Report: Many Prolific Opioid Prescribers Have Gone Overlooked By Tennessee Regulators

Jan 23, 2020

Research analysts with the Tennessee Office of the Comptroller developed their own model for determining abnormal prescribing patterns, which included prescribing opioids and benzodiazapines at the same time.
Credit Blake Farmer | WPLN

Tennessee health officials haven’t been questioning many of the state’s highest opioid prescribers. Of the most prolific, half have never triggered an inquiry, and most have never been disciplined.

The state comptroller was asked by lawmakers to look into how the state Department of Health polices opioid prescribing. They found 62 prescribers that were far outside the standard practice of medicine, and only half were on the state’s radar.

Research analyst Kristina Podesta says their patterns might be explainable.

“The data that we’re looking at in black and white, unfortunately, isn’t that simple when you’re dealing with patients,” she says. “So I think there’s a lot more that goes into it than just the data.”

Podesta says, though, these doctors’ practices were extraordinary, and they should have at least gotten a second look from health officials. (Asked for a response, a Department of Health spokesperson says the agency has not had time to review the 24-page report released Wednesday.)

For the doctors, physician assistants and nurse practitioners who do end up being disciplined, the comptroller’s report also highlights how long the process takes. Health Department investigators make a recommendation, and the appointed medical boards usually sign off. But scheduling all of the hearings usually extends past two years. At times, a doctor has been criminally charged before losing his license.

Auditors question the role of consultants, who ultimately decide whether the prescribing patterns add up to malpractice. All the while, the doctors are free to keep prescribing addictive narcotics.