Feature Prescribing

California doctors under investigation for prescribing practices

BMJ 2015; 350 doi: https://doi.org/10.1136/bmj.h74 (Published 29 January 2015) Cite this as: BMJ 2015;350:h74
  1. Jeanne Lenzer, associate editor, The BMJ, New York, USA
  1. jeanne.lenzer{at}gmail.com

A local newspaper raised the alarm over doctors allegedly prescribing antipsychotic drugs for large numbers of foster children just to calm them down. Jeanne Lenzer reports

Following a year long investigation by the San Jose Mercury News, several investigations have been launched into the prescribing practices of doctors treating California’s foster children.

The newspaper spent nine months negotiating with the California Department of Health Care Services for access to data from 2004 to 2014 on the more than 60 000 children in foster care in California. The records show that nearly a quarter of foster children aged between 10 and 18 years were prescribed psychotropic medicines, and 60% of those children were prescribed powerful antipsychotic drugs, often by doctors receiving payments from drug companies.1

The newspaper’s investigative series, which began in August 2014 and is ongoing, has shocked officials and triggered calls for change. In response to the newspaper’s reports, California Department of Health Care Services introduced a requirement from 1 October 2014 that doctors obtain permission to prescribe antipsychotic medicines. Doctors have to file a treatment authorization review request with a state pharmacist, who must verify the medical necessity. Several California counties have also said they are reviewing their medication practices, and California state senators Holly Mitchell and Jim Beall say they are considering legislation to curb overprescribing. Mitchell told the newspaper, “Drugging kids to make them behave isn’t care, isn’t responsible, and shouldn’t be legal.”

Kimberly Kirchmeyer, executive director of the California Medical Board, told the newspaper’s investigative reporter, Karen de Sá, that even though there is no law prohibiting doctors from taking industry payments, doctors who take payments could be guilty of “unprofessional conduct.” The board is looking into potentially “inappropriate” prescribing practices of …

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