ABSTRACT
OBJECTIVE: To provide a "big picture" overview of the characteristics and outcomes of recent criminal and administrative cases in which physicians have been criminally prosecuted or charged by medical boards with offenses related to inappropriate prescribing of opioid analgesics. DESIGN: We identified as many criminal and administrative cases of these types as possible that occurred between 1998 and 2006. Cases were identified using a wide variety of sources, including organizational and government agency databases, published news accounts, and Web sites. Factual characteristics of these cases and their outcomes, and of the physicians involved, were then further researched using additional sources and methods. SETTING: Study findings are intended to apply to practicing U.S. patient care physicians as a whole. PATIENTS OR OTHER PARTICIPANTS: There were no patients or participants in this study. Outcome Measures. We analyzed the numbers and types of cases and physicians involved, criminal and administrative charges brought, case outcomes and sanctions, specialties, and other characteristics of the physicians involved. RESULTS: The study identified 725 doctors, representing an estimated 0.1% of practicing patient care physicians, who were charged between 1998 and 2006 with criminal and/or administrative offenses related to prescribing opioid analgesics. A plurality of these (39.3%) were General Practice/Family Medicine physicians, compared with 3.5% who were self-identified or board-certified pain specialists. Physicians in this sample were more likely to be male, older, and not board certified (P < 0.001). Drug Enforcement Administration (DEA) criminal and complaint investigations averaged 658 per year (2003-2006) and "for cause" surrenders of DEA registrations averaged 369.7 (2000-2006). CONCLUSIONS: Criminal or administrative charges and sanctions for prescribing opioid analgesics are rare. In addition, there appears to be little objective basis for concern that pain specialists have been "singled out" for prosecution or administrative sanctioning for such offenses.
Subject(s)
Analgesics, Opioid , Drug Prescriptions , Malpractice/legislation & jurisprudence , Physicians/legislation & jurisprudence , Adult , Aged , Analgesics, Opioid/administration & dosage , Drug and Narcotic Control/legislation & jurisprudence , Drug and Narcotic Control/methods , Female , Humans , Law Enforcement/methods , Licensure, Medical/legislation & jurisprudence , Male , Middle Aged , Physician-Patient Relations , Professional Misconduct/legislation & jurisprudenceABSTRACT
Prescribing prescription-only medications solely on the basis of a questionnaire filled out on an internet site is merely an updated version of "diagnosis by mail" and has been condemned by all respectable authorities for over 100 years. The Wisconsin Medical Examining Board has disciplined 1 physician for the practice, and authorities in other states have taken similar actions.
