As the state works to thwart patients who shop around to score prescription painkillers, attention is turning to the other side of Florida's pill mill crisis: pain clinic doctors.
A committee of physicians met in Tampa on Saturday to advance sweeping regulations for pain clinics. The rules would set training standards for doctors, mandate annual inspections and require pain clinics to have basic facilities like private examining rooms.
Pain clinics would also have to report to the state how many of their patients come from out of state and drug-test patients to make sure they're not selling the drugs they were prescribed.
"This is a pioneering effort," said Larry McPherson, executive director of the Florida Board of Medicine. "We heard from practitioners. We heard from the parents who lost their kids because of this. We heard from law enforcement."
He could not say how long it will take to finalize the rules, which need approval by the state medical boards. The yearlong effort to develop them kicked off with a 2009 state law addressing prescription drug abuse.
The rules would apply to physicians working in state-registered pain clinics who mostly treat pain by prescribing drugs. And many expect to see the proposed regulations challenged by physicians or pain clinic owners who could be driven out of business.
"Right now, the public is demanding that we do something," said Brigitte Goersch, an Orlando businesswoman serving as a consumer member of the Board of Medicine. "I don't want to be afraid of litigation."
Especially controversial are the training requirements for doctors, who would need to have completed a recognized fellowship or residency involving pain management, or have approved board certification. Doctors without formal training would need to demonstrate extensive experience and receive supplemental education.
The rules seek to curb the shady practices at pain clinics spotlighted in a spate of recent arrests in the Tampa Bay region.
Clinics would have to post signs stating their name and hours of operation. Facilities must feature reception and waiting areas, examining rooms and bathrooms. The clinic would have to post the names of the physicians practicing there.
Once a year, state health inspectors would pay unannounced visits to pain clinics, unless they are accredited by an approved group. During inspections, patient medical records would be reviewed at random. Pain clinics would pay a $1,500 fee to fund the inspections.
Many details remain unresolved, such as which organizations could accredit pain clinics. The committee of physicians developing the rules also must decide how many prescriptions may be written by a single pain clinic within a 24-hour period.
The legal counsel for the Board of Medicine stressed the urgency of finalizing the rules. In recent months, the Pinellas and Hillsborough county commissions, and others statewide, have passed temporary moratoriums on new pain clinics, seeking to curb the spread of illegitimate establishments. Such actions are hurting doctors trying to practice responsible medicine, and the patients who need them.
"We're seeing what's happening because these rules aren't in place," counsel Ed Tellechea said.
Letitia Stein can be reached at firstname.lastname@example.org or (813) 226-3322. For more health news, visit www.tampabay.com/health.