Term: Doctor Shopping

Description: Doctor Shopping is an illegal activity in which patients go to multiple physicians with the intent of being prescribed the same or similar medications (usually a controlled substance) within the same 30 day time period. What makes this practice illegal is that the physicians are not being informed by the patient that he or she has been seeing other doctors for the same illness/condition. The main purpose of doctor shopping is to fraudulently refill a prescription before the 30 days it normally expires.

The majority of the people that doctor shop are addicted to a certain controlled substance. The most common of those being sleeping pills, benzodiazepines, amphetamines and opiates. Most of the time, the patient gradually visits more physicians as his or her tolerance to the drug increases (i.e. the person needs more to achieve the same effect). Some shoppers even illegally distribute the medications they have acquired and do not even ingest any of them. For example, some patients shop for the drug, oxycodone, a highly-addictive opiate similar to heroin, which is now being used as a popular street drug. In fact, this drug has actually become more widely accepted and used than heroin, due to its tiny innocent pill form. Patients with no jobs at all, will often sell these excess pills for money.

Doctor Shopping has become an increasing problem in America and many states have passed laws against it. Some consequences for violating these laws include: a five year sentence in prison, loss of civil rights, seizure of private medical records during the investigation, and also the shame attached to being labeled as an addict. Physicians are continually being arrested and having their medical licenses revoked for overprescribing or wrongfully prescribing medicine. Some physicians have become a source of doctor shopping in Florida by opening practices known as pain clinics. Pain clinics allow patients to be seen and prescribed medication at the same facility for any pain they may have. Many individuals who doctor shop have been imprisoned. Most doctors are becoming less lenient in what they prescribe because they do not want to be sued and/or arrested. This lack of information from the patient to the physician is how many accidental overdoses, addictions, and/or adverse drug interactions occur. Thirty-four states have a general doctor shopping law, one state has a specific doctor shopping law and fifteen states have both a specific and a general doctor shopping law. Specific doctor shopping laws are set in place so that patients cannot withhold from any health care provider that they have received any controlled substance or prescription order from any other practitioner. Recently Alabama has passed three laws that will help prevent doctor shopping and drug overdose. In the past Alabama was in the top 20 states for having the most deaths due to drug overdose. In Alabama it is a misdemeanor to doctor shop; lying to doctors to get more prescriptions. If an individual is convicted of doctor shopping the punishment is up to a year in jail and if they are convicted multiple times the individual could be sentenced to up to ten years in jail. In New York, a tracking system called "I-STOP" has been set in place to determine if individuals are addicts or dealers that doctor shop.


Applications: In 2010, Florida became known as the epicenter; in that ninety out of one hundred of the top oxycodone purchasing physicians in the nation were located in Florida. A new way of going about ending the doctor shopping problem was started in Florida last year. "People's names, whether paying in cash or by insurance, credit card or otherwise, are entered into a data bank that "cross references" the person's name with the narcotics they purchase. If a person's name shows that he or she got Lortab's for instance from pharmacy A on June 4, 2010 using a prescription from Dr. Jones, and then again filled a prescription from Pharmacy B for Lortabs on June 15, 2010 using a prescription from Dr. Smith, law enforecment authorities are notified by the computer system that monitors these purchases and there exists a high probability that law enforcement will attempt to interview and subsequently arrest the person who appears to be doctor shopping." (floridacriminallawblog.com) Doctor shopping is a felony offense in Florida according to Florida Statute ss. 893.13(7)(a)8. A person is usually charged with this violation when they have visited multiple doctors within a short period of time in an effort to receive multiple prescriptions. Two of the main signs that doctor shopping has occurred is if the individual pays with cash for the visit with the doctor and if the patent lives in a city or country that is different than where the doctor's office is located.

Florida's Pill Mill Law:
  • Tightens rules for the writing of prescriptions and pain-treatment plans.
  • Penalizes doctors who over-prescribe painkillers with minimum fines of $10,000 and 6-month suspensions.
  • Requires doctors to use electronic or counterfeit-proof prescription pads purchased from vendors approved by the state Health Department and requires the vendors to report monthly sales of pads to state officials.
  • Establishes mandatory buy-back program for doctors to transfer narcotics back to the distributors once the prohibition on doctors dispensing certain addictive drugs goes into effect.
  • Makes it a first-degree misdemeanor if a pharmacist "knowingly fails" to report to police an attempt to purchase drugs fraudulently.
  • The length of time pharmacies are given to report prescription information into the state drug database is shorten from fifteen days to seven days.
  • Prohibits pharmaceutical companies from providing money for the operation of the database.
  • Requires wholesalers who sell controlled substances to pharmacies to report distribution data to the state.
  • Requires doctors who work at pain management clinics to tell the state when they begin and stop working at such a clinic.
  • Allows law enforcement offices to look at or copy pain clinic records without a search warrant.


Web Resources:
Florida Criminal Law Blog
Pill Mill Law

Related Terminology:
  • Controlled substance -a substance (as a drug) whose use and possession is regulated by law (dictionary.com).
  • Narcotic - Any of a class of substances that blunt the senses, as opium, morphine, and alcohol, that in large quantities produce euphoria, stupor, or coma, that when used constantly can cause habituation or addiction, and that are used in medicine to relieve pain, cause sedation and induce sleep (dictionary.com).
  • Pill Mil- a doctor's office, clinic, or healthcare facility that routinely colludes in the prescribing and dispensing of contolled substances outside the scope of the prevailing standards of medical practice in the community or violates the laws of the State of Florida regarding the prescribing and dispensing of controlled prescription drugs. Many pill mills are cash only, contain armed guards, and perform inappropriate medical examinations.

Citations/References:
www.dictionary.com
Doctor Shopping in Florida
http://myfloridalegal.com/pages.nsf/main/aa7aaf5caa22638d8525791b006a30c8
http://www.cdc.gov/homeandrecreationalsafety/Poisoning/laws/dr_shopping.html
http://defensehelp.com/felony-criminal-charges-lawyer/doctor-shopping
http://www.nabp.net/news/three-new-alabama-laws-aim-to-crack-down-on-doctor-shopping-and-prescription-drug-abuse
http://www.silive.com/news/index.ssf/2013/09/i-stop_hailed_as_deterrent_to.html


Graphics:
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