Counseling Patients with Opioid Prescriptions

Pharmacists must decline opioid prescriptions if their suspicions of invalidity cannot be resolved. Explaining these suspicions to patients can be viewed as a criticism of the prescriber, and this perceived criticism can result in litigation by the prescriber against the pharmacy.

In one recent case, a physician sued a pharmacy whose team members had allegedly made defamatory statements about the physician. The physician claimed that these statements had been made by pharmacy personnel:

  • Factual (and incorrect) statements relating to the physician: That he was in jail, that he overprescribed to a pregnant woman, that one of his patients died of an overdose, and that someone in his office was producing fraudulent prescriptions.
  • Factual (an incorrect) statements that the physician was being investigated by the DEA, FBI, and Board of Medicine, or that his license had been revoked.
  • Potentially misleading statements that the physician “is being investigated” or “audited,” or was “under review.”
  • Statements of opinion regarding the physician’s practices: “he is filling too many prescriptions” and “he writes too many pain pills.”
  • Statements of opinion regarding the physician’s relationship with his patients: “he is bad news, “you should find another doctor,” “your doctor won’t be in business much longer,” and “he may lose his license.”
  • Criticisms of the physician’s patients, such as “you shouldn’t be taking these pain pills,” “you are probably a drug addict,” and “you are just a drug addict.”

The pharmacy defended the case by arguing that many of the statements were true (truth is an absolute defense to a case alleging slander), that other statements were mere matters of opinion, and that the balance of the statements was necessary content of a pharmacist-patient consultation.

The court refused to dismiss the physician’s case against the pharmacy. It will likely be settled out of court, or perhaps it already has been settled out of court.

The law is clear that the mere refusal to honor a physician’s prescription does not support a lawsuit for defamation by the physician against the pharmacy. However, disparaging statements made about the physician when the refusal to dispense is explained to the patient may support a lawsuit for defamation. This is certainly a situation in which caution with the spoken word is important.

If you would like to learn more about how justifications for refusing an opioid prescription can lead to legal liability for defamation, then take the continuing education course “Defaming the Prescriber.”

 

MAKE YOUR IMPACT January 1, 1970

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