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Position Statement: FL PDMP and “Controlled Substance Prescribers”

9-8-14-revision_stoppnowControlled Substance Prescriber Definitio1

Problems with FL state board disciplining docs

 

This is why FL became known and is known as the OxyExpress.

Mike Deeson, WTSP 7:11 p.m. EDT September 12, 2014

http://www.wtsp.com/story/news/investigations/2014/09/12/problems-with-florida-board-of-medicine-disciplining-doctors/15531799/

 

St. Petersburg, Florida — It should come as no surprise the Florida Board of Medicine ranks as one of the worst in the country for disciplining doctors. Last year, 10 Investigates looked at the Board’s record and found it to be abysmal.

Related Story: Despite malpractice settlements, few docs lose licenses

During our investigation, 10 Investigates looked at how the Florida Board of Medicine appeared to be reluctant to discipline or pull a physician’s license even in the most egregious cases.

A prime example is Dr. Gunwant Dhaliwal who we first reported fondling patients’ breasts in 2007. Dhaliwal was first accused in 1999 of doing the same thing. Despite the fact several victims came forth and Dhaliwal was arrested, convicted, served time in jail, and was ordered to pay $800,000 in a civil lawsuit, the Board didn’t hear his case until last year. At that time, only one member of the Board, Dr. Jason Rosenberg argued that Dhaliwal should never be allowed to practice medicine in Florida again.

Rosenberg said at Dhaliwal’s hearing “He [Dhaliwal] was convicted of a crime we consider heinous we should revoke his license. Nothing else is acceptable.”

When he saw his fellow board members were reluctant, Rosenberg said, “What are we telling the citizens of Florida. Your doctor fondles your breasts, gets deprived of his liberty after his day in court and now we’re going to go back and let him practice. Wrong message!”

However, instead of stripping Dhaliwal of his license, the Board suspended him for six months, gave him a $10,000 fine and he is practicing once again in Pasco County under probation. The only restriction is that Dhaliwal must have a licensed female health practitioner chaperone him when he examines a female patient, and the female practitioner has to document she was there in the patient’s records. Otherwise, it’s business as usual for Dr. Dhaliwal and that’s fine with the Board.

Last year, 10 Investigates looked at the Florida Board of Medicine’s record disciplining doctors and found it to be abysmal. WTSP

Despite malpractice settlements, few FL docs lose licenses

This is the root of the problem.  You can not have a pain clinic without a physician.
http://www.wtsp.com/story/news/health/2014/09/12/despite-multiple-malpractice-payouts-doctors-often-keep-practicing/15530643/

Ben Eisler and Mark Strassmann, CBS News 6:02 p.m. EDT September 12, 2014

(CBS News) Dr. James Dunphy met his wife Susie in college. They went to medical school together, got married and had two sons. On a family trip to Florida in 2009, Dr. Susie Dunphy was diagnosed with appendicitis. She had emergency surgery; two days later the 42-year-old bled to death in her hospital bed.

James Dunphy said the hardest part was breaking the news to his two young boys.

“I told them it would be okay, and that I would be their mom and dad now,” Dunphy said.

In the weeks after her death, Dunphy reviewed his wife’s medical file. What he read convinced him that her doctor could have prevented her death. He said his wife’s blood pressure had been critically low for hours after the surgery. But no lab tests or imaging studies were ordered to see what was wrong.

“These are the kind of vitals that anybody with basic training can recognize as abnormal,” Dunphy told CBS News.

Dunphy sued his wife’s surgeon for failing to adequately monitor her after the procedure, blaming him in part for her death.

The surgeon, Dr. Ernest Rehnke of St. Petersburg, denied wrongdoing. But he settled the case for $250,000 – the maximum his insurance policy would pay for a single claim.

A review of Florida records by CBS News found Rehnke has had 11 medical malpractice lawsuit payouts since 2000 – tying him for the most of any practicing physician in Florida. Yet the Florida Board of Medicine, which is responsible for stopping dangerous doctors from practicing, has never restricted his license.

CBS News investigates effectiveness of state medical boards at stopping dangerous physicians. CBS News

CBS News then looked at the 25 doctors with the most malpractice payouts in Florida. CBS News found just four of them lost their licenses – and three of those four only lost them after they had been arrested and charged with either drug trafficking or billing fraud. The fourth lost his license after he failed to comply with the terms of a lesser punishment. In other words, not a single one of them had been stopped from practicing solely for providing poor medical care.

A malpractice payout can come as a result of a judgment or a settlement – though most come from settlements.

Dr. Sidney Wolfe of the watchdog group Public Citizen said the findings show the Florida Board of Medicine is not doing its job.

“When you look at these doctors with the largest number of malpractice suits, you have to ask the question — at what point could we have prevented the last five, or the last ten?” he told CBS News.

Wolfe said it’s a problem found not just in Florida. He has published studies on state medical boards nationwide. He said many of them are failing to protect patients. His latest report found that from 1990 to 2009, more than half the doctors in the U.S. who had their privileges restricted or revoked by a hospital had never even been fined by their state medical board. He said hospitals generally only go after the most dangerous physicians.

Public Citizen has also ranked medical boards based on the number of actions taken per physician in their state. Those with the most: Ohio, Oklahoma and Alaska. Those with the least: South Carolina, Minnesota, Wisconsin and Florida.

About a year after Susie Dunphy’s death, her husband received a letter in the mail from the Florida Board of Medicine. It said the agency had investigated his wife’s case and found no basis to file a complaint against Rehnke.

“I thought it was unbelievable,” Dunphy said. “I teach medical students. This is something so basic I would expect my medical students to recognize this is not normal…It makes me wonder if they even reviewed the case.”

The Florida Board of Medicine declined CBS News’ repeated requests for an interview. Last month CBS News even went to the agency’s public meeting in Orlando, but no one would agree to talk with CBS News. In a statement, a spokesperson wrote, “[we] must follow the due process of law in order to ensure the rights and entitlements of all parties to any action…The department is diligent in its efforts to ensure the public is protected from unsafe or unscrupulous health care practice.”

Rehnke also would not give CBS News an interview or even a statement.

Elected officials in each state have oversight over their medical boards. In Florida, State Senator Jeremy Ring, chairman of the Government Oversight Committee, said that as a result of our reporting, he will introduce legislation to improve the board’s ability to protect patients.

You can look up malpractice payouts made on behalf of Florida doctors here.

MORE: Problems with state board disciplining docs

FL PDMP Utilization Data September 2014

FL PDMP Utilization Data Sept 2014

Florida:
Please look at the very poor compliance rates of our PDMP (E-FORCSE).
1. Pharmacists are mandated to enter patient prescription data, but not review the patient prescription history.
2. Physicians have NOT been mandated to do either, enter or review.
3. FL Attorney General Pam Bondi secured funding to keep the PDMP up and running. 
How effective can this be if it is not being used? (Keep in mind it does not cost any money for any prescriber or dispenser to use this data base.)
This is proof that Florida continues to contribute to the now national PHYSICAN prescribed drug epidemic.
FL Pharmacists are mandated to be registered and enter data; 44.49% compliance. 
The health safety of Florida citizens continues to be at risk as do the lives of our seasonal citizens that come from Canada and many US states.  In addition, our Veterans are also at risk.
Please contact your Senators and Representatives today and let them know that this is unacceptable.
To find your FL Senators:
To find your FL Representatives:
Help us make a difference by making the calls and/or email this data to your senators and representatives – copy and paste – keep it simple.
Please just do it!

Maureen and I did some traveling this week

We met with DOH, chief Bureau of Enforcement. He recognizes the need to restructure the DOH to better investigate and discipline/remove bad doctors. We have faith in his ability and will remain in touch. We spoke about the need for DEA to reduce the production amount in order to save lives and the DOH part in this to make sure the bad doctors are eliminated from our system. He informed us that CVS and Walgreens have placed self-imposed quota’s already We are going to try to quantify this before going to Washington as this information will help our cause.
We also scheduled meetings to garner support for the Bill Senator Eleanor Sobel has agreed to write to make the PDMP mandatory for doctors to use in Florida and to participate in the inter-state exchange. Many we met with have heard from people in their districts in chronic pain and not being able to get their prescribed opiates. Your Senators and Congressman both state and National must hear from you to tell of the suffering keeping this drug on the market in such quantities is causing.
. Representative Matt Hudson District 80 — met with Legislative Assistant
This meeting was not as positive as we had hoped. The person we met with felt the Fl pill mill situation is solved. Much more concerned with the people suffering from not being able to get their opoiates. (I am including contact information for those of you who would like to share your view 239 417-6270 E: sheila.jackson@myfloridahouse.gov
.U.S. Congressman Vern Buchanan — Met with District Director who expressed a great interest in the information we shared. She too, as all have heard from the chronic pain sufferers but also from mothers that have lost children due to the presciption drug epidemic. We would like Vern Buchanan to support S-1657 and also to direct us regarding the Senate Investigation letter of Purdue Pharma which continues to sit in the Finance committee And no investigation is taking place. We will continue to be in touch with this office and believe the help we seek will not be ignored. 941 951-6643 Sally.Tibbetts@mail.house.gov
.Senator Jack Latvala— Met with Legislative Assistant. She also has heard from both sides and is able to view problem with empathy. She was very helpful to us and will review information we spoke of with the Senator. 727 793-2797 caddell.tracy@flsenate.gov
.Senator Maria Sachs We had a scheduled meeting on Monday June 30th 2014 at 2p. She stood us up. We spent 45 minutes with her aid and left much information asking for her support to strengthen the PDMP. Her aid apologized to us stating that she said she was going to be there. There has been no follow up to date.
.Ellyn Bogdanoff will be running against Maria Sachs in November. We have a meeting scheduled with her on Monday.
. Joe Kaufman who is running for Congress against Debbie Wasserman Schultz. This would be a big upset but we would have someone in office who would be supportive of our efforts. He spent time with us and listened to all our needs.
*** We have meetings scheduled in Washington DC when we will be there to support the FED UP RALLY
Senator Manchin’s office, Senator Feinstein’s office, Senator Grassley’s office, Senator Udall’s office, Representative Blackburn’s office and thanks to a mom from Kentucky, Emily Walden, a meeting with the DEA in Arlington Va.

Stay tuned

FYI:  Florida: (August 12, 2014) Congressman V. Buchanan’s Safe Prescribing Act has been co-sponsored by over 50 bipartisan members of Congress including five distinguished Committee Chairmen.
“Today’s announcement is a win for every man, woman, and child who has endured the horrors of prescription drug abuse,” said Buchanan, the House sponsor of the Safe Prescribing Act of 2013 (H.R. 1285). “We are one giant step closer to curbing an epidemic that wreaks havoc on countless families and communities across our state.”