As the state works to thwart patients who shop around to score
prescription painkillers, attention is turning to the other side of
Florida's pill mill crisis: pain clinic doctors.
A committee of physicians met in Tampa on Saturday to advance
sweeping regulations for pain clinics. The rules would set training
standards for doctors, mandate annual inspections and require pain
clinics to have basic facilities like private examining rooms.
Pain clinics would also have to report to the state how many of
their patients come from out of state and drug-test patients to
make sure they're not selling the drugs they were prescribed.
"This is a pioneering effort," said Larry McPherson, executive
director of the Florida Board of Medicine. "We heard from
practitioners. We heard from the parents who lost their kids
because of this. We heard from law enforcement."
He could not say how long it will take to finalize the rules,
which need approval by the state medical boards. The yearlong
effort to develop them kicked off with a 2009 state law addressing
prescription drug abuse.
The rules would apply to physicians working in state-registered
pain clinics who mostly treat pain by prescribing drugs. And many
expect to see the proposed regulations challenged by physicians or
pain clinic owners who could be driven out of business.
"Right now, the public is demanding that we do something,"
said Brigitte Goersch, an Orlando businesswoman serving as a
consumer member of the Board of Medicine. "I don't want to be
afraid of litigation."
Especially controversial are the training requirements for
doctors, who would need to have completed a recognized fellowship
or residency involving pain management, or have approved board
certification. Doctors without formal training would need to
demonstrate extensive experience and receive supplemental
education.
The rules seek to curb the shady practices at pain clinics
spotlighted in a spate of recent arrests in the Tampa Bay region.
Clinics would have to post signs stating their name and hours of
operation. Facilities must feature reception and waiting areas,
examining rooms and bathrooms. The clinic would have to post the
names of the physicians practicing there.
Once a year, state health inspectors would pay unannounced
visits to pain clinics, unless they are accredited by an approved
group. During inspections, patient medical records would be
reviewed at random. Pain clinics would pay a $1,500 fee to fund the
inspections.
Many details remain unresolved, such as which organizations
could accredit pain clinics. The committee of physicians developing
the rules also must decide how many prescriptions may be written by
a single pain clinic within a 24-hour period.
The legal counsel for the Board of Medicine stressed the urgency
of finalizing the rules. In recent months, the Pinellas and
Hillsborough county commissions, and others statewide, have passed
temporary moratoriums on new pain clinics, seeking to curb the
spread of illegitimate establishments. Such actions are hurting
doctors trying to practice responsible medicine, and the patients
who need them.
"We're seeing what's happening because these rules aren't in
place," counsel Ed Tellechea said.
Letitia Stein can be reached at lsteinsptimes.com or (813)
226-3322. For more health news, visit www.tampabay.com/health.
c.2010 St. Petersburg Times