Doctors beware. Government prosecutors are fighting the opiate epidemic on many fronts. Now more than ever local police in coordination with DEA and Commonwealth Attorney General drug enforcement investigators are investigating doctors for writing unreasonable amounts of scheduled narcotic prescriptions.

DEA federal data base schedule II generated prescription writing reports spawn both federal and state investigations. Local and federal investigators also receive complaints from family members of addicts, alive or dead. Drug purchasers or drug dealers — “flipped” or “turned” that are now confidential sources seeking to avoid jail — will happily turn on their doctor.

Once a doctor is targeted for engaging in pill mill conduct federal, state, or local police send confidential informants – fake or real patients – to that doctor. Wired fake patients happily record doctor’s physical evaluations, confidential patient conversations, and writing prescription discussions.

Doctors that breach pain management best practice protocols, for either real or fake patients, are prosecuted. Red flags include not requiring pre-prescribing drug tests, objective MRI or x-rays if warranted, or even conducting basic physical evaluations.

Treating physicians must check the prescription drug monitoring data base. Investigators are statutorily authorized to access the PDMP data base to investigate law compliance. Every prescripber must confirm the patient has neither sought or nor received a similar medication from any other provider. Failure to check the PDMP database is a red flag. It is very easy to confirm doctors database access to review patient prescription history. While the doctor may not ascertain a fake patient from a real one, data base checking gives investigators a baseline determination wether a targeted doctor is or is not compliant with the law.

Physician evaluation appointments must correspond to an appropriate amount of time spent with each patient. Physical examinations, chart documentation, and PDMP checks require time. Charting must document a diagnosed medical condition which warrants a prescription for a therapeutic medical purpose. Multiple prescriptions for multiple, contra-indicated schedule controlled substances are an easy tip off to police investigators of excessive and inappropriate prescription writing. This is part of the criminal prosecution foundation.

Established physician practice red flags are utilized in Medical or Osteopathic Board Immediate Temporary Suspension (ITS) petitions. These petitions emergently, immediately, but temporarily suspend a license pending either the criminal prosecution or investigation. Call me when you get these petitions. Do not solely rely on criminal legal counsel on how to address these petitions.

My criminal practice experience together with my licensing experience allows me to better represent the physician at this juncture. Too many physicians get the wrong legal advice on how to deal with these matters with a pending criminal case. On too many occasions either these probable cause suspension hearings are continued or exchanged for a consent agreement for an immediate indefinite license suspension. This is wrong.

Do not enter into any consent agreement pending a criminal investigation. The language of some consent agreements require the doctor to make admissions that will have legal consequences in the criminal matter. Further, agreements for an indefinite suspension and automatic probation upon reinstatement ignore many parts of the criminal matter that may not actually come to fruition. Do not rely on the representations of criminal counsel that does not know how and why the medical board prosecutions proceed the way they do. Call me to discuss your case.