I love the troll tracker. In case you’re unfamiliar with the term (or your state doesn’t have one), this is the online Prescription Monitoring Program database to see who is (or isn’t) getting controlled drugs from too many prescribers. It’s an excellent way to track the doctor-shoppers, emergency department-habituators, and other known problem patients.
I generally assume someone is innocent until proven guilty. And, in all fairness, I must admit the PMP has exonerated more patients than it’s caught (at least in my practice). Many of the people I’ve nailed with it were ones I had absolutely no suspicion of, while a lot of patients I was sure I was going to catch turned out to be innocent.
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I’d love to see a program like this on a national scale. For my practice, it wouldn’t really matter (I’m several hours from the nearest state line), but for cities that straddle state borders (such as Kansas City) it would be very helpful. If a state program only tracks pharmacies within a state, it’s easy for patients to easily cross back and forth in some areas.
What surprises me is that so many states (and politicians) are opposed to these programs. They claim it’s a violation of privacy! Well, in my view, if you’re committing a crime (like abusing controlled drugs and lying to doctors to get them) that should trump your personal privacy.
The database tracks only controlled drugs. If you’re on HIV treatment, or Zocor, or lithium, I’m not able to see that. And I’m not snooping on my neighbors for the hell of it, either. The database is audited and, at any time, the state could call me to question my searches. I have to be able to show I have a good cause for looking up a person, otherwise I’ll find myself in deep doo-doo.
We doctors are in a difficult bind. There are laws and ethics that require us to alleviate pain and suffering. Balanced against those are the laws, watchdogs, and boards that can nail us for overprescribing controlled drugs.
So any tool that can help us stay on the right side of this issue is a good one. It can help confirm the guilty, and clear the innocent. This allows those who truly need pain relief to continue getting it and, if relieving suffering isn’t a central tenet of medicine, I don’t know what is.
Dr. Block has a solo neurology private practice in Scottsdale, Ariz. E-mail him at clinicalneurologynews@elsevier.com.