'Doctor shopping' cases overwhelming state authorities

Despite heightened industry attention on curbing prescription painkiller abuse and misuse, officials in several regions say that doctor shopping is still a daily problem, in part because inappropriate prescribers don't face tough enough consequences.

Dr. Aaron Gootman, a pain physician in Fayetteville, N.C., is one example, of a doctor who has prescribed too liberally and gotten away with it, the Fayetteville Observer reported.

According to the newspaper article, even after a patient died of an overdose after being prescribed Oxycontin on the day she was dismissed from Gootman's practice, neither Gootman nor any of his prescribers have faced public sanction or allegations of criminal wrongdoing.

In defense of his reputation, Gootman told the newspaper that pain is a notoriously difficult problem to treat.

"You can't really assess a person's character based on a 20-minute office visit. Sometimes, the shades of gray are so close to white you can't see them," Gootman said. "I would rather have a patient fool me and get medicine illicitly than to deny medicine to a patient that is suffering in pain."

And despite an increase in physician education and tools to identify patients at risk for prescription abuse, authorities told the New Hampshire Union Leader that they are currently so busy addressing the crime of doctor shopping in the state that they have time to focus on only the most egregious cases.

"Everyone knows that doctor shopping is a problem," Dr. Gilbert Fanciullo, director of the Pain Management Center at Dartmouth-Hitchcock Medical Center in Lebanon, N.H., told the newspaper. "Doctors want to be able to help, they want to prescribe appropriate pain medications to treat conditions. But they also have to worry about who is addicted to the drug, who is diverting the drug, and who is abusing the drug."

As a result, the time doctors spend trying to determine whether patients' pain is legitimate is not only just partially effective, but also affects the wait time and care of other patients.

"You ask the questions, but they aren't going to stop everyone," said Fanciullo. "With so many addicts looking for prescription pills, it makes doctors hesitant to prescribe certain drugs. That lowers a person's chances of getting the pain relievers they legitimately should be getting."

To learn more:
- read the article from the New Hampshire Union Leader
- see the story from the Fayetteville Observer

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