Tuesday, December 06, 2005

Power without Accountability

The December 5, 2005 issue of The Boston Globe carried an article by medical reporter Scott Allen about a Dr. Michael Brown and the Drug Monitoring Program operated by the Massachusetts Department of Public Health.

Dr. Brown was arrested last fall for over-prescribing highly addictive drugs including, notably, the pain killer OxyContin.

The article dealt with the question of whether the Drug Monitoring Program was sufficiently aggressive in spotting inappropriate prescribing patterns and reporting them to the proper regulatory authorities.

What I read into it was the ineffectiveness of government regulation as a means of supervising medical practice. Dr. Brown had been under suspicion for about ten years. A formal complaint against him had been lodged with the Board of Registration in 1999, but the complainant was a drug addict and Brown denied the charges. The Board was unable to resolve it and disposed of the matter by making an entry in the doctor’s file. A mothers’ group had picketed his office last summer. Not until he was actually arrested was his medical license suspended.

I think that reporter Allen put his finger on the core of the problem when, early in the article, he referred to Dr. Brown as “an internist working alone in Sandwich.”

People who have the power to significantly affect other people’s lives ought to be accountable to bosses who are responsible for supervising their performance and for taking appropriate action when performance falls short of the mark. We don’t require that in the case of medicine. We ought to.

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