Still No Relief In Sight For Patients In Pain

Although the new policy to allow physicians to give terminal cancer patients adequate narcotics to ease their pain had been reached in August of 1998, it is still being kept largely under wraps by the State Department of Health.
Correspondence from State Health Commissioner Dr. Antonia C. Novello, dated February 15, to Dr. Charles Aswad, executive vice president of the Medical Society of the State of New York, and obtained by The Queens Courier, spelled out details of the new policy.
The new policy is intended to replace a harsh one that discourages physicians from prescribing narcotics and other controlled substances to their pain wracked patients and leaves them open to charges of medical misconduct for over-prescribing.
But to this date, neither DOH or the Society has notified the States Physicians about the new pain relief policy. The Queens Courier obtained a copy of the new policy statement "for the use of controlled substances for the treatment of pain," dated last March 30.
DOH spokesperson Kristine Smith wrote this newspaper on September 18 that the new policy will "soon" be mailed to every one of the 63,000 physicians in New York State.
This newspaper canvassed directors of palliative care and other pain experts who said they were unaware of the more liberal policy on pain relief for terminally ill patients. Smith explained the announcement letter outlining the new policy was still being finalized.
"There had been some problems with the printer and that delayed the process," she said.
Smith said that doctor-fear of DOH misconduct charges for providing pain relief is "ludicrous. Our agency is trying to get the message out. Its on our web site. Its not for lack of trying."
Smith had no answer as to why DOH hasnt held a news conference to drive home the new policy to doctors.
The old policy left doctors wary of the stricter DOH regulations and they feared being cited by DOH for medical misconduct. This physician concern of state agency action against them dates from the Rockefeller drug laws that dealt stiff sentences to drug abusers.
According to Christina Southard, spokesperson for the Medical Society of the State of New York, the new policy changes havent been issued yet because Dr. Novello hasnt signed off on it.
"I guess doctors are very law abiding citizens and are waiting for Novello to sign the law into policy," she said. "Its a chilling fact."
Asked why the leaders of the Medical Society havent demanded Novello sign off on the law, Southard said:
"Its probably because we were part of the process that resulted in the new policy."
A companion DOH policy, first formulated on February 15, is scheduled to replace the familiar triplicate prescription forms doctors must complete when issuing controlled substances. The new single page form is considered a simpler system that enables pharmacists to report controlled substances electronically to DOH, assuring that doctors are not "diverting" narcotics.
But the States 119,000 registered pharmacists are still waiting for the Department of Health to distribute the forms.
The new system is expected to replace a cumbersome one that required pharmacists to keep records of the prescriptions and mail a copy to DOH. The agency reviews the forms to determine if doctors are writing "inappropriate" controlled substances for their patients.
Asked the status of the new forms, Selig Corman, director of public affairs for the Albany-based Pharmaceutical Society of New York, said his members had not yet received them.
"The wheels turn slowly at DOH," Corman said. "We are aware of the change only because its been discussed in our meetings. But nothing has been heard officially from the DOH.
DOHs Smith said the new prescription form is still "not promulgated and may not be issued for some time."
Last week Assemblywoman Nettie Mayersohn of Flushing, Novello to release the new pain relief policy to the States doctors.