How e-prescribing stops doctor shopping

There are times when the refresh was just jaw-dropping. It radically changed what I did.

Doctor shopping is part of the dark underbelly of medicine.

Addicts go from doctor-to-doctor, describing phony symptoms, and getting real prescriptions for dangerous painkillers or stimulants.

Doctors feel helpless. They are taught to trust. They're not cops.

Now, thanks to e-prescribing software, they don't have to be.

Dr. Matt Weyenberg (right) found this out the hard way. He's in family practice with a Plano clinic called Village Health Partners. They're big believers in automation. They've been given awards for it. And they've gotten the chance to beta test the latest stuff.

The practice's main vendor is GE Centricity, but they also use Kryptiq for e-prescribing. It was in testing the latest version of that software that Dr. Weyenberg learned some of his patients have been telling him sweet little lies.

"I click a button and it goes back to the SureScripts network, through Kryptiq, so if the patient had anything filled at SureScripts pharmacies it shows up. You see the doctor's name, quantity and dose. The medical history is just viewed – it doesn't go into the chart.

"There are times when the refresh was just jaw-dropping. It radically changed what I did."  Some of these were patients he had been seeing for years.

He confronted them gently. He explained what he knew, offered the help of pain clinics, psychiatrists, addiction centers. Some took him up on it. Most didn't. But the trust level was gone. Dr. Weyenberg dismissed them from the practice.

"I had an example last fall of someone getting Ritalin from 16 doctors. I spent a half hour on the phone with him, that day," convincing them to get help, "and I then called a psychiatrist from whom he'd brought the letter saying he had ADHD symptoms.

"The doctor asked how I figured it out. I said with my Electronic Medical Record (EMR), and he said what's an EMR."

There are insurers who police this doctor shopping. But addict-patients are smart. They pay cash and keep going. Maybe now some of them will know to avoid the doctors who have fancy software, but with the HITECH stimulus and its penalties kicking-in later this decade, those are going to be fewer-and-fewer.

Maybe then doctor shopping will end. It can end with the insurer, or with the doctor, or the pharmacist. But it needs to end. And e-prescribing software can help end it.


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