Howell's case is a reminder to physicians of what can go wrong in pain management. For those physicians who dispense pain medications as part of their practice it is important to learn from such cases without being fearful of prescribing narcotics. There is a legal way to prescribe controlled substances for intractable pain.
The law in California is that "No physician and surgeon shall be subject to disciplinary action by the board for prescribing or administering controlled substances in the course of treatment of a person for intractable pain." Cal. Bus. Prof. Code Section 2241.5(c). How do you as a physician ensure that you fall within this law?
The first place to start is to review the California Medical Board's Guidelines for Prescribing Controlled Substances for Pain. This is a summary of the standard of care for managing pain patients. It has detailed advice that you are expected to know before you prescribe narcotics for pain management.
Second, review and comply with the DEA's Practitioner Manual to ensure you are complying with federal rules and regulations. It is usually the DEA who sends in undercover patients and initiates investigations when the CURES reports show a large number of prescriptions from a physician. There are more cases of state and local law enforcement getting involved in undercover operations as well but the DEA is in the forefront.
Third, seek legal and expert advice to make sure that your practice is compliant with existing laws, regulations and medical standard of care. If you did not comply with the existing rules in the past, it is not too late to change your practices and become compliant.
Posted by Tracy Green, Esq. Please email Ms. Green at tgreen@greenassoc.com or call her at 213-233-2260 to schedule a complimentary 30-minute consultation.
Any questions or comments should be directed to Tracy Green, a very experienced California physician attorney at tgreen@greenassoc.com. The firm focuses its practice on the representation of licensed professionals, individuals and businesses in civil, business, administrative and criminal proceedings. They have a specialty in representing licensed health care providers in California and throughout the country. Their website is: http://www.greenassoc.com/
