“I do want to know when a patient is suspected of doctor- shopping. But other than that, I want to be able to use my clinical judgment.”
“red-tape reduction bill” the organization plans to take to state lawmakers when they return in January. Key features of the bill will address last year’s backlog in issuing controlled substance permits; ensure that the new DPS online prescrip- tion drug-monitoring database remains a secure and user-friendly tool for doctors; and push lawmakers for other in-office conveniences that mean less time spent on needless paperwork and more time dedicated to patients.
Physicians sweat the small stuff be- cause it can add up to big problems, TMA Director of Legislative Affairs Dan Finch says.
But the projected efficiencies apparently didn’t trickle down to doctors, thousands of whom were snared in a backlog of ex- piring licenses last summer. The Texas Medical Association received complaints from physicians across the state about DPS delays in processing their applica- tions for renewed permits. Back in West Texas, the delay carried grave consequences. The physician prac- tices in a rural hospital, and without the license, the emergency physician staffing company he works for was preparing to pull his hospital credential or place him under the supervision of another staff doctor.
“They said I could not work,” said the
emergency physician, who wishes to re- main anonymous. Nor could he prescribe to the critically ill patients he cares for weekly at a nearby heart hospital. A replacement doctor wasn’t much of an option. For these patients, “I’m the whole show,” he added. His hospi- tal schedule is typically booked three to four months in advance, and often he’s not just the only emergency physician in the underserved area but also the only long-term care specialist and hospitalist. His wife says the physician was “too busy taking care of patients to deal with the mess,” so she was prepared to fly to Austin to give DPS a copy of his appli-
42 TEXAS MEDICINE December 2012
cation and a new check because there wasn’t a way to do either online. She couldn’t even download the form. How- ever, even that extreme gesture would not have done much good, she was told, because recent budget cuts forced DPS to close its cashier’s window. Twenty-four hours before the doctor’s
controlled substance certificate would have expired, thanks to TMA’s help, his wife connected with a DPS director who reprocessed the application over the phone.
But on a Thursday at 5:30 p.m., there
were no guarantees DPS would complete the background check before Monday morning, and the emergency physician was on call that weekend beginning at 6 am Friday. Fortunately, 20 minutes later, DPS
called to say the doctor was in the clear. Also, fortunately, he had a seven-year relationship with the hospital and the emergency services contractor, who took his word that the renewal went through. “This would not have happened with- out that relationship,” the physician said.
No more red tape TMA wants to make sure that red-tape nightmare and others like it don’t hap- pen again.
That’s the thrust behind an omnibus
TMA continues to press for legislative solutions “to cut through the additional rules, regulations, and other unproduc- tive elements that do nothing to improve quality” and everything to interfere with doctors’ ability to practice medicine ef- ficiently and effectively, he says. Take, for example, the hassles physi- cians had in renewing their state con- trolled substances permit they must have to maintain a valid federal Drug Enforce- ment Administration license, Mr. Finch says. DPS cooperated with TMA to help locate physicians’ pending applications, speed up processing, and give doctors more advanced notice of impending ex- pirations. The quick fix did the job, but physicians want long-term solutions. As a first step, doctors want to see the agency follow through on its promise to automate the current paper-based re- newal process and allow doctors to sub- mit and pay for renewals online, similar to updating their medical licenses. Be- cause the information entered on the form every year rarely changes, auto- matically populating it with physicians’ personal information and prescribing identification numbers also makes sense, doctors say. A DPS spokesperson said the program is “functioning well” and the agency is “exploring options for online registration and payment services.” Meanwhile, DPS has maintained the extended license re- newal policy and notifies physicians 90 days before expiration of the license “to give them ample time to complete this important process,” the spokesperson says.
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