In recent years, the opioid problem has plagued communities across the country. These powerful pain management products have been problematic for physicians as well. Opioids are the leading class of medication attributed to claims of medical malpractice. Coverys, a provider of professional medical liability insurance, recently completed a study investigating the current opioid “epidemic”. They researched 10,000 closed cases occurring between 2012 and 2016 revealing that 24% of claims relating to medication involved these drugs, despite only comprising a mere 5% of the total dispensed prescription medications.
Robert Hanscom, VP of Analytics for Coverys, explained that opioid-related claims were primarily the result of patient overdoses. Approximately 30% of these claims originated from improper follow-up after initially prescribing the drugs, where prescriptions were often continuously refilled without assessing the patient’s condition or status.
Physicians were alleged to have acted inappropriately, according to standards of care, in about 15% of opioid-related cases. Many physicians continued to prescribe the medication in response to pressure from patient requests. Overall, claims of malpractice stemming from medications made up 8% of all claims. The leading reasons for claims were mistakes in diagnosis (32%) and surgically-related mishaps (24%).
The employment of electronic health record systems and electronic prescribing systems were largely viewed as a remedy to medication-related mistakes; however, were offset because physicians operate in an increasingly “fast-paced” environment amid financial pressures with doctors seeing increasing volumes of patients each day resulting in shorter visits and hastily made decisions.
Patient demand for the drugs led a very small percentage of physicians to exploit this problem for their own financial gain through criminal activity. Recently, a Philadelphia physician was sentenced to 25 years in prison after transforming his practice into a “pill mill”. Dr. Jeffrey Bado faced charges of illegally distributing opioid medications to his large base of addicted patients and drug dealers. He took cash payments of up to $800 during appointments where he prescribed high volumes of opioids and stopped accepting medical insurance. At trial, he was found guilty of 269 counts of drug distribution and over 30 counts of fraud among others.
One cause of the crisis traces back to 1997 when an American Pain Society initiative furthered the notion that patients had a basic right to pain management. Administrators in medical organizations began to recognize that patient satisfaction was largely tied to the way their pain was minimized and encouraged physician prescribing. At the same time, patients who appreciated the effectiveness and the “high” obtained from opioids continued pressuring their doctors for these drugs. Soon the prescription volume massively increased.
Often, doctors unaware of the widespread drug abuse unknowingly became suppliers fueling the problem. Years later, the true consequences began to surface with approximately 25% of patients prescribed these drugs found to be addicted to some degree. Overdoses became common, causing roughly 1,000 visits emergency rooms nationwide per day. Recently the opioid problem has led to a conscious effort to decrease these prescriptions in the wake of massive legal problems.