It has been over thirty years since I received a visit from an investigator from the State Board of Texas. Needless to say I was scared to death. On that day he requested and received copies of 3 patient files. I was not informed for 3 months why they wanted them or what I had been accused of. The registered letter with the State Board’s accusations came during the middle of the week and took my breath away. I was being accused of writing prescriptions in excess of necessity for treatment rendered on all three patients. The letter required that I come to Austin, Texas, and meet in person with the investigators, secretary, and two board members to discuss these accusations. I was given the opportunity to answer any and all of the accusations in written form 30 days prior the hearing, and could have an attorney present if I wished. Bottom line: They cleared me of charges related to two of the patients while they went after just one.
The patient in question was referred from an Oral Surgeon that I knew in order to do full mouth rehabilitation following an auto accident requiring bilateral mandibular joint replacement. During the two year period of treatment, I had written eleven Class II prescriptions for pain (131 pills) while doing 18 root canals, and crowing every tooth. Unbeknownst to me, the patient had received 6 times that amount of pain pills from other doctors she was seeing. I was never informed that the patient was showing up on the DEA’s computer scan that identified her as an addict or drug seller. As it turned out, I was given two years probation, a $2,500.00 fine, and had to take 8 hours of continuing education on drugs and their use.
A bad outcome from what I still consider clinically necessary medications without having knowledge of her overuse/abuse via other prescriptions from other doctors. Because of this we firmed up our policy on how we deal with drug prescriptions and patients. The policy along with the system we used with each patient has gone through many iterations, and I am not sure how or where we finally got the form we currently use, but I thought you might consider adding this form to your offices.
1. Prescriptions will not be refilled after normal business hours, on holidays or weekends when the doctor on call does not have your records. This is for your safety and the safety of others. An early refill on your pain medicine will NOT be granted if you take more than the prescribed amount.
2. Prescription refills should be called into your pharmacy, or to our office during regular office hours. It may take up to 24 hours to refill a prescription.
3. Prescriptions will not be refilled if you have cancelled your last appointment, did not show for your last appointment, if you do not follow through with recommended treatment, you have been discharged from the practice, or if you were to return only as needed. WE DO NOT PRACTICE PAIN MANAGEMENT.
4. Prescriptions that have been lost or discarded will not be refilled.
5. Prescriptions that have been stolen will not be refilled.
6. During the time of your care in this office, unless we have referred you to a pain management specialist, this office will be the ONLY SOURCE OF YOUR PAIN MEDICATION. You may still receive other medications (for an example: for infections, swelling, etc.) from your family doctor, but only ONE doctor should ever prescribe pain medication at a time.
7. It is our legal duty to report to the authorities the name of patients who we believe may be taking, selling, or distributing narcotics or other medications illegally.
8. We reserve the right to terminate the doctorapatient relationship in the event of any breech in this policy by the patient.
APPOINTMENT CANCELLATION: A 24-hour notice is required when cancelling an appointment.
NO SHOW WITHOUT ANY NOTICE OF CANCELLATIOIN FOR AN APPOINTMENT: There will be a $50.00 charge after the first no show appointment in order to be scheduled again to see the doctor. If two no show appointments occur the patient/dentist relationship will be terminated.
I HAVE READ THE ABOVE AND UNDERSTAND THE PRESCRIPTION, CANCELLATION AND NO SHOW POLICIES.
PATIENT SIGNATURE:____________________________________ DATE:___________________