From a Drs view.....
As I sit here pondering all the excellent comments to the original blog about my writings, I am drawn to a recent email from a colleague who treats pain. A patient of his had a car accident while on appropriately prescribed opioids that had caused no sedative effects for the past 5 years. Others were injured, and because the driver was on opioids, it is assumed he was driving impaired. The physician may now be implicated, though office exams showed no impairment and the patient signed a "contract" agreeing to not drive impaired. It is possible the physician may be charged with a civil or even a criminal suit. Medical malpractice insurance does not cover expenses nor defense for criminal or civil charges, only for medical malpractice.
The physician writes: "herein lies the real and basic reason doctors are so reluctant to prescribe any medications for patients with painful conditions. If prosecuted and convicted of civil or criminal behavior, you can lose your life savings, your home, and your retirement savings including your 401K and your IRA. You can go to prison, and several well meaning doctors have. Neither your assets nor your freedom are protected."
In fact, another colleague of mine, Jennifer Bolen, JD maintains a website, "The Legal Side of Pain" to help physicians navigate the legal landmines associated with the practice of pain medicine.
The physician further observes: "without a change in the laws regarding civil and criminal liability for doctors who prescribe medications for painful conditions it is unlikely things will change much. Patients in pain will still find it difficult to find a physician willing to treat them. And who can blame physicians for being reluctant to prescribe, given the liability issues that go beyond medical malpractice."
And so, apparently I have added another step to the list of long term solutions necessary for real change in access to appropriate pain management: legislation addressing the liability born by the attending physician of a person with persistent pain being treated with opioids. Don't hold your breath for that one.
Kathy Hahn ;Pain-Topics.org News/Research UPDATES