FLSPMP moves to set record straight on issue of patient privacy, PDMP

The Florida Society of Pain Management Providers (www.Flspmp.org) moves to set the record straight on the issue of patient privacy and the Prescription Drug Monitoring Program (PDMP).

As Governor Scott has made privacy the chief issue in his bid to repeal the PDMP system and a few legislators have follow suit with statements that go as far to state that there is reason the doctor closes the door when they see the patient and that medical records should be private. In principal and practice the FLSPMP believes that patient privacy is a significant concern yet those in the legislature that take this position with the PDMP have two issues that make their position dubious:

1. The PDMP does not disclose medical records; there are no diagnosis or physician notes in the database and most importantly it only monitors the prescribing of approximately 200 prescription medications (out of 13,000). There are no true psychiatric or other potentially embarrassing medications that are recorded in the database. Additionally the monitored medications are all both federal and state designated controlled substances and thus privacy concerns are limited by laws currently in place that monitor their prescribing and dispensing.
2. Until last year the seizing of a patient's complete medical records by the state was legally protected by two items in law. These items required the state to first obtain a probable cause subpoena along with an attempt (by the state) to notify the patient and secure their approval to obtain their private medical records. In 2010 both those protections were removed by the legislature for all patients that are treated in a State of Florida licensed pain management facility.

The Florida State Line is a "BLOOD BORDER"!

Last Thursday's workshop held by the House Health and Human Service committee made it clear that their position is that PDMPs don't work because a single national study shows that since the inception of State PDMPs there has been no reduction in mortality rates. We believe the study is flawed as those that seek and abuse the medications travel outside their home state with a PDMP to source their supply thus dramatically reducing the affect of their home states PDMP.

The Florida state line is the new "blood border" as Florida is the "destination state" for all those that abuse or supply abusers with controlled medications as Florida has no PDMP. Without a PDMP "doctor shopping" is simple, almost impossible to detect and makes the most legitimate physician an unwitting supplier. Until all states implement PDMPs and then link them together (or the Federal government implements a national system) mortality rates will not be reduced. It is illogical to use a single study as a reason to repeal especially when the studies author recently stated in testimony the position that is echoed by all that support the PDMP system:  

"While PDMPs are not a silver bullet for ending the prescription drug epidemic, they are a critical tool to address this complex and worsening public health crisis"

It should also be noted that another PDMP study by Simeone R. Holland that looked at individual state PDMPs affects showed lower rates of consumption of schedule II controlled substances and stimulants and that states with unsolicited reports to the physician which alerted them to suspicious behavior showed larger results.

"What is clear from these two studies is that while the PDMP is not a perfect tool it is a necessary and needed tool needed for the health, safety and welfare of not just Floridians but all citizens and shouldn't that be the first concern of our elected officials," said Warren Pearson; Executive Director of the FLSPMP and former Florida DOH chief prosecutor of pain clinics.

To address legitimate patient privacy concerns the FLSPMP's recommends two items:

1. Require that law enforcement procure a subpoena before accessing the PDMP database as many states now require and as required in all other searches per the 4th amendment.
2. Legislators should immediately reinstate the constitutional 4th amendment protections to pain patient's medical records that they removed last year.

We commend Senate President Mike Haridopolos, Attorney General Pam Bondi and Senator Mike Fasano for providing the true leadership needed in this most important issue. It is time to end this debate and for the legislature to fully unite in opposing Governors Scott's proposal to repeal the PDMP.

Additionally the Florida Society of Pain Management Providers urges legislators upon session start to immediately validate the Board of Medicines Standards of Practice for Pain Clinics which will allow FULL CLINIC INSPECTIONS to begin. It is these rules and the PDMP that will bring an end to "PILL MILLS" and allow legitimate pain clinics to care for legitimate patients.