Doctor shoppers are multiplying

On Saturday, March 22, 2008, a patient called my office complaining of a toothache. The name sounded familiar and alarming. My records indicated that I last saw this individual in 1999. After several calls to area pharmacies, he was identified as a "doctor shopper" at that time.

"Doctor shopping" refers to the practice of a patient requesting care from multiple practitioners, often simultaneously, without making efforts to coordinate care or informing the practitioner of the multiple caregivers.

This usually stems from a patient's addiction to, reliance on, or illegal trafficking of certain prescription drugs. Verified reports include practices where patients self-injure or mutilate themselves, such as breaking or chipping teeth to visit emergency rooms complaining of toothaches in order to receive prescription painkillers.

To address this problem, in 1998, Kentucky established KASPER (Kentucky All Schedule Prescription Electronic Reporting). Any time an individual presents a prescription for a scheduled drug to a pharmacy, information is entered into the state's database. This database may be accessed (on the Internet) by any licensed health care provider. It is often used when there is a suspicion of a drug-related problem. This database can also be utilized by any law enforcement agency.

The results of the Kasper report on this individual contained the following:

u From April 27, 2006 to Dec. 28, 2006, this patient visited eight different providers, seven different pharmacies and was prescribed 2,583 tablets of controlled drugs.

u From Jan. 8, 2007 through Dec. 26, 2007, this patient visited six different providers, 10 different pharmacies and was prescribed 4,853 tablets of controlled drugs. That averages to be nearly 14 tablets a day over this period.

u From Jan. 2, 2008 through March 4, 2008, this patient visited four different providers, four different pharmacies and was prescribed 503 tablets of controlled drugs.

The patient was on Medicaid. Therefore, many, if not all of the prescriptions were paid for by the government. It is no doubt a lucrative enterprise for this criminal since each tablet demands astronomical prices on the street when they are sold.

The Kentucky Board of Dentistry advises that such cases be turned over to the appropriate law enforcement agency. In years past, when my office was located in the city limits of Greensburg, I worked with the Greensburg City Police on these cases, and in several instances, these criminals were actually arrested while in the dental chair.

On Monday morning, I related the incident to the Greensburg Police Department. Since the patient was from Campbellsville, I was told that an officer from the Campbellsville Police Department would be in contact. Within 30 minutes, an officer called me. He said that they routinely handle this type of case and that an investigation on this individual would begin immediately. I also spoke to an investigator with the Kentucky State Police later that afternoon; he had already been advised of the incident and was taking appropriate action on the case.

The law is crystal clear. The crime is "the unlawful procurement of a controlled substance" by fraudulently getting medication from doctors in Kentucky. It reads as follows:

KRS 218A.I40 Prohibited acts relating to controlled substances

(1) (a) No person shall obtain or attempt to obtain a prescription for a controlled substance by knowingly misrepresenting to, or knowingly withholding information from, a practitioner.

(5) Any person who violates any subsection of this section shall be guilty of a Class D felony for a first offense and a Class C felony for subsequent offenses.

I commend both city departments and the Kentucky State Police for the professional manner in which they handled this situation.

Robert L. Simmons, DMD

Greensburg