Self-regulating profession? Administrative discipline of “pill mill” physicians in Florida

ABSTRACT

Background: A relatively large number of “pill mills,” in which physicians prescribed and sometimes dispensed controlled substances without medical justification, operated in Florida beginning in the mid-2000s. Investigations into these operations have resulted in the arrest and conviction of dozens of physicians for activities related to illegal trafficking in controlled substances. Methods: Using information from the federal Drug Enforcement Administration, the Florida Department of Health, and court records, we constructed a database of Florida-licensed medical doctors who had been indicted or convicted of crimes related to illegal prescribing of controlled substances in Florida during 2010–2015. We then determined whether and when physicians in this data set were temporarily or permanently barred from practicing medicine in the state. Results: We identified 43 physicians who faced criminal action for prescribing-related crimes during the study period. Twenty-eight of these physicians had been convicted or pled guilty as of September 30, 2016, of which 25 (89%) had been permanently barred from practicing medicine in the state. Only 1 of the 25 physicians permanently lost their license before they had been convicted or pled guilty. On average, physicians did not lose their license to practice for more than 9 months (291 days) after being convicted and 587 days after being indicted of a crime directly related to illegal prescribing of controlled substances. Seventeen physicians (68%) maintained their licenses for at least 1 year after being indicted. Conclusions: This review suggests that the adoption of a more proactive and streamlined process may reduce the time from when physicians are indicted or convicted of illegally prescribing or dispensing controlled substances to board investigation and potential sanction, potentially reducing opioid-related adverse events in the state.

KEYWORDS:

• Enforcement
• opioid
• overdose
• pill mill

Acknowledgments

The authors thank Jessica Southwell for research assistance. The authors declare they have no conflicts of interest.

Author contributions

C. Davis conceptualized the article, supervised and conducted research, and led the writing. D. Carr conducted research, created graphs and tables, and contributed to the writing. Both authors reviewed and approved the submitted manuscript.