So, I contacted the risk management department of my malpractice insurance about this question and am awaiting a response. Obviously laws will vary by state. Fortunately, most patients calling in to become a new patient are bread and butter mood and anxiety disorders. Occasionally there is a nightmare case that strolls through who is clearly drug seeking and I had one blow up my voicemail. However, I managed to terminate the relationship without there being many bitter feelings left between us and she was well aware of where else to go to find a new doctor. I started to check new clients on the drug monitoring database as a precaution now. Especially after I had one intake who I found out at one point was on 100mg oxycodone, 10mg xanax, 70mg vyvanse, and 30mg adderall all that the same time. His SUDs were so significant he developed hypogonadism and I am not equipped to do things like suboxone inductions in my office so I referred him to a higher level of care. Had I known, I probably would have just recommended he go elsewhere rather than see him in the first place. Question is, is there anything illegal/horridly unethical about me looking up patients and opting to not do an intake on them based on something I find in their drug monitoring data base history? I am not too keen on taking risks like prescribing someone something potentially sedating and the chance they'd go off to another doc for oxycodone and then another for xanax...etc. etc. Often times patients who continue to do this are still in pre contemplation and not really willing to address the core issues at hand and if they're just plain drug seeking, it's just not a match for me. Any thoughts? Thanks.
