(Editor’s Note: In November, California voters will decide the fate of Proposition 46, which would require random drug and alcohol testing of doctors. The California Medical Board would be required to suspend a doctor pending the investigation of a positive test and take disciplinary action if the doctor was impaired while on duty. Proposition 46 would also raise the state’s cap on damages in medical negligence lawsuits to over $1 million from the current cap of $250,000).
Physician groups have expressed dismay at a requirement to be drug tested under a stipulation in California’s Proposition 46. The fact is that doctors who treat chronic pain often require their patients to submit to random drug tests in order to receive pain medication. Moreover, the entire medical literature contains approximately zero objections by any healthcare provider or researcher to this drug testing.
I discovered by accident that Medicare was being bilked by physicians through drug tests. Medicare data reveal that between 2000 and 2009, drug testing increased over 4,000%, while the Medicare population grew by only 16%. More specifically, office drug testing by anesthesiologists during that same time period increased over 3,000,000%, and anesthesiologists commonly treat people with pain.
As a result of the huge increases, Medicare began investigating and changed their reimbursement rules. Also, drug testing labs have been prosecuted and fined for misconduct, including providing kickbacks to doctors for drug testing their patients.
Let me repeat that: Doctors were receiving kickbacks for drug testing their patients. It is worthy to note that the California Medical Board neither investigated nor took action against any California physician who may have received kickbacks.
Medical errors in the United States cause an estimated 100,000 deaths per year and 1,000,000 injuries. The California Medical Board estimates between 10% and 15% of California licensed physicians have substance abuse problems (10,000 to 15,000 physicians), while the national average is around 14 percent.
Anesthesiologists are especially vulnerable to addiction and have some of the highest rates relative to other specialties. Doctors are human and suffer from addiction and other maladies like everyone else, but they should not be practicing medicine under the influence. This is a public safety issue.
There is a large power disparity between the doctor who heals, and the patient that is in need of help. Physicians can do great harm to people if they are abusing drugs and alcohol and thus it is unconscionable that any doctor would argue against their profession being drug tested.
I ask the same question that pain doctors may ask about their patients — what do they have to hide?
Although many physicians drug test their patients, they oppose being tested themselves. Apparently, doctors are confused between the Hippocratic Oath, and being hypocrites.
National Pain Report welcomes opposing points of view on issues affecting the chronic pain community.