How do I report a Doctor to the DEA? Anyone ever do this?

[nervousinkzoo]

It is long overdue.

This particular doctor has done the following while I have worked with her or near her at this clinic:

After I inform her a particular patient I have worked up is suspected to be under the influence, she sends them home with narcotics. This has happened dozens of times in the last few months.

After I hand her evidence of failed urine drug screenings,including positives for cocaine, pcp, meth, and marijuana, she sends patients home with narcotics.

After I hand her evidence of multiple doctors writing for the same drug for the same patient, she sends them home with narcotics. She even gave narcotics to the patient that was obtaining meds under two names and was caught by the local ER.

To top this off, she fails to adequately treat some of the underlying chronic issues some of these patients have.

Patients are often on doses and combinations of painkillers that exceed safe limits.

For the life of me, I cannot find anything defensible about this doctors behavior. I know the patients seeking these drugs have issues of their own. But on my lunch today I saw one of her morning patients crushing and snorting pills just a few cars down from where I was eating my sandwich. That plus the months of overhearing patients comparing notes on what they scored and even talking about who they are selling their "script" to has put me over the edge.

Can I get anywhere with this? I have another job so I am not worried about retaliation.

[nervousinkzoo]

BTW, don't think that you won't feel the effects of your actions because you have another job. You will learn that it is a very small community that we work in!

This is what scares me.

[leslie :-D]

i commend you for not looking the other way.

if you feel you have strong evidence against this physician, you can share your concerns with:

DEA, Submit A Tip

there are too many of these docs, who have contributed towards many becoming addicted.

time to bring out the trash, imo.

leslie

[lzink]

And therein lies the problem. I was surprized at how other nurses rise to defend this doc.

If she is right or wrong is up to the Board of Healing Arts. The physicians "rational" is not the point. If he/she is prescribing an unsafe amount of narcotics the rational is irrelvant.

If the BHA agrees no harm, that's thier decision and visa vera. Again, if you look at your NPA as a licensed professional you have a "professional obligation" to report, not judge, just report the facts. This nurse has "asked questions" and had "conversations" with this doc and what happened......nothing. It takes guts to report a physician, but if you play it safe as it sounds like many other nurses have and someone dies, don't think for a minute the defense attornies won't bring out the fact that as a nurse you knew better and did nothing about it.

This subject matter could use some fresh air...if this doc is unscrupulous he/she counts on you not reporting the facts that you have witnessed. He/she is counting on you to be too intimadated by his/her creditionals, and yes the "power" of his/her position. Now everyone should understand why physicians carry mal-practice insurance and why it cost an arm and a leg. No pun intended. I also agree that if you go forward doing what you think is the right thing to do it's not going to be easy on you, but you may save the life of an unsuspecting patient. I would like to point out that the DEA isn't counting the number of pills Dr. X prescribes because they are too busy enforcing our border etc. Ask any pharmacists, there isn't a computer program that ties a physicians script writting habits together, in part thanks to HIPPA. Well I think I'm going to drop this hot potatoe for another day. And for all of the health care providers who "ran" to defend the actions of this doc, ask yourselves why, what is your rational for defending a doc you don't even know? As a nurse you will come to your own conclusion according to your conscience (and the Law) who know's you might save not only a patient, but in the end play an important factor in saving a Physicians' life because he sought treatment with the encouragement of the BHA instead of having sanctions against his license. FLTNRSE2

[TriciaJ, RN]

I agree with lzink. I don't know when nurses are going to realize they're grown-ups and lose the "it's not nice to tattle" mentality. You have a legal responsibility to report unsafe practice. Let the State Board of Medicine and the DEA sort out if there's been any actual wrongdoing and if there's proof.

Two nurses in Texas went through hell in order to uphold their professional responsibility. They paved the way for us all to be empowered to speak up when something isn't right. I think we owe them our gratitude and our willingness to not shirk our own responsibilities.

[Whispera, MSN, RN]

This is off-topic but I feel I have to write about it. In the box that appears above things we write, many of us have all sorts of information about ourselves. This could lead to someone else reading about us and being able to identify us. Therefore, we must be careful what we post because we don't know who's reading our words. Please consider this before you write things that could be identified as to facility, other person, yourself, and your work....

[SuesquatchRN, BSN, RN]

I think she probably figures they're going to get the drugs one way or another.

I think it's none of your business. And I think it's too hard to get narcotics, too hard to get adequate pain control, rehab is useless, and druggies are not going to comply with any PoC for their morbidities so why should she waste her precious time.

[caliotter3]

Some time back I looked up my former doctor on the medical board site out of curiosity, because when I was under his care he had a big problem with a high profile malpractice lawsuit. I was saddened to read paragraph after paragraph and page after page of the allegations used to revoke his medical license. It read just like your post, with the exception that it included the untimely deaths of two or three patients. I could not believe the descriptions of how he bypassed common sense to give obviously impaired people controlled substances to their detriment and his. Have one or two of these patients pass away and you may find this doctor in the same boat. It usually catches up to them when deaths are involved.

[shannonFNP, BSN, MSN, RN]

I think she probably figures they're going to get the drugs one way or another.

I think it's none of your business. And I think it's too hard to get narcotics, too hard to get adequate pain control, rehab is useless, and druggies are not going to comply with any PoC for their morbidities so why should she waste her precious time.

I am going to politely disagree. I feel it is absolutely the OP's business if she is involved in these patient's care and observing what she feels are unsafe practices. It is always our duty to question an order that could be a detriment to patient health. That being said, there may be many different routes to go about before going to the extremes.

I'm not suggesting you do or don't contact the DEA, but never, EVER, think that it's not your business to intervene if you feel that you are observing unsafe practices. It is our duty to advocate, whether or not the patient realizes that narcotics may be doing more harm than good when not exercising proper precautions (i.e.: Don't take that pill with booze or crack).

Your duty of questioning an order doesn't mean you have to be right-- just that you have to act by questioning the doctor and moving up the chain of command as you deem necessary.

[SuesquatchRN, BSN, RN]

I feel it is absolutely the OP's business if she is involved in these patient's care and observing what she feels are unsafe practices. It is always our duty to question an order that could be a detriment to patient health. That being said, there may be many different routes to go about before going to the extremes.

Going to the DEA is far beyond questioning an order.

[shannonFNP, BSN, MSN, RN]

I'm sorry if you misinterpreted what I said. I don't have an opinion on whether she should go to the DEA because I don't know all of the facts. My comment was relative to whether or not it was her 'business' to be concerned about the abundant narcotic scripts. If she feels that the doctor is being unsafe, it's her business to act. Now, going to the DEA... that's a choice only she can make (hopefully with some legal counsel to determine the appropriateness). I just don't want the OP to think that in nursing practice it's not her 'business' what the doctor does.

[Rikki's Number]

That is part of why I am a bit nerved-up about reporting her. I have accumulated quite a few chart numbers with evidence of violated pain contracts, failed UDS, and correspondence from methadone clinics indicating patients were not get controlled substances from us. I just tallied them and I am at 281 5-digit numbers in a notebook. I don't know if she is a big enough fish to interest the DEA. I don't know if this "evidence" even means anything to anyone but me. All I do know is that it sucks she is in my neighborhood.

I will probably be committing career suicide at this clinic, but I am working somewhere else also. I am well regarded at both locations. I think that may change soon.

Let me see if I understand this correctly. You are storing patient information in a notebook? And, you are keeping correspondence about patients without their consent? At least 281 of them? And you think this is not going to bite you in the butt?

Before you say that you are only keeping chart numbers, perhaps you might want to review HIPAA.

I have known people who were fired for much less than this. Be careful. This could follow you for years.

Know which battles to fight. This one seems like a loser for you. Let it go.

[badmamajama]

In my state there is an anonymous line with our BON where we can call and ask questions about either ours or someone else's nursing practice. I have used this for my own sake as well as to question if a facility policy is within my scope. See if there is something available in with your state medical board. If so use this as a way to see what is the best way for you to handle this. Nurses have good perspective on how this is going to affect you personally and professionally and what you are obligated to do, and the medical board can give you further insight on what they expect from their physicians.

I think you are right to be concerned and I commend you for not turning a blind eye. I can't believe anyone would tell you to do nothing. What kind of patient advocacy is that? And shouldn't nurses stick together, support each other when we have concerns?

That being said, get rid of that notebook. If you have specific cases that concern you write down non-identifying factors, such as age, gender, situation, but nothing that can come right back to the patient or you will be in more trouble than the doctor. If the powers-that-be decide she is worth investigating they will go through every chart she as sneezed at and find what they need. Believe me, I've seen it and it will scare you to death when you see your name on a chart being investigated.

(fyi A doctor I once worked for was being investigated by our state medical board and when they looked at some of the charts and saw some of the nursing errors they in turn called our BON who launched their own investigation. I'm not telling you this to deter you from doing what you think is right, I just advise you to make sure you are doing everything everything right as much as possible before you are taken down with her.)

feel free to pm me.

T