Describes them as “micromanaging the practice of medicine and dictating clinical practice”
Contact: Richard Gulla
781-434-7101
rgulla@mms.org
Waltham, Mass. – May 14, 2013 – The Massachusetts Medical Society (MMS) today offered testimony before the legislature’s Joint Committee on Public Health, voicing strong opposition to two bills before the committee and describing them as “the latest in an apparently never-ending series of initiatives micromanaging the practice of medicine in the Commonwealth” and “dictating the clinical practice of physicians.”
The Society is taking strong issue with House 1931, An Act Relative to OxyContin and Other Schedule II Controlled Substances, and with House 3359, An Act Relative to 72-Hour Emergency Prescribing.
The MMS said that Chapter 244 of the Acts of 2012 is already requiring physicians by law and regulation to change and adapt certain procedures and that additional legislation would be redundant and wasteful.
“The Massachusetts Medical Society is now working with the Department of Public Health on an advisory council on opioid abuse,’ the MMS stated. “We are working on making the Prescription Monitoring Program an effective tool in combating drug abuse. We are providers of continuing medical education program on pain management and addiction.”
“Shouldn’t we be reviewing the impact of Chapter 244 before furthering new legislation that addresses the same subjects? The Medical Society is respectfully asking the Committee not to advance these bills nor any similar legislation.”
MMS, which has more than 24,000 physician members across the state, urged lawmakers to remember that the practice of medicine is based on carefully developed standards of care, that medicine is ever-evolving and changing, and that such bills as House 1931 and 3359 remove clinical options that need to be considered in any treatment being decided between physician and patient.
Opposition to House 1931
House 1931 would require continuing medical education courses on prescribing Schedule II drugs for all physicians and make it a condition of licensure for physicians.
“Prescription drug abuse is an important issue,” the Medical Society said in its testimony against House 1931. “That’s why a 20-page law on the subject was enacted last year.”
The Medical Society said that many physicians do not prescribe Schedule II drugs, and that all physicians are now required by law and by regulation from the Board of Registration in Medicine, which oversees the practice of medicine, to take educational courses in pain management, and those courses include the clinical use of these drugs. “Passage of this law,” the Medical Society stated,” would waste enormous resources in irrelevant or redundant educational programs for thousands of physicians.”
The bill would also require all physicians and dentists in the state to give an informational packet from the U.S. Drug Enforcement Agency to patients about OxyContin and other Schedule II controlled substances, require patients to read the packet in the presence of the prescribing provider, and require patients to sign an affidavit affirming they have read the information before every prescription issued.
Opposition to House 3359
House 3359 would prevent a physician in an emergency department from providing more than 72 hours worth of a controlled substance to a patient seeking emergency care.
“We suspect this is another anti-drug abuse bill,” the Society stated in its written testimony. It noted that controlled substances are defined in Massachusetts as anything requiring a prescription, and that would include antibiotics or any of thousands of medications that would be prescribed for a 14-day period or longer. It would also include blood pressure medications, insulin, and many other well established treatments that require long-term use.
MMS also argued that the bill leaves many questions unanswered. It isn’t clear, for example, what is meant by the prohibition on “providing” more than a 72-hour supply. MMS also noted that Chapter 94C already limits dispensing to the amount required for immediate treatment, or until a prescription may be filled, and that this limitation is further defined in regulations to constitute 72 hours.
On that basis, MMS argued, House 3359 is redundant when applied to dispensing medication. MMS also argued that if the bill applies to all prescriptions, it is a major prohibition of the practice of medicine according to appropriate standards of care by limiting all prescriptions to 72 hours of treatment, while the standards of care for many patients would dictate treatment plans of much longer duration.
The language of the bill promoted the Society to ask if the legislature really intends to require every patient who visits an emergency room to follow up with a primary care visit to receive the same diagnosis and an additional prescription for the balance of a course of treatment. Do lawmakers expect MassHealth, Medicare, and insurers to pay for this additional visit to a physician and pharmacy? “Clearly the answer must be no,” MMS said.
Further, the Society said, since the bill is limited only to physicians, does that mean the intent is to allow extended provision by nurse practitioners, physician assistants and others in the emergency room?
“The MMS respectfully asks the Committee on Public Health to leave prescribing decisions to emergency department staff. They have earned the respect and the gratitude of the Commonwealth and the world. Let them do their jobs and please reject H 3359 and all similar legislation."
The Massachusetts Medical Society, with more than 24,000 physicians and student members, is dedicated to educating and advocating for the patients and physicians of Massachusetts. The Society publishes the New England Journal of Medicine, a leading global medical journal and web site, and Journal Watch alerts and newsletters covering 13 specialties. The Society is also a leader in continuing medical education for health care professionals throughout Massachusetts, conducting a variety of medical education programs for physicians and health care professionals. Founded in 1781, MMS is the oldest continuously operating medical society in the country. For more information please visit www.massmed.org, www.nejm.org or www.jwatch.org.
