from this office until the conviction is final? Somehow, I'm thinking that answer will be no. After all, pharmacists are apparently responsible for completing prior authorizations that they can't even do. Also, the OP never said that the source of his/her information was from the news.

I don't think you can always judge the legitimacy of a prescription based on the Rx alone. Some people are very skilled at writing up bogus scripts (including diagnosis codes). I've also seen plenty of opioid prescriptions from regulars that don't have diagnosis codes... but never mind that, the lazy bum doctors don't even bother writing the patient's date of birth or address on the Rx either.

If the patient goes to see a different doctor, then they will be able to get their medication. Also, if this is a case where the pharmacist wants to call and verify the Rx (e.g. for a new patient), then the patient will also be able to get their medication. Their access to medication will be delayed, but not denied indefinitely. And yes, I AGREE, delays in therapy are detrimental to legitimate patients. This is unfortunate, but that is the world drug seekers have created by abusing the system.

 

[Slippers]

If I have to delay someone's access to pain medication therapy for something as idiotically stupid as 'MD forgot to sign their prescription,' or 'MD forgot to write the date on the prescription' then isn't a DEA raid more important? Theoretically, an unsigned Rx could lead a patient being out of meds for up to 72 hours if they bring it to you Friday after MD's office closes. Realistically, we all know what will probably happen is that this patient will kill some time at the store across the street, forge the date/signature, show up later, and claim it was the doctor (or show up at shift change or a different pharmacy) but under the law, the pharmacy cannot accept an unsigned prescription...

 

[lord999]

So, you’re saying that your judgement on DEA licensure is better than the DEA’s? That seems a little absurd. If the DEA has scrutinized a provider and decided their practice meets DEA standards, what objection do you have?

Reputation, of course. Professional boycotting is a time-honored and necessary tradition in the health care field to deal with problem providers. Not that it's right (it's not at some level to refuse business to someone in trouble but not convicted), but you can choose who you deal with businesswise in terms of risk management. If there's a cloud over them (and DEA raiding a client is definitely a cloud), it doesn't matter whether they are guilty or innocent, a business has a goodwill reputation to maintain and does not have to engage in business with anyone that isn't trustworthy by their standards. That's why having a nice handshake got you somewhere in the past, and a measure of trust (or distrust) does avoid so many business problems.

This is going to sound callous, but at some level, I don't care what the facts or truth really are because neither matter if the effect is that dealing with this person or company risk future trouble. If I have a feeling that someone is going to be a liability to deal with, guilty or not, I'm going to think real hard about doing any business with them, and if I feel that I must, then limiting exposure (or insisting on being compensated for that risk) lest I get drawn into the trouble themselves.

In the industry, it's the difference between dealing with a company like a Teva or Roche (companies that are known to be scrupulous with their contracts and payments) or a company like Bayer AG or GSK (well-known for the opposite behavior as well as reputational damage working with them). It's well-known that if you're going to do a side job for Bayer, you're going to ask for more, because all of their jobs come with surprises (and definitely so now that they have Monsanto).

 

[CetiAlphaFive]

There are flaws with the current RX confirmation process that lead to legitimate RXs being denied for patients who are in severe pain because of what a RPh hears in the news. Obviously you should check the legitimacy of an RX, however, your decision should be made based on the RX and the diagnosis, and not what you hear in the news. If the DEA hasn't revoked a provider's DEA number or hasn't convicted them, then how can you blanket deny all of their RXs? That's irrational and detrimental for a legitimate patient.

OK.
Let's operate under the assumption that the "innocent until proven guilty" meme is applicable in the context of a pharmacist practicing as a professional.

Take a look at this doctor:
Texas Medical Board taking action against local doctor

He still has a valid DEA number.
His irresponsible prescribing has directly killed at least two people.

He's been inappropriately writing himself controls and is BARELY getting a slap on the wrist by TMB.
There's two full graves somewhere because of this guy, and the DEA and medical board don't really care.

Please indulge me:

Muh innocent until proven m'guilty

 

[Apotheker2015]

Sorry out of stock? Grow some balls and tell them they you are no longer filling scripts from this office. Period. You don't need to give them any reason for it other than you are not comfortable with it. If they want to make a big deal out of it, shut them down. Trust me, it's a lot easier to do this than to have them calling you every day, coming in every month, complaining, etc.

I hate when pharmacists use the out of stock excuse, not only in this situation but others as well.

I get your point. I am not one to say "out of stock". I also do not advocate for saying "you are not comfortable filling the prescription". I always repeat company policy like a parrot. "Per company policy, I am unable to confirm bla bla bla bla." Whatever your company policy states, you print that out and hand it to them every time. Then you add a detailed note to the patient's profile.
If you say "you're not comfortable", you are also telling them someone else might be. "Per company policy", tells them they're unlikely to have any luck at any other pharmacy within the chain. If your company requires you to share the script with other locations within the chain, then tell them that.
Be polite, but assertive and they will know to take their nonsense elsewhere. If you work for an independent pharmacy, then you ask the owner to specifically tell you how to word it. That way it does not come back to you.

 

[BigBoss]

OK.
Let's operate under the assumption that the "innocent until proven guilty" meme is applicable in the context of a pharmacist practicing as a professional.

Take a look at this doctor:
Texas Medical Board taking action against local doctor

He still has a valid DEA number.
His irresponsible prescribing has directly killed at least two people.

He's been inappropriately writing himself controls and is BARELY getting a slap on the wrist by TMB.
There's two full graves somewhere because of this guy, and the DEA and medical board don't really care.

Please indulge me:

Muh innocent until proven m'guilty

if the board scrutinized him yet did not revoke his medical license, then what authority do you have to scrutinize? Are you more capable and educated on such matters than the board? Why didn’t the state’s attorney general charge him?


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[CetiAlphaFive]

if the board scrutinized him yet did not revoke his medical license, then what authority do you have to scrutinize? Are you more capable and educated on such matters than the board? Why didn’t the state’s attorney general charge him?
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Absolutely. Yes.

That's the whole point.

The whole point is that the medical boards and DEA are far too lenient.
The expert witness in that trial testified that he considered #120 Norco and Xanax to be less than a normal amount.

I'll answer yes for my friend who instituted a blanket refusal for this doctor and alerted me to the case.

Yes, we do know better than the medical board to institute a blanket refusal on an MD who dispensed a month's supply of Norco and Xanax to a teenager at an urgent care clinic and was self-Prescribing controls.
If you need a memo to help you make that decision, that's on you.

 

[BigBoss]

Absolutely. Yes.

That's the whole point.

The whole point is that the medical boards and DEA are far too lenient.
The expert witness in that trial testified that he considered #120 Norco and Xanax to be less than a normal amount.

I'll answer yes for my friend who instituted a blanket refusal for this doctor and alerted me to the case.

Yes, we do know better than the medical board to institute a blanket refusal on an MD who dispensed a month's supply of Norco and Xanax to a teenager at an urgent care clinic and was self-Prescribing controls.
If you need a memo to help you make that decision, that's on you.

Some may argue that your judgment is too harsh. The board has already disciplined him by making him take the law exam and earning CME credit. There were 80 other physicians in that memo including him who were either disciplined via re-education or had their license revoked, which tells me that the board understands how each physician should be disciplined based on the details of each case. RPhs make mistakes everyday as well, should their respective boards be as harsh to them as well?

 

[Slippers]

The board has already disciplined him by making him take the law exam and earning CME credit

Law exam??? This physician needed to go to a rehab program, not retake a law course.

 

[VA Hopeful Dr]

Some may argue that your judgment is too harsh.

As a physician who practices in the state with the least restrictive medical board, I don't.

Y'all are professionals for God's sake. if you're just going to go by whether or not the doctors DEA license is under suspension for deciding to fill controls, why aren't we replacing you with a Norco vending machine?

This is pure pattern recognition. It is the very rare physician who is only sanctioned by the medical board a single time for prescription drug issues. It's usually a years-long thing with multiple cases before any of their licenses get revoked more than temporarily. Your job is to make sure the prescriptions that we are writing are safe for the patients. In cases like this, I think it's fairly clear that it's not.

 

[CetiAlphaFive]

Some may argue that your judgment is too harsh. The board has already disciplined him by making him take the law exam and earning CME credit. There were 80 other physicians in that memo including him who were either disciplined via re-education or had their license revoked, which tells me that the board understands how each physician should be disciplined based on the details of each case. RPhs make mistakes everyday as well, should their respective boards be as harsh to them as well?

Jesus wept

 

[CetiAlphaFive]

OK, @BigBoss , let's peel this onion a little more and see how you still feel about "innocent until proven guilty."

The physician knew the kid was a drug seeking GOMER, because he presented to the urgent care clinic FOUR DAYS after being treated in the ER.
Do you think an experienced physician can't tell the difference between fresh and 4 day old sutures?
He prescribed #120 xanax because the patient told him he couldn't get ahold of his psychiatrist in time. Nobody called the psychiatrist that didn't exist. Nobody checked the state records.

After the two kids died, a physician assistant at this physician's office was arrested for participating in an illicit drug ring.

Is the physician still OK in your eyes?


EDIT;

I should also note that I do not care abou the disciplinary aspect.
They could tar, feather, draw, and quarter them for all I care.

What I care is that the physician has demonstrated, more than once, that he is unable to exercise good judgement.

I feel fine applying that logic to any MD who has been careless enough to earn the attention of a narc unit

 

[BigBoss]

OK, @BigBoss , let's peel this onion a little more and see how you still feel about "innocent until proven guilty."

The physician knew the kid was a drug seeking GOMER, because he presented to the urgent care clinic FOUR DAYS after being treated in the ER.
Do you think an experienced physician can't tell the difference between fresh and 4 day old sutures?
He prescribed #120 xanax because the patient told him he couldn't get ahold of his psychiatrist in time. Nobody called the psychiatrist that didn't exist. Nobody checked the state records.

After the two kids died, a physician assistant at this physician's office was arrested for participating in an illicit drug ring.

Is the physician still OK in your eyes?


EDIT;

I should also note that I do not care abou the disciplinary aspect.
They could tar, feather, draw, and quarter them for all I care.

What I care is that the physician has demonstrated, more than once, that he is unable to exercise good judgement.

I feel fine applying that logic to any MD who has been careless enough to earn the attention of a narc unit

Alright, the additional information you provided changes the narrative, in which case the disciplinary action should have been harsher.


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[CetiAlphaFive]

Alright, the additional information you provided changes the narrative, in which case the disciplinary action should have been harsher.
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The DEA number is still valid, tho.
His medical license is still valid.

He hasn't been found guilty in any court of law.

Why is it different?

 

[BigBoss]

The DEA number is still valid, tho.
His medical license is still valid.

He hasn't been found guilty in any court of law.

Why is it different?

I'm saying if the additional details you provided and the evidence holds up as you claim, then the disciplinary action should have been harsher, which includes the attorney general charging the physician. The absence of a criminal proceeding leads me to believe there was not enough evidence to charge him, or the physician has good malpractice insurance and criminal defense lawyers. As a result, he gets to keep his DEA number and medical license.

 

[zelman]

As a physician who practices in the state with the least restrictive medical board, I don't.

Y'all are professionals for God's sake. if you're just going to go by whether or not the doctors DEA license is under suspension for deciding to fill controls, why aren't we replacing you with a Norco vending machine?

This is pure pattern recognition. It is the very rare physician who is only sanctioned by the medical board a single time for prescription drug issues. It's usually a years-long thing with multiple cases before any of their licenses get revoked more than temporarily. Your job is to make sure the prescriptions that we are writing are safe for the patients. In cases like this, I think it's fairly clear that it's not.

So, do you provide a patient’s complete medical record with every prescription? Without any more info than “take a Percocet every 6 hrs as needed” the pharmacist filling your order can’t know if it’s appropriate.

 

[VA Hopeful Dr]

So, do you provide a patient’s complete medical record with every prescription? Without any more info than “take a Percocet every 6 hrs as needed” the pharmacist filling your order can’t know if it’s appropriate.

Really? So if a had an opioid naive patient today that I started on 100mg oxycodone TID you would have no way of knowing if that was appropriate and you'd fill that?

Doesn't every state but like 1 have a database of controlled drug prescriptions? Doesn't each pharmacy keep records of their own? In the OP example that started all of this, don't you have access to a news source?

 

[zelman]

Really? So if a had an opioid naive patient today that I started on 100mg oxycodone TID you would have no way of knowing if that was appropriate and you'd fill that?

Doesn't every state but like 1 have a database of controlled drug prescriptions? Doesn't each pharmacy keep records of their own? In the OP example that started all of this, don't you have access to a news source?

If that patient just moved to my state, no. I wouldn’t know if the therapy was new without getting more info from their medical records.

I also do not look up any prescribers on CNN as part of my daily practice.

 

[VA Hopeful Dr]

If that patient just moved to my state, no. I wouldn’t know if the therapy was new without getting more info from their medical records.

I also do not look up any prescribers on CNN as part of my daily practice.

Huh. My state's database interfaces with 35 other states. Guess we're just lucky.

If someone came in new to the area with a script for >100MME you wouldn't at least call the doctor to make sure that's OK?

The OP was stating that he/she knew about the case, not that you have to Google every doctor whose patients you fill scripts for.

 

[Sabril]

As a physician who practices in the state with the least restrictive medical board, I don't.

Y'all are professionals for God's sake. if you're just going to go by whether or not the doctors DEA license is under suspension for deciding to fill controls, why aren't we replacing you with a Norco vending machine?

This is pure pattern recognition. It is the very rare physician who is only sanctioned by the medical board a single time for prescription drug issues. It's usually a years-long thing with multiple cases before any of their licenses get revoked more than temporarily. Your job is to make sure the prescriptions that we are writing are safe for the patients. In cases like this, I think it's fairly clear that it's not.

well said.

Of note is that even though the DEA can grant a license, in most cases it has to go through a judge to take it away. It can suspend a license by proving "“imminent danger" but is still subjected to being reviewed (the DEA did that last march and blew the shat off the roof of a wholesaler but eventually was overruled)

Normally, the DEA will try to "convince" you to voluntarily give up your license using whatever means they can come up with and few people would agree. So if your strategy is to "wait and see", you probably won't know for a very long time.

 

[wucool33]

I'm saying if the additional details you provided and the evidence holds up as you claim, then the disciplinary action should have been harsher, which includes the attorney general charging the physician. The absence of a criminal proceeding leads me to believe there was not enough evidence to charge him, or the physician has good malpractice insurance and criminal defense lawyers. As a result, he gets to keep his DEA number and medical license.

Ok, so you would still fill his prescriptions? Because you know... his DEA and stuff are still active. We don’t want to be too harsh here now.

 

[BigBoss]

Ok, so you would still fill his prescriptions? Because you know... his DEA and stuff are still active. We don’t want to be too harsh here now.

Depends on the RX. If it meets all the criteria, then sure.


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[wucool33]

Depends on the RX. If it meets all the criteria, then sure.


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You are either just saying this because you 1) don’t want to backtrack 2) are just a very negligent individual 3) are a new grad that doesn’t know anything 4) are just crazy