Embrace Changes and Prevent Overdose: A Basic Blueprint for Legal Risk Mitigation and Response

Through the lens of medical expert testimony and case examples, attendees will learn core areas of risk mitigation with a focus on making electronic medical records and paper charting work for the practitioner to demonstrate prescribing in the usual course of professional practice. Overdose—a small word that packs a major punch, and a big reason for recent legal-regulatory changes in controlled substance prescribing and medication assisted treatment (MAT). Too often, prescribers are caught unprepared to respond to licensing board and legal inquiries surrounding overdose events. Many prescribers haven’t examined their own risk mitigation and documentation processes following changes to prescribing guidelines and rules, or even after learning about a patient’s emergency room visit or demise. Many prescribers also lack a structured approach to patient education to mitigate the risks associated with the use of controlled substances, errantly relying solely on a piece of paper to capture what should be a process of informed consent. Professional licensing board and criminal cases involving overdose events do not usually end well for the unprepared prescriber. Yet, there is much the prescriber can do proactively to signal his/her intent to prescribe for a legitimate medical purpose while acting in the usual course of professional practice and taking “reasonable steps” to mitigate abuse and diversion of controlled medication. This educational program includes lessons learned by the speaker through more than a decade of chart audits and legal case work. Attendees will have access to one or two sample templates that can be used to improve daily charting and to demonstrate adherence to risk evaluation, monitoring, and common documentation requirements. While prescribers cannot control what their patients do once they leave the medical office, they are responsible for establishing a safe framework for opioid prescribing, including a proper response when something goes wrong. This lecture will help the prescriber demonstrate thoughtful prescribing in the “usual course of professional practice” and improve the prescriber’s chances of minimizing legal liability associated with patient overdose.