It was the CALF Medical Board that starting going after what prescribers wrote for up to TEN YEARS AGO…  Even going after some prescribers that had been retired for a few years.

Remember the Biden’s Admin attempt to create a dis-information czar in the Dept of Homeland Security ?  That job lasted about 2 weeks – at most.

Just imagine, if this bill is signed into law, that the Medical licensing board could state that opiates have no proven efficacy in treating pain long term and any prescriber who prescribes opiates to especially intractable chronic pain pts… could be threatened with license revocation.  What would be the outcome if the licensing board decided that any prescriber that prescribes any medication that was not backed by FDA clinical trials (OFF LABEL)… is misinformation.  The permutations of this law may not be calculated up front…

Former Planned Parenthood president warns against California’s medical misinformation bill

https://www.foxnews.com/media/former-planned-parenthood-president-warns-against-californias-medical-misinformation-bill

Leana Wen warned that the California legislation could have a ‘chilling effect on medical practice, with widespread repercussions’

Former Planned Parenthood president Leana Wen gave a dire warning in a Monday op-ed that California’s bill, regardless of its intention, can actually hurt the medical system rather than reform it.

“One of the many lessons from the COVID-19 pandemic is that misinformation can be deadly,” Wen recalled. She stated that mentality is in California’s AB 2098, a bill she describes as one, “that passed the California legislature and is waiting to be signed into law by Gov. Gavin Newsom.” 

She further noted that, “The measure would make California the first state that could take legal action against health-care professionals for conveying false information about COVID-19 and its treatments.”

While she did not ascribe bad faith to the people pushing the bill, she warned that it would have disastrous results.

“While well-intentioned, this legislation will have a chilling effect on medical practice, with widespread repercussions that could paradoxically worsen patient care,” she suggested.

She illustrated how the bill could end up punishing doctors who are acting with the best of intentions.

“AB 2098, taken to the extreme, could put many practitioners at risk. But is it really right for physicians to be threatened with suspension or revocation of their license for offering nuanced guidance on a complex issue that is hardly settled by existing science?” she asked.

Wen also recounted one of the most contentious aspects of the COVID-19 pandemic, the week-to-week overhauls of COVID-19 guidance policies from experts and government officials. 

“Indeed, another lesson from COVID is that science is constantly evolving. In a public health emergency, official guidance often lags cutting-edge research,” Wen recalled. “Consider how long it took the CDC to acknowledge that the coronavirus is airborne. Should doctors have been censured for recommending N95 masks before they were accepted as an effective method for reducing virus transmission?”

Wen followed by claiming that the bill, if anything, was similar to a Trump-era policy.

“In a way, though the California bill was introduced by Democratic legislators, it is not unlike the Trump administration’s Title X ‘gag rule,’ which barred health-care providers who worked in clinics that received federal funding from referring patients for abortion care,” she recounted. “I strongly opposed the Title X gag rule for the same reason I oppose AB 2098: Both censor what doctors can say to our patients. Both represent political interference with the practice of medicine.”

She concluded her piece by warning that “California’s bill is a recipe for medical practice to be subject to the whims of partisan politics.”

Wen has dissented with many liberals on handling COVID-19 before, declaring in a previous op-ed for The Post that she will be sending her kids back to school this fall, a major turnaround from her earlier rhetoric on the lockdown.

“I began trying to think of the coronavirus as I do other everyday risks, such as falls, car accidents or drowning,” she noted. “Of course I want to shield my children from injuries, and I take precautions, such as using car seats and teaching them how to swim. By the same logic, I vaccinated them against the coronavirus. But I won’t put their childhood on hold in an effort to eliminate all risk.”

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Some believe our country is on the verge of a Civil War, they may be right, but it won’t be a bilateral war like our last Civil War..  Our society has voluntarily divided itself in – for lack of a better description – TRIBES.

The chronic pain community is not all that different from our country of as a whole.

Recently a fellow chronic pain pt who had been advocating for end stage pediatric pts in a large hospital system that has a “no opiate” policy.  All of a sudden the advocated was told that he was no longer permitted to advocate for these end of life pediatric cancer pts.  I suppose that this major hospital system will return to treating these pediatric pts with NSAIDS and Acetaminophen and let them live the rest of their lives in a torturous level of pain.

There are rumors as to who said what and to whom… I am not going to elaborate. However, they know who they are and what was said to cause this to happen.  One can only imagine the deprived mental status of those who have been involved in this.

Some have told me that this tribe of malcontents have monetized chronic pain pts’- personal information  and several other covert processes. I started my blog in 2012 and have tried to motivate and educate chronic pain pts in some ways that they can navigate their way to getting their pain management back.  Some chronic painers have told me that I should charge for my advice.  My Pharmacy degree, license and career has provided for Barb and myself a comfortable retirement.

After this issue with these end of life pediatric pts,  Going forward… I am going to ASK of people that want my advice to make a contribution to one of the four national charities listed below, these are all about THE KIDS… and charities we support.  Maybe in some small way, my advice can help more than just one person/family. 

https://www.stjude.org/ St. Jude Children’s Research Hospital – deals with kids dealing with cancer and/or life threatening health issues

https://lovetotherescue.org/ Shriners Hospital – deals with kids, born with “broken bodies” and birth defects

https://rmhc-kentuckiana.org/ Ronald Mc Donald House – this is near us and just a few blocks from a very large regional pediatric hospital ,3 other major hospitals within blocks, one being a teaching hospital and having the only LEVEL ONE TRAUMA CENTERS for 100 miles and part of a medical university and  helps provide housing for families with kids in the hospital

https://t2t.org/ Tunnel to Towers Foundation – helps get handicapable housing for veterans, first responders with “broken bodies” , families with spouse/parent killed in the line of duty and Gold Star Families

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This was written by Bob Sheerin’s wife (Amanda)… this particular hospital – because of some – at best – half-truths from a tribe of malcontents – who claim to be chronic pain pts and advocates – sent to someone at this hospital.  Bob was told that he was no longer going to be able to advocate for these end of life pediatric cancer pts.  This particular pt, Bob had previously advocated for this kid and the parent reached out to Bob in apparently a moment of crisis. Bob does not ask for money, doesn’t expect to be showered with accolades nor be the center of some SPOTLIGHT.  He has the heart and soul of a servant to those in need. I am honored to have Bob as a friend.

Here is a quote from a Pharmacist that at one time held the second highest elected office in our country – VICE PRESIDENT:  It should also apply to individuals

“The moral test of a government is how it treats those who are at the dawn of life, the children; those who are in the twilight of life, the aged; and those who are in the shadow of life, the sick and the needy, and the handicapped.” – Hubert Humphrey 

Instead of the family going to dinner, my husband gets a call for emergency advocacy assistance. An 8 year old girl with cancer at the Children’s Hospital needed his help ASAP. We drove all the way there and what happened next was pretty damn impressive. Bob takes over the whole child wing like these kids have known him their whole life. He Handed out toys, pens, crayons, coloring books, sketch pads and even entertained the siblings in the TV room while waiting. All the nurses and doctors played along with Bobs stupid sock puppets and even ran into the family of a child he had advocated for in the past so he checked in on that child as he was back in the hospital. That Mom made me tear up with their story and how my husband had helped their family. Pain and suffering throughout the ward turned into entertainment hour, these babies forgot they were sick for just a short time. Bob was treated like a superhero but that doesn’t surprise me really his ability to entertain kids has always impressed me as all kids love Bob. This setting was one I hadn’t seen before and watching these children and their families embrace him the way they did made me so proud. As the day closed Bob was able to advocate successfully for the little girl we were called to help and with ease I may add. Watching Bob advocate was way better than the dinner I didn’t get. We ended up eating fast food and we giggled all the way home at the children’s experiences and laughter. A great advocate not only helps the patients in need but helps the patients who need him the most. After what I witnessed and what our own kids saw, I see why people call from all over to ask for help.. No one and I mean no one could have accomplished that task. After all, laughter is the best medicine, so they say. One baby got the help she needed and the rest got a show. So Proud of you babe, you’re a hard act to follow.

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Majority of retail pharmacists fear losing Medicare-eligible patients

https://drugstorenews.com/majority-retail-pharmacists-fear-losing-medicare-eligible-patients

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US to roll back coverage of COVID-19 vaccines, treatments starting this fall

https://www.beckershospitalreview.com/finance/us-to-roll-back-coverage-of-covid-19-vaccines-treatments-starting-this-fall.html

The Biden administration is set to begin shifting costs of COVID-19 vaccines and treatments to the commercial market, ending the practice of the U.S. government purchasing the drugs and making them available at no cost, The Wall Street Journal reported Aug. 18.

HHS is set to hold an Aug. 30 planning meeting with representatives from drugmakers, pharmacies and state health departments to discuss the change. Shifting how COVID-19 vaccines, tests and treatments are funded is expected to take months, an agency spokesperson told The Journal. 

The eventual end to underwriting COVID-19 drugs was always in the cards for the U.S. government under both the Biden and Trump administrations. At an event sponsored by the US Chamber of Commerce Foundation Aug. 16, White House Covid-19 Response Coordinator Ashish Jha, MD, said the administration has been thinking about its move from the “acute emergency phase” of the pandemic in which the government is purchasing vaccines, treatments and diagnostic tests.

“My hope is that in 2023, you’re going to see the commercialization of almost all of these products. Some of that is actually going to begin this fall, in the days and weeks ahead. You’re going to see commercialization of some of these things,” Dr. Jha said.

Vaccines, diagnostic testing and treatments would move closer into the regular U.S. healthcare system under the change. “If you need a treatment, you get a treatment the way you’d get treatments for heart disease and other viruses and bacteria and other kinds of things,” Dr. Jha said. 

Top of mind for the administration is ensuring that moving COVID-19 resources into the commercial market does not leave 30 million Americans who are uninsured at a disadvantage. “Right now everybody can walk into CVS and get a vaccine. I want to make sure when we make this transition, we don’t end up in a point where nobody can get a vaccine because we didn’t get the transition right,” Dr. Jha said. 

Health insurers and pharmacy benefit managers will be more involved in negotiating prices with the manufacturers of COVID-19 drugs, with prices likely ending up higher than what the government has paid, likely resulting in premium increases, Larry Levitt, executive vice president for health policy at Kaiser Family Foundation, told The Journal. 

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California Approves Bill to Punish Doctors Who Spread False Information

https://www.doximity.com/articles/f1bb07d5-6b97-4cfd-b74b-23f49a29687f

Trying to strike a balance between free speech and public health, California’s Legislature on Monday approved a bill that would allow regulators to punish doctors for spreading false information about Covid-19 vaccinations and treatments.

The legislation, if signed by Gov. Gavin Newsom, would make the state the first to try to legislate a remedy to a problem that the American Medical Association, among other medical groups and experts, says has worsened the impact of the pandemic, resulting in thousands of unnecessary hospitalizations and deaths.

The law would designate spreading false or misleading medical information to patients as “unprofessional conduct,” subject to punishment by the agency that licenses doctors, the Medical Board of California. That could include suspending or revoking a doctor’s license to practice medicine in the state.

While the legislation has raised concerns over freedom of speech, the bill’s sponsors said the extensive harm caused by false information required holding incompetent or ill-intentioned doctors accountable.

“In order for a patient to give informed consent, they have to be well informed,” said State Senator Richard Pan, a Democrat from Sacramento and a co-author of the bill. A pediatrician himself and a prominent proponent of stronger vaccination requirements, he said the law was intended to address “the most egregious cases” of deliberately misleading patients.

California’s legislation reflects the growing political and regional divisions that have dogged the pandemic from the beginning. Other states have gone in the other direction, seeking to protect doctors from punishment by regulatory boards, including for advocating treatments involving hydroxychloroquine, ivermectin and other medications that the American Medical Association says remain unproven.

If enacted, the law could face a legal challenge. Governor Newsom, who has three weeks to sign the legislation, has not yet taken a public position on it.

While other nations have criminalized the spread of vaccine misinformation — and have higher vaccination rates — the response by states and the U.S. government has largely been limited to combating misconceptions with accurate information, said Michelle M. Mello, a professor of law and health policy at Stanford University.

She noted that even laws that cited a “compelling interest,” like public health and safety, to police disinformation ran the risk of having a chilling effect, a First Amendment standard for many courts.

“Initiatives like this will be challenged in court and will be hard to sustain,” she said in an interview. “That doesn’t mean it’s not a good idea.”

California’s response follows a warning last year by the national Federation of State Medical Boards that licensing boards should do more to discipline doctors who share false claims. The American Medical Association has also warned that spreading disinformation violates the code of ethics that licensed doctors agree to follow.

The measure was among a flurry of Covid-related bills proposed by a legislative working group that drew fierce opposition from lawmakers and voters. Some of the most contentious bills have stalled or died, including one that would have required all California schoolchildren to be vaccinated.

As the legislation moved through the Legislature, its sponsors narrowed its scope to deal directly with doctors’ direct interaction with patients. It does not address comments online or on television, though those have been the cause of some of the most impactful instances of Covid misinformation and disinformation.

“Inaccurate information spread by physicians can have pernicious influences on individuals with widespread negative impact, especially through the ubiquity of smartphones and other internet-connected devises on wrists, desktops and laptops reaching across thousands of miles to other individuals in an instant,” the Federation of State Medical Boards wrote in a report in April. “Physicians’ status and titles lend credence to their claims.”

The legislation would not require the suspension or revocation of a doctor’s license, leaving such determinations to the Medical Board of California. It is intended to make the dissemination of false information about Covid-19 subject to the same rules as other kinds of “unprofessional conduct” taken up by the board.

The legislation defines disinformation as falsehoods “deliberately disseminated with malicious intent or an intent to mislead.” Treading into the at times contentious debates over alternative, often unproven Covid treatments, the bill defines misinformation as spreading information “that is contradicted by contemporary scientific consensus contrary to the standard of care.”

It says doctors have “a duty to provide their patients with accurate, science-based information.” That would include the use of approved vaccines, which have been subject to fierce debates and political activism across the country, though there is broad agreement among medical professionals about their effectiveness.

A group called Physicians for Informed Consent opposed the legislation, saying it would silence doctors. The group filed a lawsuit this month to seek an injunction preventing the Medical Board of California from disciplining doctors based on accusations of disinformation. In its lawsuit, it called the legislation’s definition of misinformation “hopelessly vague.”

In a recent letter to Surgeon General Vivek H. Murthy, James L. Madara, chief executive of the American Medical Association, said disinformation swirling around vaccines had contributed to ignorance among the public that had worsened the pandemic’s impact.

“The most unfortunate result of this has been significant vaccine hesitancy and refusal among certain communities and within certain demographics, ultimately resulting in continued higher rates of severe illness, hospitalization and death due to Covid-19 in these populations — outcomes largely preventable with vaccination,” he wrote.

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Can’t help but notice.. NACDS ( National Assoc of Chain Drug Stores) that represents some 50%-60% of all community pharmacies, nor AMCP (Academy of Managed Care Pharmacy) which represents all the PBM/mail order pharmacies are not aligning with this statement. I am not waiting for a similar statement supporting those pts dealing with subjective diseases and have a medically necessary medications – often a controlled substance. I guess that the SCOTUS ruling (9-0 vote) https://www.scotusblog.com/case-files/cases/ruan-v-united-states/  Which basically told the DEA that they could not use objective criteria in judging prescribers treating pts dealing with SUBJECTIVE DISEASE. Is this a “wink & nod” to all the pharmacists employed by these chains… that denial of care – refusing to fill controlled meds… they are perfectly okay with.

AMA, APhA, ASHP, NCPA Statement on State Laws Impacting Patient Access to Medically Necessary Medications

https://www.ashp.org/news/2022/09/08/statement-on-state-laws-impacting-patient-access-to-medically-necessary-medications

The American Medical Association (AMA), American Pharmacists Association (APhA), American Society of Health-System Pharmacists (ASHP), and National Community Pharmacists Association (NCPA) are concerned about state laws that limit patients’ access to medically necessary medications and impede physicians and pharmacists from using their professional judgment.

Following the U.S. Supreme Court Dobbs v. Jackson Women’s Health Organization decision, physicians, pharmacists, and other health care professionals face a confusing legal landscape due to state laws’ lack of clarity, confusing language, and unknown implementation by regulatory and enforcement bodies. This includes many questions about how broadly state laws will be interpreted and the impact of these actions on physicians’ and pharmacists’ ability to serve the needs of their patients. Physicians and pharmacists need clear guidance from state boards of medicine and pharmacy, agencies, and policymakers to support the prescribing and dispensing of medically necessary medications that may be affected by this new legal and regulatory paradigm. Without such guidance, we are deeply concerned that our patients will lose access to care and suffer irreparable harm.

In the wake of the Dobbs decision, over half of U.S. states have severely restricted or are expected to soon restrict access to abortion services, including medications that induce abortions. In many states, these laws prohibit prescribing and dispensing an “abortion-inducing drug,” or contain other comparable terms. This language is vague, and it is unclear whether it prohibits certain medications only when prescribed to induce abortion or whether a medication is prohibited entirely if it has the potential to induce abortion regardless of the condition for which it was prescribed. Namely, methotrexate can be used off-label for the termination of intrauterine pregnancy and is also approved and used off-label for numerous indications such as cancer and ectopic pregnancy along with being commonly prescribed as the first-line treatment of inflammatory diseases such as arthritis. Similarly, mifepristone is indicated for the termination of pregnancy but is also prescribed in a medical emergency to treat ectopic pregnancy, preeclampsia, and other emergent medical presentations during labor and delivery and for the medical management of a miscarriage.

Our members and our patients report that this uncertainty is disrupting care. Patients who rely on these medications for reasons unrelated to pregnancy termination report new challenges in accessing these and other medications, and it is placing our patients’ health at risk. Many health care professionals, including physicians and pharmacists, are uncertain of their legal liability related to prescribing and/or dispensing these medications regardless of whether they are being used for an abortion or another indication. We are aware of the following examples that highlight reactionary steps taken by various stakeholders stemming from a lack of clarity in state policy and resulting in patients experiencing delays or denials in accessing medications for medically necessary purposes:

• At some health systems and hospitals, we have heard reports of legal counsel, tasked with minimizing legal exposure for their institution and employees, prioritizing caution over access and advising against providing certain medications.
• Some organizations have removed emergency contraceptives (which are not abortifacients) from kits used to care for victims of sexual assault—compounding the trauma these victims experience—because the legal risk is too unclear.
• Some pharmacies are implementing policies requiring pharmacists to reject prescriptions unless new, burdensome administrative processes are met, such as confirming a female patient’s diagnosis with the prescriber for every potential abortifacient regardless of whether the medication has multiple uses.

Without access to medications proven to be safe and effective, our patients’ health is at risk. As physicians and pharmacists, we view patient wellbeing as paramount and are deeply troubled that continuity of care is being disrupted. We call on state policymakers to ensure through guidance, law, or regulation that patient care is not disrupted and that physicians and pharmacists shall be free to continue to practice medicine and pharmacy without fear of professional sanction or liability. We strongly urge state medical and pharmacy boards, agencies, and policymakers to act to help ensure that our patients retain continuity of care and that our members clearly understand their legal and licensing obligations.

About ASHP
ASHP is the collective voice of pharmacists who serve as patient care providers in hospitals, health systems, ambulatory clinics, and other healthcare settings spanning the full spectrum of medication use. The organization’s more than 60,000 members include pharmacists, student pharmacists, and pharmacy technicians. For 80 years, ASHP has been at the forefront of efforts to improve medication use and enhance patient safety. For more information about the wide array of ASHP activities and the many ways in which pharmacists advance healthcare, visit ASHP’s website, ashp.org, or its consumer website, SafeMedication.com.

About AMA
The American Medical Association is the physician’s powerful ally in patient care. As the only medical association that convenes 190+ state and specialty medical societies and other critical stakeholders, the AMA represents physicians with a unified voice to all key players in health care. The AMA leverages its strength by removing the obstacles that interfere with patient care, leading the charge to prevent chronic disease and confront public health crises, and, driving the future of medicine to tackle the biggest challenges in health care. For more information, visit ama-assn.org.

About APhA
APhA is the only organization advancing the entire pharmacy profession. Our expert staff and strong volunteer leadership, including many experienced pharmacists, allow us to deliver vital leadership to help pharmacists, pharmaceutical scientists, student pharmacists, and pharmacy technicians find success and satisfaction in their work and advocate for changes that benefit them, their patients, and their communities. For more information, please visit www.pharmacist.com.

About NCPA
Founded in 1898, the National Community Pharmacists Association is the voice for the community pharmacist, representing nearly 19,400 pharmacies that employ 215,000 individuals nationwide. Community pharmacies are rooted in the communities where they are located and are among America’s most accessible health care providers. To learn more, visit www.ncpa.org.

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Patients see their pharmacists as more dependable than their doctors, data shows

https://www.legalreader.com/data-shows-patients-trust-pharmacists-more-than-doctors/

A recent study found that more than half of Hispanic patients 50 years of age and older (61%), and 59% of African Americans the same ages view pharmacists as “supportive partners compared to doctors, particularly due to the pharmacists’ guidance when it comes to health and wellness.” CulturIntelTM published its “How to Leverage Doctors and Pharmacists in Marketing Plans to Yield Better Health Outcomes Study” on the trust matter after weeding through over one million online public domain conversations posted in the one-year span between April 2021 and April 2022. These conversations included “1.6 million public domain digital conversations about doctors and 84,000 public domain digital conversations about pharmacists,” the company reported.

While trust is an important factor in the relationship between any provider and a patient, pharmacies have gotten somewhat of a bad rap lately with all of the litigation being filed against these chains over claims they’ve helped to fuel the opioid epidemic. So, it’s interesting that the majority of minority patients in the stated age bracket continue to view pharmacists as trustworthy, and this begs that question – why?

The study reported that 67% of African American and Hispanic patients 50 years of age and older “collectively have a more positive sentiment toward pharmacists than doctors. The sentiment for both pharmacists and doctors are driven by a combination of soft skills like friendliness and support, as well as hard skills like effectiveness and expertise.”

And, while bias in the healthcare field continues to be a relevant issue, it seems pharmacists are not viewed this way.

“Interestingly enough, among Hispanic and Black people, pharmacists do not seem to suffer from the perception that they are being ‘biased,’ or that as pharmacists they are showing an unfair prejudice towards diverse communities,” said Caroline Brethanoux, chief strategy officer, CIEN+ and CulturIntel. “On the other hand, doctors are deemed biased in their interactions with diverse patients due to their personal experiences and historical injustice in the healthcare system. Within these communities, pharmacists could potentially become a gateway to foster more trust towards the healthcare system and drive better health outcomes as a result.”

The study found that “across all segments, 37% of the conversations in which patients are discussing doctors online are mostly driven by negativity compared to 22% of negative discussions about pharmacists.”

CulturIntel explained, “People are concerned about doctors being rude and disrespectful, but also incompetent and ineffective, suggesting a lack of trust in their abilities and their knowledge. Additionally, there are complaints about doctors’ biased behavior, especially among African Americans and Hispanic conversations which are not discussed for pharmacists,”

This is especially interesting because, in the opioid cases filed against pharmacies, many defendants have countered that doctors should be held accountable for suspicious orders. The pharmacies contend they are only fulfilling patients’ needs by filling the orders given to them that were written by physicians. Whether patients believe that their doctors are writing inappropriate prescriptions is something that hasn’t gotten a ton of attention, but it’s a curious question, nevertheless, given the trust patients put in their pharmacists and their apparent distrust of doctors.

Sources:

Study: Pharmacists May Overcome Trust Barriers Among Diverse Patients

Chicago-area counties sue pharmacy chains for allegedly feeding opioid crisis

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