AMA warns RPH’s about inappropriate inquiries about pain med prescribing

This is a excerpt from the AMA website

Issued a warning against “inappropriate inquiries” from pharmacies to verify the medical rationale behind prescriptions and diagnoses, calling them an unwarranted interference with the practice of medicine.

I am not sure that this is the same/similar diversionary tactic that a magician uses… direct your attention away from what is really going on…


The pot calling the kettle black..

Most/all physician do little due diligence in identifying the first time patient that comes to the practice seeking pain management.

Driver’s licenses can be forged/faked… when you look right at the bottom line.. it is much easier and profitable to forge one driver license.. than try to counterfeit currency… in fact the FEDS continues to revise our currency.. because more and more crooks are getting better and better at duplicating our currency.  Making a driver’s license is – with today’s technology – is not much more than child’s play.  IMO.. we are up against 21st century crooks .. using mid 20th century methodology..

I am not aware of any state that will let healthcare professionals to have access to the state’s driver’s license on line database.. all we really need to verify is the name and the pic that was put on the original license.. all other data points can change or be altered.

I have first hand experience with a 3 prescriber practice wanting me to come into the practice to help sanitize, manage & build the pain management portion of their practice. One of the prescribers in particular was “chaffing at the bit” to get me in the practice…  This particular doc was so eager, that he was willing to give up his office for me to work out of …

The doc that was the “money man” could not get past the point that initially some resources/manpower was going to have to be expended… determining who would be accept to the practice.. without generating any revenue.  He couldn’t wrap his head around the fact that within a few months.. all the available slots of the pain portion of the practice would be full of LEGIT pts.. and unless a pt was discharged, quit or died.. there would be no further need to expend resources in “qualifying” pts to be accepted to the practice.

I was so confident in what I could do.. I offered to work on a revenue sharing basis.. if I didn’t generate any extra revenue… I wouldn’t get paid anything… I had a hand full of meeting with two of the prescriber of the practice.. each nearly one hour long..  The “money man” could not get past the first few months of not generating money on every pts that wanted to be treated by the practice… He seemed more interested in trying to figure out – after the patient was being treated by the practice – who was not a legit pt and discharging them.

Let’s look at the DEA… their REAL CHARGE is to arrest those that would divert drugs… they have no job.. unless the drugs are on their way to the street or on the street.. It is much like the death penalty… some believe that the very fact that there is the death penalty.. it will discourage crooks from doing serious crimes that would subject them to the death penalty… I don’t subscribe to that philosophy …

If you worked for the DEA.. would you rather go after south of the border cartels… that are well armed and won’t hesitate to shoot you.. or would you rather go after entities that aren’t armed, and have very good documentation of what they have done.. and all you have to do is find a few clerical errors and you can fine the crap out of them…

Right now the DEA.. has some 8 K+ employees… and > 50% sit at desks.. not out in the field… and the overall cost per DEA staff member is > 250K annually.

Until EVERY HEALTHCARE PROFESSIONAL demands proper ID from the person.. and be able to verify it using State/Federal on line database.. nothing is going to change.. except the DEA’s budget will get bigger and have more employees to come after us… It is like a dog chasing its own tail.. and we keep feeding the dog… if we stop feeding the dog… maybe he will go away or even DIE !

BUT.. the genesis of all of this … is the prescribers’ office… leaving Rx pads lying around.. that can be stolen and forged… not properly screening pts… BEFORE they are accepted by the practice.

All of us are part of the problem.. although … some are more of the problem than others… you know who you are !

4 Responses

  1. It seems like all the comments I read about are pharmacists refusing to fill controlled prescriptions related to forged or altered prescriptions. I completely agree with a pharmacist refusing to fill a questionable prescription, delaying the prescription until it can be verified, or refusing to fill when there may be a contraindication. However, I don’t read any comments about a more recent issue where pharmacists are refusing to fill any controlled prescriptions at all, which is happening in Florida routinely. In fact I have seen signs posted in several pharmacies which state “We do not fill any controlled prescriptions for any reason”. In my opinion a pharmacist which refuses to stock or fill any controlled prescriptions clearly violates the pharmacy ethics oath which states that “I will consider the welfare of humanity and relief of suffering my primary concerns”. I also think it may violate the terms of the ADA act for persons who are disabled since it is clearly discriminating against specific medications overwhelmingly prescribed to disabled persons. I am very happy to see that more chronic pain suffering persons are becoming involved with this issue and I think we could all benefit from supporting the different pain management organizations so that these organizations could obtain legal council and fight back just like the ACLU has done for years. In fact the ACLU may be a good forum for us who are having our civil rights trampled upon by overzealous pharmacists and physicians who are failing miserably to provide proper pain management programs because they fear the DEA may knock on their door. I think it is time for the medical profession to support those of us with chronic pain issues by taking preemptive legal action to clear the way for proper treatment. Especially since it is in the best interest of those medical professionals to continue the practice of pain management if not they will be without a specialty which many of them have studied and practiced for years. I also think that if these recent policies implemented by pharmacists and physicians are specifically targeting forged prescriptions, altered prescriptions, and inappropriate treatments there is a better way to handle these problems. Why not have just a few mail order pharmacies which fill only controlled medications and can spend the time to verify every prescription and the adequacy of the treatment. This would pretty much eliminate doctor shopping since these limited pharmacies would be the only ones that could fill these prescriptions and they would see right away when a patient was obtaining multiple prescriptions. Additionally, these limited pharmacies could employ a medical doctor to review any questionable prescriptions and discuss them with the prescribing provider. This would prevent a pharmacist from going outside the scope of his position by requiring the provider to adjust the quantity or specific medications being prescribed. Seem to me that this would solve the issues which the medical profession and the DEA are claiming to be the problem, if indeed, these issues are really the problem.

  2. I felt like I was constantly telling doc offices they be miles ahead if they ran the INSPECTS there in the office BEFORE writing the prescription. The excuses I heard was ‘didn’t know that was available’ “I signed up but cant remember my username/password’, “I leave that for my nurse to do” you name it I’ve heard the excuse. It’s laziness on their part as far as I’m concerned. Most of them had me fax my copy to their office, but of course this is after I’ve already got the script in my hand, patient waiting and I’m not going to fill it, but trying to get a date out of the doc when it could be filled. Knowing my giving back the rx back to the patient and he would go elsewhere was just not me…all i’d be doing is contributing to the problem. After 25 years, I have no problem writing next due date or last filled date on the front of the rx so the next pharmacy knows. Don’t know if any other pharmacists do this, but IMHO I felt like I was doing a little something to slow down the problem.

  3. Yesterday, I received a phone call from a nurse at a physicians office and she was inquiring as to whether a patient had gotten any ‘narcotics’ at my pharmacy. This sort of thing shocks me. Why are they not accessing the online prescription monitoring program where they can get information about controlled substances filled for a patient at any pharmacy in the state?

  4. I do what I can on licenses, but unless they start requiring only the prescribed patient to show up and pick up the Rx, I continue to write names and #’s on the Rx itself at least on who’s picking up and running my INSPECTs. When I renewed my DL, it was when you had to get one of those ‘Secured licenses’ (I had to bring in upteen documents to prove who I was) Not sure what happened to that program. IMHO, no matter what hoops are put in place, the legit patients will continue to be screwed while illegitimate patients will continue to get theirs. I also have had patients who have licenses from other states which I notice while they are digging for the IN license in their wallet. I haven’t been working but looking for a while, but saw where we can get info from other states…does that show up on INSPECT or does one have to run a separate report from each surrounding state.

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