They’ve got mail! The “they” in this case are about 500 physicians across the state. The “mail” refers to letters they received from the Medical Board of California (MBC). Why them and not others? These practitioners wrote prescriptions for opioids for particular patients – those who succumbed to opioid overdoses. It’s a connect-the-dots play that falls under the banner of the “Death Certificate Project.”
Let’s go back to 2015, when the initiative began. That year, MBC invoked a requirement. According to it, coroners in the state had to forward information to the agency about people who died from opioids. It would be the front end of an intricate process.
The reports came in and kept on coming. MBC used the information. They matched the data to the records of the state’s Department of Justice’s Controlled Substance Utilization Review and Evaluation System (CURES). By doing so, they identified doctors who prescribed opioids for the people whose name appeared on the death certificates.
The MBC took further action. They launched formal investigations directed at physicians suspected of acting inappropriately. And then, based on the merit of the cases, they accused some of wrongdoing.
“Some” is vague and may understate the scope. The news item about this topic termed the amount “unprecedented.” In July 2019, the Executive Director of MBC laid it all out in numbers. From 2017-18, MBC filed hundreds of accusations – 405 in all. That was the beginning; 450 disciplinary orders came next. A year earlier, the count came to about 150 accusations, which originated from the Death Certificate Project or its “progeny.” That term in quotes refers to data from CURES that went beyond the last prescribing physician on record to others in the opioid Rx trail. MBC also is pursuing those ensnared in this wider net.
Where Do We Stand Now?
MBC largely looks into the behavior of doctors based on complaints from patients. However, the Death Certificate Project differs. Here, MBC starts at its own behest and focuses on those who have defied state law in their prescribing practices. Those who fall into this category have a price to pay. That includes reputational damage, probation or loss of their professional license.
Recipients of MBC letters tend to go through a series of reactions. It may start with grief on learning their patient overdosed and died. Fear may set in next and well as anger. Then they need to snap into action to explore their patient charts to respond to the charges.
MedPage Today recently reported on the status of this initiative. To date, 64 doctors have been charged with grossly negligent practices related to the way they prescribed opioids. Of this total, five surrendered their licenses. Six are now on probation. And eight received public reprimands. Factoring in two cases that have been withdrawn, 43 in this group remain. Those doctors are in a holding pattern as they await final decisions. However, yet others are under active investigation.
In all, the Death Certificate Project strives to halt drug overdoses. Although it can’t reclaim those who died, it nevertheless seeks, in its back-to-front method, to save lives.
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