The Prescription Responsibility Debate

August 30, 2010

When a doctor writes a prescription for pain medications or other narcotics, does his or her responsibility stop once their signature is complete? A California physician thinks so and is defending herself against a criminal investigation alleging her of improperly dispensing the drugs, which in some cases led to overdose deaths of some of her patients.

When a doctor writes a prescription for pain medications or other narcotics, does his or her responsibility stop once their signature is complete? A California physician thinks so and is defending herself against a criminal investigation alleging her of improperly dispensing the drugs, which in some cases led to overdose deaths of some of her patients.

Dr. Lisa Tseng, a Rowland Heights, Calif., osteopath, was recently the target of a raid of her office by state and federal authorities, according to the Los Angeles Times. A federal search warrant affidavit claims Tseng of routinely prescribing Oxycodone and other often-abused medications to those seeking drugs without adequately assessing their medical need or possible addictions, the report states.

A Times investigation indicates that Tseng was a prescribing physician in six overdose deaths of patients in their 20s dating back to 2007. She still has her license to practice, but the DEA has suspended her license to prescribe controlled substances, dubbing her “an imminent danger to public health and safety,” the Times states.

Tseng told the Times - as her office was being raided -that she “never intended to kill anybody,” and then made the following statement: “I really believe I did nothing wrong. I was really strict with my patients, and I followed guidelines. If one of my patients decides to take a month's supply in a day, then there is nothing I can do about that."

Then there is this from the Times. Tseng notes that she “frequently” got phone calls from parents of her patients, angry she was prescribing such powerful drugs, calling her names such as a “drug-dealing doctor.” “I tell parents a lot of times it’s their problem,” the physician told the newspaper.

In a more recent article on her case, Tseng admits she may have been tricked into giving drugs to patients who did not need them and noticed patients driving long distances to see her, one of the tell-tale signs of an addict shopping for pain medications, according to experts.

Tseng, when asked if she felt responsible for the deaths of her patients, told the newspaper, “That's a double-edged sword. If I say 'yes,' it means I'm admitting wrongdoing. If I say 'no,' it means I have no remorse.”

So my question to you is: Where does the responsibility fall - on the doctor or on the patient?
Should Tseng have been more diligent in dispensing potentially dangerous drugs to her patients and more cognizant of the signs of feeding possible addictions? She seems remorseful, but also adamant about the line between patient and doctor once a medication is prescribed.

Is the physician correct in indicating that once she wrote the prescription, following her directions on the bottle is up to the patient to follow, absolving her of any wrongdoing? And as for the parents of these patients is it “their problem,” to monitor drug intake, not the doctor’s, who has severed the responsibility once a prescription is written?

Tseng’s case is an interesting one and will, likely, be resolved in court sometime in the future. But the question over prescription responsibility still lingers today amid the press around her case.

I’m curious what you all think and how you deal with this in your practice. Weigh in below with your thoughts.