What does it take?

[Celexa]

Consulted on a patient being prescribed more controlled substances than you can count on one hand by an 'addiction medicine' physician. Looked them up in the state database. They've had multiple license suspensions over a thirty year history due to substance use, diverting medications, and repeated sexual harassment and assault of hospital staff.

Somehow they're still practicing.

I see people trying themselves in knots over what to do with patients reliably taking moderately high doses of controls for years without objective signs of abuse and meanwhile this disgrace to the profession I'm sure cheerfully goes to work every day collecting his cash only payments and actively harming patients.

So what does it actually take to lose a license? Because thirty years of eye-poppongly atrocious behavior apparently doesn't cut it.

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[Sushirolls]

Just look at your quarterly mailings from your state medical board and you'll see what it takes to lose a license.
Happens.
Not like a country like India, which I think they've revoked like 1-10 licenses over a multiyear period.

 

[littlefred]

I've seen some physicians from other specialties become addiction medicine docs after having a substance use disorder themselves. Nothing against that, and patients I think prefer if their treating doctor has had SUDs themselves.

Now prescribing controlled substances is based on an "honor system" where we have general guidelines to follow, but very few set in stone rules. Some clinicians abuse that power, but it's not grounds for losing your medical license.

I personally know of a doc who lost his license because he had pre-signed script pads with Xanax, Klonopin etc and the staff in his office would just write in the patients name (without seeing the doc). So it has to be something egregious like getting kickbacks for Rx, getting sexual favors or stuff like that for a board to look at it seriously.

Some states are more punitive than others... wishful thinking on my part is that there should only be one medical board for the nation and not by states... but that's another topic.

Edit: what was the regimen the patient was on?

 

[Celexa]

I've seen some physicians from other specialties become addiction medicine docs after having a substance use disorder themselves. Nothing against that, and patients I think prefer if their treating doctor has had SUDs themselves.

Now prescribing controlled substances is based on an "honor system" where we have general guidelines to follow, but very few set in stone rules. Some clinicians abuse that power, but it's not grounds for losing your medical license.

I personally know of a doc who lost his license because he had pre-signed script pads with Xanax, Klonopin etc and the staff in his office would just write in the patients name (without seeing the doc). So it has to be something egregious like getting kickbacks for Rx, getting sexual favors or stuff like that for a board to look at it seriously.

Some states are more punitive than others... wishful thinking on my part is that there should only be one medical board for the nation and not by states... but that's another topic.

Edit: what was the regimen the patient was on?

Trying to remain a little general, but two stimulants, two opioids, two benzos, and an additional control whose use would not fall under the physicians areas of expertise. All in a medically complex/frail patient.

You are correct in deducing that this is a physician who became an addiction medicine doctor who was originally trained in another context. Another context which they are barred from practicing (not psychiatry). I recognize people make mistakes and deserve second chances and have nothing against people who follow that path if they then practice good addiction medicine. This is absolutely not that.

 

[alina_s]

I once worked in small-town MO and there was a FP in town who had lost some of his prescribing privileges. He continued to prescribe fioricet #180/month, plus separate butalbital to the folks who liked that version of altered consciousness. The clinic was finally shut down after he’d left the state for a few months and his nurse had kept the office going. The other guy who’d retrained in family med after being banned from another field kept practicing after being arrested for DWI with many of his patients’ prescriptions on the passenger seat.

 

[Stagg737]

So what does it actually take to lose a license? Because thirty years of eye-poppongly atrocious behavior apparently doesn't cut it.

The few cases I'm aware of in my area involved 1 of 3 situations:

1. Repeated sexual misconduct with at least some documented evidence of misconduct. One involved kids.
2. Diversion/gross mismanagement of controlled substances.
3. Medicare/medicaid fraud. Don't mess with the feds.

Or you could just be Dr. Death or Swango. There's also reddit threads with some pretty crazy situations. Apparently having your coke dealer show up to your ER and buying some from him there will also do the trick.

 

[Liquid8]

A few years ago we had this guy who got himself suspended… was lucky to escape with a second chance, but wasted it.

Katz v Medical Board of Australia (Review and Regulation) [2020] VCAT 589 - BarNet Jade

The smart way to search, annotate and share Australian legal judgments, decisions and statutes!

jade.io

10. The Board took action after it received a confidential notification from a medical practitioner at the Royal Melbourne Hospital (RMH). A young woman, P, had been admitted to the Emergency Department on 3 February 2020 unconscious, with what was diagnosed as an acute benzodiazepine overdose.

11. She had collapsed at the airport while waiting for a flight to the US where she was due to attend a patient detox clinic.

12. RMH staff found three patient medication bags in her luggage, and text messages on her phone from ‘Dr Ian’ with personal messages and pet names for her, including ‘this doctor is missing his patient’. Once awake she said, and Dr Katz confirmed, that he had been treating her.

13. There is no dispute that Dr Katz has been in a personal relationship with P since late 2018.

14. In July 2019, in response to an earlier notification to the Board raising concerns that Dr Katz was treating P while being in a personal relationship, Dr Katz admitted the personal relationship but was adamant he was not treating her. At the time, the Board accepted his denial of a doctor/patient relationship and decided to take no action.

15. It is now clear, and Dr Katz admits, that he misled the Board in July last year. Since January 2019, he has been prescribing medication for P, including ‘scheduled medications’[3] such as benzodiazepines. The prescribing continued through to February 2020. As late as 26 January 2020, he applied for a permit to prescribe alprazolam to her.

16. It is also clear that, despite the regulatory action last year, Dr Katz continued the dual relationship with P.

17. P has had a regular treating psychiatrist, Dr Stephen Xu, since 2017. Dr Xu has advised the Board that P’s diagnoses include borderline personality disorder, substance abuse, and severe anxiety with panic attacks. Dr Katz did not coordinate P’s medication with Dr Xu, who was also prescribing benzodiazepine. Dr Katz did not make clinical records or prepare any treatment plan for his prescribing to P.

 

[milesed]

Our state medical board actions are all available online on around page 4-6 of a Google search. Very enlightening.