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NORMAN J CLEMENT RPH., DDS, NORMAN L. CLEMENT PHARM-TECH, MALACHI F. MACKANDAL PHARMD, BELINDA BROWN-PARKER, IN THE SPIRIT OF JOSEPH SOLVO ESQ., INC., SPIRIT OF REV. IN THE SPIRIT OF WALTER R. CLEMENT BS., MS, MBA. HARVEY JENKINS, MD, PH.D., IN THE SPIRIT OF C.T. VIVIAN, JELANI ZIMBABWE CLEMENT, BS., M.B.A., IN THE SPIRIT OF THE HON. PATRICE LUMUMBA, IN THE SPIRIT OF ERLIN CLEMENT SR., EVELYN J. CLEMENT, IN THE SPIRIT OF WALTER F. WRENN III., MD., JULIE KILLINGSWORTH, RENEE BLARE, RPH, DR. TERENCE SASAKI, MD 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., IN THE SPIRIT OF LEROY BAYLOR, JAY K. JOSHI MD., MBA, AISHA GARDNER, 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
“..Oliva argues that these surveillance tools rely on unvalidated predictive algorithms that lack scientific evidence for accurately identifying patient drug misuse..”
“..Oliva states: There is no evidence that PDMP scores accurately ascertain patient drug misuse risk…”
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“When the goal of a system shifts from healing to policing, it risks eroding patient trust and encouraging defensive medicine, in which a provider’s decisions are driven more by fear of investigation than by the patient’s unique medical needs.”
(Mr. Fishman): “Q. Is the government targeting physicians a form of selective prosecution to create statistics regardless of the merit of the case? … Ans. (AUSA Donald Zerendow) confirmed..”That’s exactly what I’m saying..sometimes the truth falls to the need to perform..” …1994 USA Today The Barbara Reynolds files
THE HIDDEN SCORE BEHIND YOUR PRESCRIPTION
DEA’s PRESCRIPTION DRUG MONITORING PROGRAM(PDMP) DESERVES SERIOUS SCRUTINY
In a lecture for the Stanford Pain Relief Innovations Lab, legal scholar Jennifer D. Oliva discusses the major issues linked to Prescription Drug Monitoring Programs (PDMPs). She contends that these surveillance systems rely on proprietary algorithms and unverified data to assign risk scores to patients, potentially unfairly influencing medical decisions.
The article highlights concerns that law enforcement-driven technology has been inappropriately integrated into the clinical setting, leading healthcare providers to rely on flawed metrics rather than professional judgment. Additionally, the text covers the consequences of the Ruan v. United States decision and indicates that federal oversight has disproportionately targeted minority medical professionals.
Professor Oliva urges a careful reexamination of how digital tracking and criminal justice policies affect the quality of chronic pain and the management of legal consequences.
A Stanford Expert Reveals: 3 Alarming Facts About America’s Prescription Drug Surveillance System
1. Your Doctor’s “Clinical Tool” is Actually a Law Enforcement Surveillance System
Prescription Drug Monitoring Programs (PDMPs) are state-level electronic databases that track controlled substance prescriptions. They are widely presented as clinical tools to help doctors identify patients who may be at risk for opioid misuse or addiction.
However, Professor Oliva reveals that the origins of these platforms are not in clinical medicine but in law enforcement.
“DEA’s Prescription Drug Monitoring Program (PDMP) predictive platforms deserve serious scrutiny because they are the only law enforcement-developed digital surveillance systems that health care providers have ever utilized to diagnose and treat patients.”
The clinical and legal implications of this distinction are profound. This introduces a fundamental conflict of interest into the clinical setting. A surveillance tool is designed to detect deviations from a norm and flag suspicion, whereas a clinical tool is designed to understand such deviations to diagnose an ailment.
Professor Oliva points out that,
“When the goal shifts from healing to policing, it risks eroding patient trust and encouraging defensive medicine, in which a provider’s decisions are driven more by fear of investigation than by the patient’s unique medical needs.”
Because these platforms were born from a surveillance, not a clinical, mindset, their core metrics were never subjected to the rigorous scientific validation required for medical tools. This leads directly to the next alarming fact.
2. The “Risk Scores” Used to Judge Patients Lack Scientific Proof
Many of these PDMP systems use proprietary algorithms to generate a “risk score” for each patient, supposedly quantifying their likelihood of drug misuse. Clinicians may see this score and use it to inform their decision whether to prescribe, adjust, or discontinue a medication.
According to Professor Oliva’s analysis, this practice has a critical flaw: the scores are not based on validated science.
She states, “There is no evidence that PDMP scores accurately ascertain patient drug misuse risk.”
This means that doctors are being encouraged to make life-altering medical decisions based on data from a black-box algorithm—an opaque system whose inner workings are not transparent to the user—that has not been proven to be accurate or reliable. Relying on an unvalidated score to deny or alter care undermines the scientific legitimacy of any clinical decision based upon it.
The use of these unproven scores would be troubling enough if it were optional. However, the regulatory environment has made it nearly impossible for clinicians to ignore them, placing them in an untenable professional position.
3. Doctors’ Reliance on These Systems May Not Be Voluntary
One might assume that a doctor would only use a clinical tool if they found it genuinely helpful for patient care. However, Professor Oliva argues that the pressure to use PDMPs and heed their risk scores is immense, effectively removing the element of choice.
The current regulatory climate puts physicians in an incredibly difficult position, where ignoring the output of these systems could expose them to professional or legal risk.
HOW FLAWED AI CREATES INJUSTICE
“It is also questionable whether clinical reliance on PDMP risk scores is truly voluntary, given that the regulatory environment leaves providers with little choice but to take seriously the information generated by proprietary PDMP algorithms.”
This creates a conflict for providers, who may be caught between their own expert clinical judgment about a patient’s needs and the demands of a surveillance system they are compelled to use. This shifts the locus of medical authority from the provider’s professional judgment to the algorithm’s opaque and unsubstantiated output.
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REFERENCES:
The Anand-Clement Rule and Predictive Justice Systems
Executive
REFERENCES:
PART-1
PART-2
PART-3
PART-4
