NORMAN J CLEMENT RPH., DDS, NORMAN L.CLEMENT PHARM-TECH, MALACHI F. MACKANDAL PHARMD, IN THE SPIRIT OF WALTER R. CLEMENT BS., MS., MBA., BELINDA BROWN-PARKER, IN THE SPIRIT OF JOSEPH SOLVO ESQ., INC.T. SPIRIT OF REV. C.T. VIVIAN, JELANI ZIMBABWE CLEMENT, BS., MBA., IN THE SPIRIT OF THE HON. PATRICE LUMUMBA, IN THE SPIRIT OF ERLIN CLEMENT SR., WALTER F. WRENN III., MD., JULIE KILLINGWORTH, LESLY POMPY MD., CHRISTOPHER RUSSO, MD., NANCY SEEFELDT, WILLIE GUINYARD BS., JOSEPH WEBSTER MD., MBA, BEVERLY C. PRINCE MD., FACS., NEIL ARNAND, MD., RICHARD KAUL, MD., LEROY BAYLOR, JAY K. JOSHI MD., MBA, ADRIENNE EDMUNDSON, ESTER HYATT PH.D., WALTER L. SMITH BS., IN THE SPIRIT OF BRAHM FISHER ESQ., MICHELE ALEXANDER MD., CUDJOE WILDING BS, MARTIN NJOKU, BS., RPH., IN THE SPIRIT OF DEBRA LYNN SHEPHERD, BERES E. MUSCHETT, STRATEGIC ADVISORS
the insurance companies rule the day
I like other physicians stood on the sidelines while individuals and insurance companies took over the control of medicine. Managed care, medical coding, prior authorization and usual and customary fees paid not by patients but the insurance companies became the rule of the day. As the insurance companies gained more and more power, physicians lost more and more control.
If a physician wanted to order certain tests they had to get permission from the prior authorization department serviced not by a physician but a clerk with predetermined questions needing a certain score which determined approval or denial. If the study or medication was not approved further steps were required involving additional time by the requesting physician.
NEEDLESS SUFFERING FROM UNTREATED PAIN
Some physicians simply gave up and told the patients the insurance didn’t approve the study or medication. Some like myself spent countless hours and days appealing the decision until we got a medical director who approved the test or medication. On top of this law enforcement declared a opiate epidemic.
Physicians and other health care providers were arrested, charged, and convicted of crimes when prescribing FDA approved medication in-spite of no change in their approach or method of treating patients. Physicians were threatened with undercover agents masquerading as patients in order to charge them with a crime.
THOUSAND OF HEALTHCARE PROVIDERS ARRESTED
Patients who were vulnerable to the criminal justice system especially women who faced the loss of their children were solicited to entrap their physicians under the threat that to not cooperate would cause them to loose their children. The DOJ/DEA and state AG’S instead of dispensing justice engaged in criminal and unfair behavior. Arrest and plea agreements became the order of the day. Because of plea agreements the public and health care providers were unaware that thousands of health care providers were being arrested and incarcerated.
These health care providers had to surrender their medical and DEA licenses and close their offices. Chronic pain patients and those being treated for Substance Use Disorder (SUD) were left without medical care and sought relief in the street, overdosed and died. Others being unable to get relief committed suicide. Pharmaceutical companies and physicians were accused of causing the opiate epidemic by over prescribing “Highly Addictive” medication. Even though medical data showed a decrease in prescription opiate pain medication, the public was not told that. They were not told that addiction is receptor driven and effective treatment is available.
Also the public was never told that heroin and later fentanyl was responsible for overdose deaths not prescription opiate pain medication . The substitution of fentanyl for other abused medication such as benzodiazepines, Adderall and Soma, cocaine and methamphetamines to date has been ignored. Also there is no system when individuals are found to have fentanyl in their system to determine whether they were opiate abusers or bought the illegal drugs thinking it was something else.
needle exchange, and clean injection sites.
The only way to turn this around is for physicians to get control of medicine. We are the ones who conduct clinical trials. We are the only ones trained to treat individuals with medical problems. The public needs to be educated about addiction not deprived of life sustaining opiate pain medication. We need to follow the lead of other countries by legalizing drugs, having fentanyl test trips, needle exchange, and clean injection sites.
These actions have been proven to decrease overdose deaths. We need to recognize that we can’t stop addiction or the flow of drugs into our country but we can decrease overdose deaths and with education new individuals suffering from SUD. Early detection of addiction and treatment with drugs like Suboxone and Sublocade to all those addicted to opiates will have a enormous impact on drug overdose deaths.
Fortunately physicians have been thrown a life line. On June 27 2022 the United States Supreme Court ruled 9-0 that a physician could not be charged with a crime for prescribing a controlled substance they were authorized to prescribe. In his written opinion Justice Beyer reestablished the doctor patient relationship.
All care including prescriptions are up to the treating physician. This is an important first step toward taking back control of medicine. It may be judicial relief to achieve the next step. Can anyone other then the physician determine reimbursement for services rendered? I believe that only the treating physician can determine fees.
Walter F. Wrenn III M.D.
FOR NOW, YOU ARE WITHIN