Medical group concerned about proposal for prescription monitoring program

By Chelsea Conaboy, Globe Staff

The Massachusetts Medical Society sent a letter to state senators today expressing support for some aspects of a bill meant to curb the state’s high rate of prescription painkiller abuse and concern for other provisions.

The physicians group said it supports a “multi-pronged approach” to address the problem, including an educational campaign for patients and measures that would provide limited legal immunity to drug users who seek help for an overdose. But the letter, signed by President Dr. Lynda Young, raises questions about whether requiring doctors in most cases to use an online database to screen patients before prescribing a narcotic painkiller -- meant to prevent “doctor-shopping” -- could interfere with good care:

While a very useful tool, the [prescription drug monitoring program] is still evolving and the MMS questions its ability to accommodate the needs of twenty thousand or so new practitioners in a timely and useful manner. For some physicians, including those who may fall into the “high prescriber” category like emergency physicians, time is of the essence. Primary care providers have a jam-packed schedule and checking with the program several times a day during a patient visit may extend waiting times for patients, extend clinical hours for overworked clinicians and distract providers from patient care issues unrelated to abuse. What if the system is down, or unavailable? Would the physician be prohibited from writing the necessary prescription?

The letter suggests phasing in the program, focusing on high prescribers and OxyContin. However, since writing about this issue for yesterday’s newspaper, I’ve heard from a couple of doctors who prescribe narcotic painkillers who said they had no idea that the program exists in Massachusetts. They expressed frustration that a tool that could help them to protect their patients is not widely available or better advertised to prescribers.