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The risk of disciplinary action by state medical boards against physicians prescribing opioids

Jack Richard1, Marcus M Reidenberg

  • 1Department of Medicine, Joan and Sanford I. Weill Medical College of Cornell University, New York, NY 10021, USA.

Journal of Pain and Symptom Management
|March 1, 2005
PubMed

Insights

Physicians face virtually no risk of discipline for prescribing opioids to patients in pain. Reviews show no cases of discipline solely for opioid overprescribing in legitimate pain management.

Area of Science:

  • Medical ethics
  • Pain management
  • Public health policy

Background:

  • Physician apprehension regarding disciplinary actions for opioid prescriptions contributes to the undertreatment of pain.
  • Understanding the actual risk of medical board discipline is crucial for appropriate pain management.

Purpose of the Study:

  • To assess the real risk of physicians facing disciplinary action from state medical boards for prescribing opioids.
  • To inform clinical practice and policy regarding opioid prescribing for pain management.

Main Methods:

  • Review of disciplinary actions by the New York State Board for Professional Medical Misconduct over 3 years.
  • Analysis of disciplinary actions from all U.S. medical boards over a 9-month period.

Main Results:

  • In New York, 10 physicians annually faced discipline related to opioid overprescribing; nationally, 120 physicians annually faced similar actions.
  • Most disciplined physicians had multiple violations, including self-prescribing, prescribing for non-patients, inadequate records, and other forms of misconduct.
  • No physicians were disciplined solely for prescribing opioids for legitimate pain conditions.

Conclusions:

  • The risk of disciplinary action for U.S. physicians prescribing opioids for patients with actual pain is exceedingly low.
  • Evidence suggests that fears of disciplinary action may be disproportionate to the actual risk, potentially hindering effective pain management.

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