Medical Board Corrective Action with Physicians Who Fail to Provide Adequate Pain Care
Kathryn L. Tucker, J. D.
Compassion & Choices
September 24, 2008
Journal of Medical Licensure and Discipline, Vol. 87, No. 4, 2001
When a physician fails to provide adequate, appropriate pain care and the patient, or the patient's survivors, complain to the state medical board, should the board take corrective or disciplinary action? We believe so. The phenomenon of undertreatment of pain is, and has been for some time, widespread, with many reports documenting that 50 percent of dying patients experience unrelieved pain. Medical boards have long been active in investigating perceived excessive prescribing as a form of "inappropriate prescribing" and the boards' willingness to investigate perceived excessive prescribing has contributed to an environment in which physicians are reluctant to prescribe controlled substances for treatment of pain. As a result, countless patients have suffered unnecessarily. The boards have an opportunity to correct this and bring some balance to a badly skewed situation by showing a willingness and commitment to investigate inappropriate prescribing when it occurs on the other end of the spectrum. Such a commitment would be an effective tool in motivating physicians to prescribe appropriately and an effective means of seeing that physicians who lack adequate knowledge of pain management get needed education in this area. Medical boards plainly have the power and authority to take on responsibility of correcting licensees who fail to treat pain adequately. Failure to prescribe adequate amounts of pain medication constitutes "inappropriate prescribing," and gives rise to board jurisdiction. There are often multiple bases upon which board jurisdiction in a case of failure to adequately treat pain could be grounded, including professional or medical incompetence, unprofessional conduct, failure to satisfy prevailing and accepted standards of care, abandonment of the patient, and failure to monitor controlled substance treatment efficacy.
Number of Pages in PDF File: 2
Keywords: pain management, pain care, palliative care, physician discipline, medical board, excessive prescribing, physician license, CME, California, Bergman
JEL Classification: I00, I10, I11, I12, I18, I19, I28, J18, K00, K10, K13, K14, K19, K32, K39
Date posted: September 24, 2008