Michael Arnold Glueck, M.D., and Robert J. Cihak, M.D., The Medicine Men
Tuesday, Nov. 23, 2004

They're also hoping that little bills zip right through, below the public's radar – bills such as H.R. 3015, which targets physicians and pharmacists in the take-no-prisoners war on pain drugs and patients suffering chronic pain.

H.R. 3015, the National All Schedules Prescription Electronic Reporting Act, passed in the U.S. House of Representatives in October. It's now before the Senate, where it's slated for a voice vote before the current session of Congress expires on January 2, 2005. A voice vote is a way to pass a bill quickly without a record of which way each senator voted.

This bill would encourage states to establish programs requiring physicians and other providers such as pharmacists to report any and every prescription for a wide range of commonly prescribed drugs, including pain medications and antidepressants. In addition to the medicine and dose, the doctor would have to give the government the patient's name, address and telephone number.

This private prescription information would then become part of a national computer database, available to the police and also possibly to employers, newspapers, blackmailers or anybody else curious about such information.

The patient would not even know about the release of this prescription information, much less consent to its release or review. Police would have access to personal prescription information without having probable cause to believe a crime had been committed and without having to convince a judge to issue a search warrant.

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Drug Enforcement Administration (DEA) agents and state licensure boards already have great powers. They currently can get information on prescriptions written for controlled substances and have sweeping authority to investigate anybody they choose and to prosecute doctors for prescribing more painkillers than agents think appropriate.

HR 3015 would dramatically enhance the reach of police and DEA agents into the privacy of doctors and patients.

Some government officials liken doctors to terrorists, and want equal judicial vigor in pursuing doctors. For example, according to a September press release from the Association of American Physicians and Surgeons, Assistant U.S. Attorney Gene Rossi declared to a reporter that "our office will try our best to root out [certain doctors] like the Taliban. Stay tuned."

In opposition to the bill, Rep. Ron Paul, M.D., of Texas said HR 3015 "is yet another unjustifiable attempt by the federal government to use the war on drugs as an excuse for invading the privacy and liberties of the American people and for expanding the federal government's disastrous micromanagement of medical care."

He pointed out that the government is embarking on a "war on pain patients and their doctors" that "has already resulted in the harassment and prosecution of many doctors ... whose only 'crime' is prescribing legal medication ... to relieve their patients' pain. These prosecutions, in turn, have scared other doctors so that they are unwilling to prescribe an adequate amount of pain medication, or even any pain medication, for their suffering patients."

Could it be that government agents are going after innocent and hard-working doctors because the doctors are easy targets? Are real criminals going free because these same government agents find it too much work to break through the complicated logistic and legal defenses that real criminals sometimes build and hide behind?

Rather than giving non-medical officials more authority, power and money, Congress and the president should restrain the DEA from essentially telling doctors how to practice medicine.

Rather than using resources to send trained actors feigning pain to entrap doctors, the DEA and other agencies should communicate and cooperate with doctors.

To further this goal, the Association of American Physicians and Surgeons (AAPS) recently developed a three-point "Communicate and Cooperate" proposal to encourage physicians and law enforcement to work together to prevent prescription drug abuse. The proposal includes several ways law enforcement agents can work with doctors, such as:

1. Working together to track suspected drug abusers. To balance current laws requiring doctors to provide information about suspected abusers to the government, government agencies would notify doctors about suspicious patient behavior such as contact with known drug dealers or abusers.

2. Reviewing possible cases with professional medical boards before filing charges in court. Doctors would review a physician's practice with police before non-medical prosecutors would file criminal charges. This would help prevent embarrassing errors by government agents and would prevent worsening the current shortage of doctors willing to adequately treat patients with chronic and painful medical conditions.

3. Mutual training of law enforcement and medical personnel. Law enforcement people would educate doctors about recognizing patterns of illegal activity and criminal intent; doctors would educate police about modern pain treatment.

And why is the U.S. Senate vote scheduled for only a "yea" or "nay" voice vote, without recording which senator voted which way? One reason is so that senators can't be held to account for their votes.

As Rep. Paul says, "Instead of further eroding our medical privacy, Congress should take steps to protect it."

Please let your senators know what you think, before it's too late.

Editor's Note: Robert J. Cihak wrote this week's column.

Robert J. Cihak, M.D., is a Senior Fellow and Board Member of the Discovery Institute and a past president of the Association of American Physicians and Surgeons. Michael Arnold Glueck, M.D., is a multiple-award-winning writer who comments on medical-legal issues.

Contact Drs. Glueck and Cihak by e-mail.

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