Controlled substances prescribing is an area filled with potential pitfalls that, if not avoided, can lead to serious disciplinary action for physicians licensed by the Texas Medical Board. Each month the press releases published by the TMB detail disciplinary actions involving nontherapeutic and inappropriate prescribing as well as actions involving the proper operation of pain management clinics.
Instances of inappropriate and nontherapeutic prescribing that have resulted in disciplinary actions in the recent past include the following:
- Prescribing controlled substances to relatives and other persons with whom the physician has a close personal relationship;
- Prescribing without adequate documentation of a clinical diagnosis;
- Prescribing for periods of time exceeding the current needs of the patient;
- Prescribing without conducting a physical examination;
- Prescribing without making a proper medical record;
- Failure to look for and respond to aberrant drug use; and
These matters have resulted in sanctions including various combinations of the following:
- Restriction from prescribing certain drugs;
- Losing the authority to treat patients for chronic pain;
- Completion of a physician prescribing course;
- Completion of a specified number of hours of CME in risk management and ethics;
- Payment of administrative penalties;
- Passing the Medical Jurisprudence Exam within a specified time period;
- Following all recommendations of the Texas Physician Health Program; and
- Not obtaining DEA or DPS Controlled Substances Registrations without TMB approval.
Repeat offenses and failure to comply with the terms of any disciplinary action are met with even stiffer penalties.
Pain management and the prescription of pain medications must be undertaken in compliance with DEA requirements, Texas law, TMB rules, and ethical standards. Physicians must take the utmost care adhere to procedures that include appropriate documentation and delegation policies, as well as procedures to detect indications of patient misuse or addiction.
Physicians should be aware of the potential consequences of noncompliance with pain management rules and requirements. Even physicians with the best of intentions can run afoul of the law. If you find yourself facing charges of inappropriate or nontherapeutic prescribing, having an experienced Texas professional license defense attorney at your side can significantly increase the likelihood of a positive outcome. Contact Oscar San Miguel, Attorney at Law, at the first sign of a problem.