Business

Physicians asked to help with Rx abuse-prevention programs

The number of states with prescription monitoring programs doubled in six years.

By Pamela Lewis Dolan — Posted Jan. 28, 2009

Print  |   Email  |   Respond  |   Reprints  |   Like Facebook  |   Share Twitter  |   Tweet Linkedin

As prescription drug abuse becomes a greater concern among governors and legislators, several states are turning to physicians to help curb the problem through prescription drug monitoring programs. Iowa is the latest state to adopt such efforts.

While the programs have the potential to place physicians in the unwitting position of law enforcement officials, several physician organizations, including the American Medical Association, have expressed support for them. They feel the programs could be a tool for physicians to identify patients in need of help.

According to Sherry Green, executive director of the National Alliance for Model State Drug Laws, there are 38 states with laws authorizing monitoring programs and 32 that have a program up and running. The number of states with monitoring programs has more than doubled since 2002 when the U.S. Dept. of Justice made grants available to create programs.

Under the programs, states create Web sites on which pharmacists report controlled substance prescriptions that are filled. Physicians can gain access to the site to identify possible doctor shoppers or addicts, or even those who might be involved in illegal drug diversion.

Jeanine Freeman, senior vice president of legal affairs for the Iowa Medical Society, said when Iowa received a grant to create a drug monitoring program two years ago the medical society's initial concern was that the program would be established under grant only with no statutory requirement.

"There's too much that comes into play here," Freeman said, adding that patient privacy and physician liability were at the top of the list of concerns from members. It was the medical society's view that the state needed statutory requirements spelling out how the program would be created and used.

"We spent the better part of a year to a year and a half working with the board of pharmacy and regulators to establish a program we thought would work in our state. The law that was designed, we were behind," she said. The state is now in the process of authorizing users and collecting data. Physicians and other prescribers will be able to start requesting data by early March.

According to Terry Witkowski, executive officer of the Iowa Board of Pharmacy, which will facilitate the program and maintain the Web site, pharmacists must report all schedule II, III and IV controlled substances that are dispensed. What the physicians do with the information is up to them.

Russ Miller, executive director of the Tennessee Medical Assn., said the majority of physicians in that state find using the system disruptive to their daily routines. And others, he said, feel the program isn't living up to its potential as the data are only updated twice a month. The medical society is pushing for upgrades to the program that would include real-time reporting.

But those who use it consider it an important component of providing patient care, Miller said.

Some states allow law enforcement officials to access the database, but in many states that's off limits. Green said while none of the programs has mandates that physicians must report what they find, many states have laws that require physicians to report any suspected criminal activity. Under HIPAA, personal information can be disclosed under some exceptions, one of which is reasons of law enforcement. In Iowa, as in other states, physicians aren't required to give specific information, just enough for law enforcement officials to prompt an investigation.

The AMA took up the issue at its 2008 Annual Meeting after several state medical societies asked for its help in drafting proposed state laws. AMA policy advocates that any information found through such databases be used first for education prior to any civil action against any physicians. Possible action could target a physician's prescribing history.

Back to top


ADVERTISEMENT

ADVERTISE HERE


Featured
Read story

Confronting bias against obese patients

Medical educators are starting to raise awareness about how weight-related stigma can impair patient-physician communication and the treatment of obesity. Read story


Read story

Goodbye

American Medical News is ceasing publication after 55 years of serving physicians by keeping them informed of their rapidly changing profession. Read story


Read story

Policing medical practice employees after work

Doctors can try to regulate staff actions outside the office, but they must watch what they try to stamp out and how they do it. Read story


Read story

Diabetes prevention: Set on a course for lifestyle change

The YMCA's evidence-based program is helping prediabetic patients eat right, get active and lose weight. Read story


Read story

Medicaid's muddled preventive care picture

The health system reform law promises no-cost coverage of a lengthy list of screenings and other prevention services, but some beneficiaries still might miss out. Read story


Read story

How to get tax breaks for your medical practice

Federal, state and local governments offer doctors incentives because practices are recognized as economic engines. But physicians must know how and where to find them. Read story


Read story

Advance pay ACOs: A down payment on Medicare's future

Accountable care organizations that pay doctors up-front bring practice improvements, but it's unclear yet if program actuaries will see a return on investment. Read story


Read story

Physician liability: Your team, your legal risk

When health care team members drop the ball, it's often doctors who end up in court. How can physicians improve such care and avoid risks? Read story

  • Stay informed
  • Twitter
  • Facebook
  • RSS
  • LinkedIn