January 5

Health Professionals Completing Applications

Today health professionals are required to certify the accuracy of answers to many applications for licenses from state and federal government, applications for contracts with insurance companies, PBM’s, wholesalers, and various boards of specialty certifications, etc. Many of the key questions are poorly worded and sometimes ambiguous.

You cannot believe the number of health professionals seriously harmed when the answers to application questions—particularly those regarding prior disciplinary history or criminal record—are answered inaccurately. The consequences when a health professional misreads a question and in good faith answers it erroneously are enormous including: loss of license, loss of board certification, loss of Medicare certification, insurance contracts, and the list goes on and on. This situation becomes particularly burdensome when you are licensed in more than one state. If you have any complications in your professional history or you are not certain about how to answer a question, call me at (586) 598-4650 and we will complete the document together.

It is bad enough when the busy health professional skims through the questions and answers and makes declarations and certifications on his own but it is even more dangerous when you delegate the answering of the questions to other persons who may not complete the forms carefully enough. It is not a defense that someone else filled in the questions when the health professional signs that they have read and answered the questions truthfully and accurately.

Along the same lines, be certain that all of the boards in all of the states know your most reliable mailing address. Many times, the Board of Pharmacy or Medicine sends a formal complaint or other very serious document to the address they have on file. If it is an old address or the mail goes to a location where you don’t check your mail frequently, disasters occur. That disaster is you are defaulted on the complaint which leads most frequently to an immediate revocation of your license. Many times the default cannot be overturned. That means that whatever explanation or defense you have to the allegations will not be heard and they will be treated as the truth and you will be punished accordingly. All because you didn’t get your complaint on time in the mail or more recklessly, you decide to ignore it hoping…“it will go away if I ignore this”. They won’t ignore you and you will lose in a major fashion.

Like it or not, you have to stay on top of correspondence from various state boards and you have to address matters in a timely and professional manner. Despair and procrastination does not help. Ignoring problems always results in disasters.

In short and plain language, spending a few dollars on an attorney such as me to assist you with completing important applications and certifications is money extremely well spent. Additionally, if you get correspondence or a phone call from a state regarding your professional license, this is not amateur time and you really need an attorney with specialized knowledge. What you say or don’t say will be held against you. The ideal response is to contact me before you say or do anything. What you say to authorities will likely be exactly the wrong thing or it will be intentionally misconstrued or misrepresented in reports. Life does not give you rehearsals or do-overs.

It has always been thus but today it is more important than ever for you to use your constitutional right to an attorney and your right to silence. Remember that the Fifth Amendment right to remain silent protects the innocent as well as the guilty. Don’t hang yourself with your own tongue.

November 4

New Pharmacist Duty

A federal district court in Utah held that pharmacists have a duty to counsel patients when they offer advice or recommendations about non-prescription drugs – OTCs. The duty owed by pharmacists is to offer advice in conformance with what a reasonable, prudent pharmacist would do in the same circumstances. If you are interested in reading the case – Whiting ex rel. Estate of Theron Daniel Whiting, No. 2:12-CV-288 DN (D. Utah June 24, 2014). This case is not binding precedent yet.

The gist of the case is that a wife called a pharmacist and asked whether her husband could take Sudafed. The wife didn’t explain the husband’s complete medical history; specifically that he suffered from “prostate trouble”. The Sudafed allegedly exacerbated the husband’s prostate trouble causing difficulty urinating, bladder distension, and burst blood vessels in the bladder.

While the court’s ruling is not binding precedent yet, it is certainly well reasoned. Contrary to what businesses pound into the public’s head, it is exceptionally difficult to win a professional malpractice case and the damages are generally much less than they ought to be. In most states there are caps on professional malpractice damages and even if a jury awards 42 million dollars, the judge quietly reduces the actual judgment to a fraction of that with a stroke of his pend.

If you want to avoid this kind of lawsuit, don’t make any recommendations. If you want to advise patients about OTCs then use the same care that a reasonably competent pharmacist would use.

October 21

Religious Grooming and Clothing in the Workplace

The U.S. Equal Employment Opportunity Commission (EEOC) guidelines are mandatory reading for you if you are an employer covered by Title VII or an employee that follows religious prescriptions. Some examples of religious dress and grooming that are discussed in the guidelines include Christian crosses, a Muslim hijab, Sikh turbans and kirpans, uncut hair and beards, Rastafarian dreadlocks, or Jewish peyes.

In most cases employers covered by Title VII must make exceptions to their usual rules or preferences to permit applicants for jobs and employees to follow religious dress and grooming practices, unless those dress and grooming requirements pose an “undue hardship” on the employer. If these issues affect you please review the guidelines and call me if you have any issues or questions.

The publication by the EEOC makes good reading even if you don’t have religious garb and grooming issues at your workplace because it is a fascinating accommodation of religious rights and employer rights.

Additionally, the EEOC guidelines explicitly protect new and individual belief systems that are explicitly not recognized by the public at large or may not have adherents other than a particular job applicant or employee. Let your imagination run wild with that for a moment.

October 17

Michigan SB 0704

SB 704 took effect on September 30, 2014. This new pharmacy law will have a big impact on your practice, particularly if you do compounding. If you are a pharmacist-in-charge (PIC) you will be impacted in a major way because you will be taking on more responsibility to ensure your pharmacy is operating within the Pharmacy Practice Act and Rules. There is an additional requirement that the PIC work an “average of eight hours a week” at each pharmacy the person is registered as a PIC. The word average is interesting. Is the eight hour a week average to be calculated on a yearly basis, or monthly?

Even more controversially, the new act prescribes criminal punishment for violation of the new compounding rules and depending on whether there is a personal injury to a patient, the prison time varies from two to 15 years as well as fines.

As you might imagine this law was engendered by the NECC contaminated sterile injection fiasco. Yes, I intended the non sequitur with the sterile and contaminated.

Call me for a consultation regarding compliance with the new law and your personal circumstances.

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