By Doug Brockway
January 21, 2015
Before we get into the meat of this post suffice it to say
that as a group of individuals there is absolutely no indication that doctors
or pharmacists are less honest and upright than the average person. In fact, someone who takes on those jobs,
with the tasks, cases and experiences that are involved, and the work and
sacrifice needed to succeed and thrive, is likely, on average, to be more honorable
than most.
Still and all it takes almost no effort to do a search
regarding health care fraud and find many, many cases of doctors and
pharmacists engaged in all manner of unethical, fraudulent and illegal
activities. There are bad apples, what the
Boston DEA’s SAC Ferguson has called “rogue” doctors and pharmacists. When it comes to stopping doctor shopping and
thus much opiate abuse the preferred systems technology, PMPs, put these rogue
providers, these foxes in the henhouse.
We have previously made the case that PMPs are inadequate to the task of preventing opiate abuse.
A key reason is that the only people examining a patient’s history of drug use
in the PMP are doctors and pharmacists. PMPs are populated by having
pharmacists enter into a data base all opiate prescriptions, all Schedule II
and III drugs, that they fill. They
enter data identifying the patient, the doctor who wrote the prescription, the
nature of the prescription (how many units of what drug), and the pharmacist
filling the prescription. Requirements vary but in most states pharmacists have
one week to submit the data after providing the drugs to the patient.
The rules and usage vary by state but doctors and
pharmacists then inquire this data base prior to writing or filling a
prescription for someone with existing, open, conflicting prescriptions or
showing a pattern of over consuming opiates. When the provider is, per usual
honest, the PMP can be effective. But it is known that the minority of doctors writes
the broad majority of illegal prescriptions. PMPs can only work in these cases
if “rogue” doctors and/or “rogue” pharmacists turn themselves in.
Here is a perfect example of the issue. This doctor was in a direct conspiracy with a drug dealer: http://www.mysanantonio.com/news/crime/article/Authorities-Doctor-wrote-phony-prescriptions-for-6030094.php
ReplyDeleteNo PMP will catch this. They do not capture prescription writing, can't establish that the patient EVER saw the doctor, can't establish that the patient saw the pharmacist in person.