What's the Impact on a Dentist's License if an Unauthorized Person Prescribes on Your Behalf?

      

IMPORTANT Notice To Dentists:

 

       While reading a Tampa Bay Times article this morning about a doctor who left his prescription pad unsecured which allowed someone to forge the Dr.'s signature on the unsecured RX pad, I was so shocked to see that it caused a death to occur to the recipient of the forged, stolen RX pad. Here is the link to ABC Action News' FB Page, which reported this story this morning on the impact of a stolen doctor's prescription Pad. This is a very disturbing situation with a very disturbing outcome. 

       

       While this situation happened here in the Tampa Bay area with a doctor's family member stealing and forging the dr's signature on a prescription pad, it can EASILY occur in dental offices anywhere. I am reminded of how many times I visit dentist's offices and see the dentist's prescription pads in an unlocked cabinet, and sometimes at the front desk; both unsecured. I have also seen COUNTLESS staff members go into patients' digital charts and print out prescriptions for patients that the DENTIST should be doing. 

       

       I'll go one step further to state that I've seen dental practice staff members have full, unrestricted capabilities to type in and print out prescriptions anytime of any day because the dentist(s) have not restricted this capability through tight administrative controls of their dental software. Audit trails are rarely run to ensure the security of these important systems are in place. In fact, like the story above, doctors and dentists usually find out about these forged signatures, or digital prescriptions with a "signature on file" stamp automatically placed on them, when something awful happens and it is exposed. It is too late when that happens, and the negative outcome is something that impacts the doctor and dentist, for many years to come, sometimes. 

   

       So what happens to a dentist's license, or doctor's license when that happens? A number of negative actions can unfold and cause a series of penalties and potential sanctions from a few different agencies. Because the dentist or doctor could be considered to have been "negligent" in securing their prescription pads, which is a legal requirement for dentists and doctors, they may incur an investigation and potential charges by their governing Board (of Dentistry, for instance). Additionally, they may be subjected to an investigative action or sanctions (restriction or revocation) by the Federal government, HIPAA, and/or the DEA (Drug Enforcement Agency). Here is a short 6-page summary on Prescribing in Florida that provides specific statutes where the rulings can be found, and is a GREAT reference for dentists in Florida! I generally keep this document handy, but then again, I'm a well-known "Landfill of Useless Dental Information" as my sons call me. I prefer to say that I am a walking, talking "Plethora of Useful Dental Information" instead. It has a much better ring to it, don't you think? :)

 

Anywhoooo, I digressed here.....back to the sactions discussion!

 

       Doctors and dentists who have had sanctions from their Board, and/or the DEA, with restrictions or revocations for prescribing schedule and legend drugs, can be found on the website Florida Controlled Substance Prescriber Registration. This is where you can look up a "Practitioner Profile", or look up "A License" and of course where doctors and dentists in Florida must "Register".  I always recommend that dentists look up their own profile and license to check that all is accurate and correct, but also to check on the licenses and profiles of other dentists within their office or immediate area. Why, you ask? Because many times dentists who are sactioned by their Board and the DEA have restrictions on their licenses that don't allow them to prescribe medications, and it is important for all to know, for the sake of safety (first and foremost) and secuirty. The situation below is the perfect example of this.

 

       Recently, I spoke to an associate dentist who was very upset about how the dentists and directors of the "practice management"- owned (which violates the Dental Practice Act, but that's a WHOLE other story) office he/she worked in were not complying with different laws, rules, and statutes. This dentist was wondering what the impact might be to his/her license by being associated with such a dangerous, non-compliant office. After speaking to the Chairman of the Board of Dentistry here in Florida, I was able to pass on important information on who to contact, and how the situation needed to be handled by the associate dentist. In addition, we reviewed all of the licenses of the dentists that own and/or work within the same dental practice and we were FLOORED by what we found. What we found (sit down, this is a mind-boggling result) is that NOT ONE of the OTHER dentists who owned, nor were currently practicing dentistry on patients with complicated treatment plans, had a DEA prescribing license!!! 

 

       This associate dentist that had the "bad gut feeling" about the dental practice they contracted with after graduation to work for, was the ONLY dentist in the practice with a current, active, and unrestricted DEA license for prescribing schedule and legend drugs, and treating "chronic nonmalignant pain" as defined by the Florida Controlled Substance Prescriber Registration!!! How can that be? Well, we discussed that (drug abuse, prescription negligence, frequent violations that lead to revocation, suspension, etc.) and it suddenly dawned on this dentist that they CAN'T possibly be the only person to prescribe schedule and legend drugs since the OTHER dentists in the office were SEEN and KNOWN to be prescribing schedule and legend drugs in the practice during the short timespan this poor associate dentist was working there!??!! This naturally led us to wonder who's name and/or prescribing license number were being used by those other dentists who had NO DEA license to prescribe them. Did this associate dentist leave his/her prescription pads in an unsecured location or with the capability of anyone accessing them, stamping "signature on file" and printing/digitally delivering them to whomever? We don't know as of this date, but the possibility exists.  "Things that make you go Hmmmmmmmmmmm......."

 

       The moral of this story is still unfolding as this situation continues to proceed on and follows the correct channels to legally follow by this associate dentist.  Dentists who are working for larger, or corporate practices should absolutely, positively review DAILY what prescriptions have been written and issued and by whom. If a large group practice or a corporate practice tells a dentist that they should just "worry about their clinical skills and not worry about tracking reports in the dental software" (such as a daily report on prescription activity within the practice), then my recommendation to that associate dentist is: RUN FOR THE HILLS AND DON'T LOOK BACK!!!!!  This is YOUR license, and YOUR legal responsibility, and NO ONE else is accountable for following the laws on Prescribing in Florida, except YOU, the dentist.

REMINDER TO ALL DENTISTS: 

       Secure your prescription pads in a locked cabinet for which only you have the key to! For digital prescribers: Do not allow ANY staff members except you, the dentist, to create prescriptions in your dental software. ALWAYS run a daily report on Prescriptions Written in the practice and by whom, at the end of EVERY day, as a basic accountability tool, and SAVE those reports in a secured, locked file cabinet or in a password protected desktop computer file. Ultimately, the dentist, and the dentist's LICENSE is at stake here ALWAYS and it is a LEGAL responsibility for ALL dentists and doctors to keep them secured. 

 

So, The Bottom Line Here is: DON'T let this happen to you!

 

       Well, that's it for me for today. Thanks for stopping by, and remember; you only have to brush and floss the teeth that you ABSOLUTELY, POSITIVELY want to keep. That's it; nothing more. 

 

Dr. Driscoll