The Hardest Pill to Swallow


Dr. Tracy Jackson discusses chronic pain in her May 2016 TEDx Nashville event. Dr. Jackson, a Vanderbilt physician, researches and works in the chronic pain management field, and she discusses how and why the healthcare system’s current approach to chronic pain management is failing patients–and society as a whole–in her TEDx talk. Why does this matter? For healthcare providers, particularly those in the southern part of the United States, the prescribing of controlled substances for the management of chronic pain has become a hotly debated and highly regulated activity. For the protection of one’s license, and the safety of one’s patients, it is incumbent on healthcare providers to educate themselves on the most effective and safe ways to treat chronic pain. For those who aren’t healthcare providers? It still matters. Opioid overdose is the number one cause of accidental death in the U.S. (See, Tedx Talk, 8:10). Let that sink in for […]

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Investigated by the Department of Health or Facing Licensure Discipline? You Have Options.


Licensure Investigation: How and Why? The Department of Health in the state where a provider is licensed has a duty to investigate valid complaints against healthcare providers. Complaints against healthcare providers can be made anonymously, and most states, like the Tennessee Department of Health, have an landing page on their websites that makes it easy to file a complaint. If the complaint is frivolous, such as “This doctor is a jerk,” the complaint will be reviewed and likely dismissed by staff at the Department of Health without further inquiry. If the complaint is more serious, such as “This doctor is overprescribing narcotics to his patients,” then the complaint will likely be investigated further. Once a complaint has been deemed serious enough for investigation, a Department of Health investigator will be assigned to make an inquiry into the complaint. This will likely begin with a telephone call or letter addressed to the health […]

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What is the OIG Exclusion List, and How Could it Affect Your Practice?


The Office of the Inspector General (OIG) of the U.S. Department of Health & Human Services maintains a list of healthcare providers who are excluded from participating in Medicare, Medicaid, and all other Federal health care programs. This list is known as the “List of Excluded Individuals/Entities (LEIE)” and it is a BIG DEAL for the healthcare providers who unfortunately find themselves on this list. Inclusion on the list seriously prohibits a provider’s ability to treat patients, as well as their ability to obtain employment opportunities. For what actions or events will a healthcare provider find themselves on the OIG Exclusion List? Permissive Exclusions: The OIG has discretionary authority to exclude individuals and entities for the following reasons: Misdemeanor convictions related to fraud or the obstruction of an investigation or audit; Misdemeanor convictions related to the unlawful manufacture, distribution, prescription, or dispensing of controlled substances The suspension, revocation, or surrender of […]

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CDC and FDA Add New Guidelines and Regulations Aimed at Curbing Overprescribing of Opioids


The Center for Disease Control and the Federal Drug Administration both recently released new guidelines, from the CDC, and new regulations, from the FDA, aimed at addressing the rising concern about the nationwide opioid epidemic. Not coincidentally, these guidelines and regulations were announced within a week of one another. I think this signals a strong message from the federal government to both state governments and health care providers: if you won’t fix this problem, we will. CDC’s New Guidelines for Prescribing Opioids for Chronic Pain Although many states have released their own guidelines for the management of chronic pain (Tennessee’s guidelines, released in 2014, are accessible here), this is the first set of guidelines available nationwide to healthcare providers. The CDC’s guidelines include 12 main recommendations, which include establishing treatment goals with patients prior to starting a patient on opioids, and avoiding concurrent opioids and benzodiazepines whenever possible. The starting […]

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When Personal & Professional Life Intersection: Notifying Your Licensing Board About your Criminal History


As a licensed professional, it can be difficult to remember that your personal life is not completely separate from your professional life. In the state of Tennessee, health care providers such as physicians, nurse practitioners, and physician assistants are required by law to update their online profiles with the Department of Health regarding criminal convictions, as well as other adverse events. Here’s the law in Tennessee: Health care providers (defined in T.C.A. § 63-51-102(b)) must update information “required to be reported” to the Department of Health within 30 days after the occurrence of an event or attainment of a status. T.C.A. § 63-51-117(d). What is information that is “required to be reported?” Criminal convictions for felonies and “serious misdemeanors,” as determined by the Board, within the past ten (10) years; Any final disciplinary action by a licensing board in any state within the past ten (10) years; Any peer review action […]

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