What are the lessons we can learn from RxSafe Marin?
The first lesson is that opioid prescribing guidelines only work when they’re widely taught to doctors, and just as widely followed. RxSafe Marin puts something on paper, talks about it in the medical community, and has “action teams” to try and implement and spread the gospel of the medical-legal framework it has developed.
The second lesson is that local efforts can quickly get more done, and more effectively than at the state or federal level. The Medical Board of California is too bureaucratic, too unwieldy, and too afraid of assuming liability or having insufficient enforcement flexibility, to be clear with doctors about what should and should not be done.
In the absence of state leadership in responsible physician education, a county has taken the initiative and filled the vacuum. And third, local guidelines offer new protection for doctors who take the time to learn and implement them. In practice, a doctor who takes advantage of a new educational opportunity, and who utilizes this new tool is declaring to all that he or she knows the science, carefully decides whether to prescribe opioids for chronic pain, and voluntarily and consistently advances what the local medical community views as the safest and best way to treat patients with pain.
What is the risk of not following opioid prescribing guidelines?
The flipside, of course, is that if you are a doctor in a community such as Marin, who doesn’t know what RxSafe Marin is, or who otherwise doesn’t practice well within available prescribing guidelines, you’re running an added risk of being arrested and prosecuted for drug crimes.
With everybody else on notice that there’s a problem that the county is trying to address, what’s your excuse for not knowing about it and not doing anything about it? I have heard DEA agents, detectives and prosecutors say that many, many times about the doctors they arrest and throw into criminal court. From the patient safety and medical practice perspective, programs like RxSafe Marin are great, and they offer support for doctors to meet the legal test of medical judgment. Doctors who don’t make the most of the opportunity are taking a huge risk, and running out of excuses.
About The Author
The Meister Law Offices provides criminal law compliance legal services for healthcare providers who write prescriptions for Schedule II painkillers and pain medication.