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Inside the MLB: Scrutiny and precedent
e-Reports, May 18, 2015
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Continued focus on controlled substances Untitled document

During the April 23 meeting, the Medical Licensing Board (MLB) of Indiana handled administrative hearings, rules updates, personal appearances, presentations and a petition for summary suspension. The ISMA Physician Assistance Program was not needed to testify this month, which is unusual.

One unfortunate, but recurring, observation concerns physicians who make legal decisions without assistance of an attorney. Several physicians represented themselves in administrative hearings and personal appearances. Two others had surrendered their DEA registrations nearly two years prior and were still trying to get them back.

“The ISMA encourages physicians to always be represented by an attorney with appropriate expertise in legal and administrative matters,” said Julie Reed, ISMA General Counsel. “After all, your livelihood is at stake.” The ISMA can provide referrals.

Scrutiny for poor judgment
The lengthiest case was about physician poor judgment in a personal capacity. The emergency room physician engaged in a short-term sexual relationship with a woman, not his spouse, and provided her alcohol and cash. He was arrested at a hotel following a local police undercover investigation and charged with attempted dealing in a schedule IV controlled substance and possession of a controlled substance, both felonies, and furnishing alcohol to a minor, a misdemeanor. He surrendered his DEA registration.

The physician ultimately pled guilty to two counts of furnishing alcohol to a minor, though he thought the woman was older than 21. The focus of the state’s interest was controlled substances, but those allegations were never proven. One or two text messages between the physician and the woman referenced controlled substances, and the physician had one pill in his pocket at the time of arrest, as well as others in his hotel room and car.

The doctor denied providing or agreeing to provide medications to the woman. He also stated he was unaware the woman was a drug addict who recently overdosed on heroin. Ultimately, the MLB concluded the state proved these counts:

  • Being convicted of a crime harmful to the public
  • Possession of a schedule IV controlled substance without a valid prescription
  • Intending to provide alcohol
  • Engaging in lewd and unprofessional conduct

The MLB concluded the state did not prove the doctor possessed a controlled substance with intent to deliver or intended to provide a controlled substance to a non-patient.

Although the physician’s attorney suggested a letter of reprimand would be sufficient punishment, MLB members disagreed. Instead, they put the physician’s license on indefinite probation, requiring CME (prescribing, patient boundaries and emergency medicine), a comprehensive psychological and addictionology evaluation and any associated recommendations. If the physician begins working again, he must be under supervision of another physician, with no prescribing controlled substances for friends or family. He also must maintain a log of all controlled substance prescriptions written, submit quarterly employer reports, and pay a $2,005 fine and legal fees.

“This case, presented to be about drug dealing, was really about poor personal judgment,” said Reed. “MLB members found the state did not prove the physician intended to provide a controlled substance to a non-patient; yet, part of his punishment addresses prescribing practices. As the state said many times, being a physician is a privilege, and physicians are in a position of trust, respect, authority and responsibility. This case was about violating that esteemed position.”

Scrutiny over administrative violations In an earlier case, three physicians were collectively accused of not properly completing and/or timely submitting approximately 800 Termination of Pregnancy reports. The American Civil Liberties Union of Indiana, representing the physicians, attempted an unprecedented courtroom argument that no material issue of fact was at issue in these cases, making them inappropriate for an MLB administrative hearing.

MLB members wanted to learn more about the cases and denied the physicians’ motion. The evidentiary hearing will be scheduled for a future meeting.

Watch upcoming issues of ISMA Reports for regular columns on MLB meetings and prescribing. Read more about the MLB on the ISMA website and in.gov.

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