HealthLawProf Blog

Editor: Katharine Van Tassel
Concordia University School of Law

Sunday, September 21, 2008

Study Finds Few Pain Doctors Face Criminal Prosecutions

The New York Times reports on a new study that shows doctors are rarely criminally prosecuted or sanctioned in connection with prescribing narcotic painkillers.  Barry Meier writes,

Pills9The study, published this month in the journal Pain Medicine, found that 725 doctors, or about 0.1 percent of practicing physicians, had been prosecuted or sanctioned by state medical boards between 1998 and 2006 on charges arising from illegally or improperly prescribing narcotics. Of that group, 25 doctors specialized in pain treatment.

“The widely publicized chilling effect of physician prosecution on physicians concerned with legal scrutiny over prescribing opioids appears disproportionate to the relatively few cases,” the study reported.

The study was undertaken by the Center for Practical Bioethics in Kansas City, Mo., the Federation of State Medical Boards and the National Association of State Attorneys General.

The study’s authors acknowledged that their review, while extensive, did not account for prosecutions against doctors brought by state and local law enforcement officials.

Also, one of the report’s authors, Dr. Scott M. Fishman, a pain specialist, said that the “chilling effect” on doctors involved not just legal cases but also visits from law enforcement agencies like the Drug Enforcement Administration.

“One has to temper the interpretation of the data with all the other phenomenon of how physicians perceive the heat of regulators,” said Dr. Fishman, a professor at the University of California, Davis. “Most of us have had visits from the D.E.A., and I can tell you that it can be a scary thing.”

The question of how doctors perceive their legal vulnerabilities when prescribing narcotics has consequences because studies have long suggested that doctors, fearful of drawing legal scrutiny, may not adequately treat patients.

In recent years, the issue has become amplified because of several highly publicized prosecutions of doctors accused of selling narcotics like OxyContin, Percocet and Vicodin, or recklessly prescribing them. Some news accounts about those cases have also contended that they were part of a broader, national crackdown against doctors who treat pain patients.

Myra Christopher, the president of the Center of Practical Bioethics, a group that supports improved patient pain care, said the purpose of the study was to “discern the facts from the folklore.”

Robert T. Libby, the author of “The Criminalization of Medicine: America’s War on Doctors” (Praeger Publishers, 2007), said he believed that the study was seriously flawed and that pain doctors were subject to repeated harassment.

“They want to say this is not real,” said Mr. Libby, who is a professor of political science at the University of North Florida in Jacksonville. “They are minimizing it.”

Dr. Fishman said that the study, despite his reservations about how broadly it could be interpreted, was not advocating any point of view.

“We looked at what was happening, and that is what we found,” he said.

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Of course, this is misleading, NYT, left wing, biased rubbish.

1) The medical licensing boards are front organizations for lawyer cult enterprise oppression of the doctor. The doctor members are rubber stamping non-entities and losers, there only to approve the decisions of the self-styled lawyer prosecutor, an employee of the political hacks running the agency for the lawyer governor. These doctor low lifes have nothing better to do than to read massive piles of documents for $50 a day. Vile traitors to clinical care. They attack innocent doctors, allow massive damages to go on from unprofessional conduct by a well known small number of people who should not be in medicine. They are lazy and stupid, and will take the easy case, rather than the necessary case.

2) They are going after a lot of doctors who take pain patients, a core duty of all of medicine. The average doctor just does not want to be targeted for ordinary care of chronic pain.

3) The 1 in a 1000 figure is designed to mollify the wrath of the public. These prosecutions have dried up the supply of doctors willing to treat chronic pain patients. The public has expressed outrage.

4) The real rate is 100 times higher because the real denominator is not all doctors. The denominator is doctors willing to treat chronic pain patients. That is a tiny number.

If ever before a licensing board, the innocent doctor has a duty to defend clinical care. He must hire a separate lawyer to terrorize the administrative law defense lawyer. The latter is a traitor. He will take a long time to resolve the case, tiny step by step. He will never counterattack the source of his job, the licensing board prosecutor doctor bully. They are probably friends, and drink to the stupidity of the public after a case is over. The second lawyer must intimidate this double agent to countersue the members of the licensing board as individuals, and the bogus prosecutor, and his partisan political hack boss. Everyone has to undergo forensic examination of their personal computers and total e-discovery, including any cult member serving as administrative law judge. These lawyers and their doctor running dogs must fear the doctor, not the other way around.

Let's assume a doctors countersuit against these oppressors has no basis in fact nor law. It is ridiculous. The judge tells the lawyer, file another of these, I am putting you in jail. Let's assume that. It will still cost the government agency $1 million to get rid of it. Break the budget of these enemies of clinical care. To deter. If a government thug generates $1 million in costs, he will exceed his value to government. He will lose his job after a brief period to save face.

However, there are many concepts that will justify a valid countersuit, which will have greater validity than the bogus prosecution of the doctor oppressor. This should include intentional interfere with the multiple contracts of the doctor, the holdings of the Supreme Court, the policy data on patient suffering.

Every doctor being bullied by these oppressor/enemies of clinical care should read this case 5 times, looking up every word until completely understood, and demand the same of the admin law defense traitor.

Tell the admin law traitor he can move to have the prosecutor stopped, preferably clasped in irons, or face a malpractice lawsuit from the second lawyer reading and second guessing every word as it is written.

Posted by: Supremacy Claus | Sep 21, 2008 4:41:51 PM

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