Pain-doctor limits set

By Carol Gentry

3/1/2010 © Health News Florida

Doctors who haven’t passed certification exams in pain management will be able to keep working in pain clinics as long as they have hospital privileges and a qualified supervising physician, under a rule adopted by a state board this weekend.

This step is only temporary. As soon as a two- to three-week “mini-fellowship” in pain management is up and running at a Florida medical school – expected Jan. 1, 2012 – uncertified pain doctors will have to complete it successfully to stay in that line of work.

Another hotly debated issue that wound up in the rule is provision for unannounced visits by health inspectors. If they find real problems, the Department of Health Secretary can issue can emergency suspension.

The rule, which implements legislative actions from 2009, is “the first real step enacted in Florida to protect the public health and safety of all Floridians from the scourge of unregulated and unchecked pain clinics,” said Dr. Allan Escher, a pain specialist.

Escher spent his last day as chairman of the Florida Board of Osteopathic Medicine presiding over passage of the rule – especially meaningful since he specializes in pain medicine.

Florida’s image as the pill-mill capital of the eastern U.S. is so bad “that many legitimate pain doctors are afraid to even tell people what they do for a living,” Escher said.

The rule now goes to the Florida Board of Medicine, which will take it up on Wednesday by conference call.

The rule goes into great detail, setting up standards of care in pain management from urine screens to medical records. But the underlying legislation didn’t give the boards authority to decide who can own a pain clinic – a gap that bills have been filed to address this year.

One of the suggested reforms that the pain rule committee decided against was limiting the number of pain pills that can be dispensed directly by a clinic, rather than issuing a prescription to be filled by a pharmacy.

A bill pending in the Legislature would limit the dispensing to three days’ worth