Any of y'all that dispense controls, if you find that your patient is doctor-hopping or seeking from multiple entities, do you report them?
The reason I ask...we had one not long ago that was dismissed from our clinic for seeing multiple providers for pain meds (Oxycodone and Percs, specifically). He called and informed us that he had been in touch with the Board (my favorite ploy), and had spoken with a 'caseworker' (they only have investigators) who told him that we were required to give him Roxy to compensate for his being dismissed.
The Public Health website was down that day, but the next day we were able to look him up and found that he was seeing even more docs that we originally thought. Doc had me call the Board to ask if he had indeed contacted them. He had not, but the investigator told me an interesting tidbit...doc hopping or 'accession of a controlled substance by fraud, omission of information, etc." is a Class C felony, punishable by 2-10 years in prison!
The nice man also asked if he had commercial or government insurance. I answered with the latter, and he suggested I call them to apprise them of what they were paying for. Doc agreed, and I was surprised to find out that government insurance companies take a pretty dim view on fraud.
So, my question...do you report this type thing? I had no idea it was as serious as all that, but it certainly gives me a new twist when counseling my patients who like to share their goodies with others (or partake of others' shared goodies).
Thanks for the thoughts.
Feb 23, '13
In a skinny minute. They need to know there are consequences for their illegal behavior.
Feb 24, '13
No. If they alter prescriptions, or commit some other kind of fraud of that order, then yes of course we alert the proper authorities. Otherwise, I turn a blind eye. I get ED reports that demonstrate my patients lied through their teeth to the ED, etc. all the time. I have people tell me they buy and sell pills all the time. Doc hopping? Breaking a pain contract? No, I don't have time for policing that. I'm running a medical practice, not a law enforcement department. Our local cops have their hands full with far more serious issues than somebody trying to score a few vicodin, and frankly so do I. I just note it in the cart and stop prescribing controlled substances for them. If they behave badly about that, we dismiss them from the practice. I'm not going to go all Sonny Crockett on them. It takes too much time and paperwork. I am not a cop and I could not give less of a beaver dam about what happens to them, so long as my name is not on the bottle. My time needs to be directed toward my actual skill set and helping the people who need me.
Feb 24, '13
Yes. What law enforcement does is up to them. In this situation, I believe not reporting is the same as enabling the problem to continue.
Feb 28, '13
I've alert the insurance company and the pharmacy. Where I'm at we can put an alert at least at the pharm most often used so they cant get narc refilled early and have me contacted if pt start gets narc from someone else. Agree with another poster Im not a cop. I dont want to do the paperwork. I do however want to cover my butt and alert other prescribers, pharmacist to the issues as much as I can.
Mar 2, '13
Jeez man, you and me think alike.
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