Rock and Hard Place

Here is a dilemma for you.  Imagine if a school bus driver came to your rehab facility after a motorcycle accident that caused a few vertebral fractures.  Add to this that the dude is not happy there and leaves in about five days AMA. You hardly know him but when you do a Rx search you find that this guy has gotten1,600 pills from several different doctors in less than four years.  Remember, we are in a world where “opioid abuse” is the new catchphrase. You also realize this guy has been getting sleeping pills and anxiolytic Rxs as well.  And he is driving kids to school!  Would you:

  1. Do nothing?
  2. Call his doctor or one of his doctors?
  3. Call this school system he works for?

Well, the story is real and happened in Alabama. The doctor called the school board and yada, yada, yada he gets sued for $6 million for malpractice and defamation of character.  The patient stated, in his deposition, “that he hadn’t taken all the pills that had been dispensed and had passed random drug tests.” He also said “he was out on medical leave during the time he was taking opioids.”

I think this falls under: NO GOOD DEED GOES UNPUNISHED.

You can read the rest of the article here. Some things I learned from it was that HIPAA has a provision that says it’s not a violation to disclose private health information for a public health reason, but even if there’s not a HIPAA violation, a patient can still sue under state law.  Isnt that great?

The good news is that the doctor won the case.  The stress of a lawsuit, however, is extremely damaging and no one wants to go through that.  In these times it is really hard to know the right answer.   Even if you just call his primary care doctor, you aren’t guaranteed he or she will do something.  You may be legally covered but what if this guy does kill someone?  Or what if YOU are the primary care doctor and this guy is getting drugs everywhere?  You have to discuss this with him but the odds are you fire him.  Then what?  Report him? Yup.  But you will be sued as well.  It kills me that this profession always puts us between a rock and a hard place.

What do you think?

What would you do?


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