title: The risk of disciplinary action by state medical boards against physicians prescribing opioids.
abstract: Concern of physicians about being disciplined for prescribing opioids for patients in pain is one cause for undertreatment of pain. This study was done to assess the actual risk of being disciplined by state medical boards. A review of records of actions by the New York State Board for Professional Medical Misconduct for 3 years and of all medical boards in the United States for 9 months was done to determine this risk. New York State, with 7.8% of U.S. physicians, had 10 physicians disciplined annually related to overprescribing opioids, while the total for the entire U.S. was 120 physicians annually. Most physicians disciplined had multiple violations in addition to overprescribing controlled substances. In the national sample, 43% were prescribing for themselves or for nonpatients, 12% prescribed for addicts without addressing the patients' problems of addiction, 42% had inadequate records, 19% prescribed without indication for opioids, 13% were incompetent in additional ways, and 8% were having sexual activity with patients. Not a single physician, for whom information was available, was disciplined solely for overprescribing opioids. The actual risk of an American physician being disciplined by a state medical board for treating a real patient with opioids for a painful medical condition is virtually nonexistent.
authors.affiliation: Department of Medicine, Joan and Sanford I. Weill Medical College of Cornell University, New York, NY 10021, USA.
authors.forename: Jack
authors.initials: J
authors.lastname: Richard
authors.forename: Marcus M
authors.initials: MM
authors.lastname: Reidenberg
mesh_terms: D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D004363:Drug Utilization / Q000706:statistics & numerical data; D004647:Employee Discipline / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data*; D033161:Government Regulation; D008007:Licensure, Medical / Q000706:statistics & numerical data*; D008318:Malpractice / Q000706:statistics & numerical data; D008511:Medicine / Q000706:statistics & numerical data; D009294:Narcotics; D009518:New York / Q000453:epidemiology; D028743:Professional Misconduct / Q000706:statistics & numerical data*; D012042:Registries; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D013038:Specialization; D014481:United States / Q000453:epidemiology
chemical_list: D009294:Narcotics