"Death Certificate Project" Helps Identify Doctors Who Overprescribe

By Victoria Kim 09/07/18

The crackdown has spooked physicians, including some who say they’re now less inclined to treat complex patients. 

stressed out doctor

Hundreds of California physicians are under investigation for their prescribing habits, as the state medical board cracks down on overprescribing.

Under the “Death Certificate Project,” the Medical Board of California is trying to take a proactive approach to identifying overprescribing behavior.

The board, a state agency that licenses/disciplines physicians, has reviewed death certificates that list a prescription opioid (or more) as the cause of death, then identify the provider(s) who prescribed the controlled substance to the patient “within three years of death, regardless of whether the particular drug caused the death or whether that doctor prescribed the lethal dose,” MedPage Today reports.

Prescribers were matched to patients through California’s prescription drug database, CURES (California Controlled Substance Utilization Review and Evaluation System).

“Our goal is consumer protection… (to) identify physicians who may be inappropriately prescribing to patients and to make sure that those individuals are educated (about opioid guidelines), and where there are violations of the Medical Practices Act, the board takes (disciplinary) action,” said Kimberly Kirchmeyer, the medical board’s executive director.

So far, 462 physicians have been identified as “warranting an investigation of patients’ files,” according to MedPage. Of these cases, 223 have been closed for either insufficient evidence, no violation, their license was already revoked/surrendered, or the physician has died.

Nine physicians have been targeted in opioid-related prescribing accusations filed by the state Attorney General; four of them were already under scrutiny on “unrelated charges.”

The state’s crackdown has spooked physicians, including some who say they’re now less inclined to treat complex patients.

“When you hear a bunch of doctors all at the same time all getting the same letter, and you realize they’re going through the same thing, you see why some are saying [to patients], ‘Sorry, if you have a lot of medical conditions, we’re not going to take care of you,’” said Dr. Brian J. Lenzkes, a San Diego internist and one of the targets of the Death Certificate Project.

Last December, Lenzkes received a letter from the state medical board notifying him that there had been a “complaint filed against you” about a patient who had died of a prescription drug overdose in 2013.

According to Lenzkes, the patient’s severe condition required him to take a regimen of prescription drugs including painkillers.

After receiving the letter, however, Lenzkes says he’s more wary of taking on pain management, saying that he’ll refer patients to pain specialists instead. “I’m not taking any more. That’s just how I feel,” he said.

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Victoria is interested in anything that has to do with how mind-altering substances impact society. Find Victoria on LinkedIn or Tumblr