Friday, December 29, 2017

"Irresponsible"

JJ thought this little exchange between Dr. Randy Easterling and Representative Joel Bomgar deserved its own post.  It took place at the December 15 meeting  of the Mississippi Board of Medical Licensure.  The Board had just approved the "opioid amendments" and allowed members of the audience to make public comments if they wished to do so.  Mr. Bomgar voiced his concerns to the Board and Board member Dr. Easterling responded. See for yourself what the bureaucrats think of you and your elected leaders.





Mr. Bomgar went up and spoke to Dr. Easterling after the meeting was adjourned.  Dr. Easterling very loudly told the State Representative "you are being irresponsible."    Dr. Easterling also used that same term to describe coverage and comments of the Board's actions as well during the meeting.  Watch for yourself*.




JJ has told the truth about these regs.  All  JJ has done is post the proposed regs, videos of the Board's comments, and what the physicians have said about them.  Judging from the traffic for these posts and the emails received, it is safe to say there is a great deal of interest in this subject and a story that is being ignored by the rest of the media.

Kingfish note: How dare Mr. Bomgar read data and reach his own conclusions.  The horror!

Earlier posts
Orthopedic surgeons oppose opioid regs 
 Bomgar on opioids: We have a death problem, not a prescription problem.
"Stop the nonsense. Talk to real doctors." (Letters)
 It would be nice if we could do this behind closed doors.
 Medical Board approves opioid regs with little notice.
Never let a good crisis go to waste.  
Board of Medical Licensure calls meeting yesterday to discuss opioid regs tomorrow.
State Health Officer warns of unintended consequences    
Doctors on proposed opioid regs: "dangerous", "Ill-conceived", "idiots" (Letters)
How much pain will proposed opioid regs create for doctors?  (Regs analyzed)
Can medical weed fight opioids?  
Opioids prescription: Mo' taxes, mo' spending, mo' jail (Gov.'s task force report)

*Transcript of Dr. Easterling's remarks.

There seems to be a disconnect and I continue to be amazed by this that someone derived from these rules and regs that you could no longer write for opioids.  There is nothing in this that prohibits the responsible, evidence-based writing of opioids for legitimate pain. If asking someone to jump through a few extra hoops prevents them from doing it, shame on them....  There are things you do and we arrived at this epidemic in large measure because the writing of these medications in large number unnecessarily has resulted in the number one public health crisis in this country. So what this board and other boards across the country, and don't think for one minute we are the only board doing this, what we are saying is if you want to treat chronic, non-cancer pain with opioids, this is what you must do under certain circumstances. If you do it, fine, keep doing it, but people don't want to hear that.  People want to hear that this board is stopping you from doing something. There is nothing in here that says if someone comes into the emergency room you can't give them dilaudid or morphine. There is nothing that says if you have a total hip, you can't go home with 20 days and if you need more, go back to your doctor for another 20 days. I just think my experience in dealing with this for the last year or so a lot of the comments that are being made in the press and otherwise are irresponsible, they're not what we are saying,  and we just ought to stand up and tell the truth.  We just ought to say what the rules say and let it be.  If a doctor decides they are not going to follow the rules and let their patients go without treatment for chronic pain, that is unfortunate, in my opinion.  

53 comments:

Anonymous said...

Please tell me that we the taxpayers of Mississippi are not paying these self serving (in some case almost illiterate) board members to dictate how the medical profession operates. That is what Med Schools are designed to do. I am sorry one of the board members son lost a friend from (obviously unprescribed) heroine.

Anonymous said...

The best sausage gets made in the dark!

Blogs like this get in the way of the serious people making sausage!

It Hurts When I Do This... said...

Where I come from, sausage is not made in the dark. Perhaps 10:32 is confusing the time-honored practice of making sausage with his hobby of packing fudge. Although similar in some respects, both are NOT done in the dark.

When we allow practitioners to cross over into the role of legislating, our wheels have jumped the track. Surely a Board of Licensure will not be allowed to design the rules by which practitioners practice. If anything, they should only be allowed in an advisory capacity (with time limits placed on their practice of elocution).

Anonymous said...

What a pompous, arrogant response! Instead of engaging meaningfully with an elected policymaker, the board member shuts down, insults him, and says he doesn't know what he's talking about! Who do these people think they are??? The legislature should rein in the board of medical licensure. They could simply undo these regulations by statute.

Anonymous said...

Easterling has this affliction of believing he is always addressing Gallo. With Gallo, he knows he is communicating with a literal dunce who is trained only to ask two or three leading questions, provided by the guest, along with the inartful practice of not letting most people speak.

However, people of great substance and depth, like Easterling, know they have wide berth on the Gallo Talk Show and he can pontificate and spew forth without any danger of being rebuked, seriously questioned or being headed off at the pass when he goes astray.

Esterling thinks everybody with whom he comes in contact mirrors the Gallo personna. But they don't. And he will soon learn he is but a chicken scratching around in coop full of chicken shit. The powers that be will reign him in and wring his neck for supper. Bomgar was sent over to warm him up.

Anonymous said...

Just another physician that thinks his opinion is all that counts.

Anonymous said...

Articulate people hardly ever show up at "public hearings". That's what caught the board off guard. Hell, this board rarely sees patients that as articulate as Joel and none that do as much homework as he does.

Anonymous said...

Easterling is an arrogant ass trying to move the goal posts. He could give a shit that he is penalizing the 99% of patients who aren't abusing opioids by making them jump through innumerable "extra hoops".

Anonymous said...



Laws are like sausages, it is better not to see them being made.

Otto von Bismarck

Anonymous said...

Remember when Dr. Egoerling used to advise people to "Get help, Get help NOW"? He ran a substance abuse clinic way back then.
Perhaps he should take his own advise!

Anonymous said...

#JoelforGovernor

Anonymous said...

Politicians should not be mandating medical practices, even if they themselves are a physician - that would constitute a conflict of interest. However, if a duly licensed physician is prescribing meds outside the realm of standards of medical necessity, and there is a sentinel event in the form of death or incapacity, then laws should be strong enough for a family to seek relief through the courts to show that the singular physician is guilty/not guilty of malpractice. Either these substances are CONTROLLED by the practitioners licensed to control them, or there is an abuse of discretion for which that practitioner should be held accountable. These are politicians simply grandstanding on an issue that they shouldn't really be meddling in. What they're really doing is politically exploiting those deaths that are happening.

Anonymous said...

Hob. Terry. For years you have threatened to defund this rogue board. Do it.

Anonymous said...

The actual truth?

Neither Randy nor Joel know a thing about these medicines.

That’s right. Nothing.

The inherent problem is that the manufacturers of the medicine have conceal s and hidden the true affects these drugs have on consumers.

So at the base....you have doctors (who feel more trained) sparring with non doctors and they are arguing over unknown data.

Until we clamp down on the Rx manufacturer and learn all they know about each drug.....this is akin to a monkey mating with a football.

Anonymous said...

It always seems that the pendulum swings too far to the right after it has swung too far to the left. If the medical licensure board did their job then the doctors that caused this crisis would no longer be practicing medicine. This problem was created by the doctors. Now they want the patients to pay the price. Joel Bomgar is a fine Christian man, a very successful businessman and a public servant. Easterling is a legend in his own mind and has absolutely no common sense. I would think that the people of Mississippi would be better served by listening to Mr. Bomgar than they would listening to Easterling.

Anonymous said...

Opium has been used for pain for thousands of years dumbass, spoken like a true trial lawyer looking for the next jackpot. Suck it

Anonymous said...

Easterling and his buddies come across as ignorant and arrogant. It’s a sad day when here guys dictate to surgeons how to practice.

Anonymous said...

Easterling is a sore loser, flaunting the only power he has after failing to get elected to the legislature. He plans to make money from this, punish lawmakers, doctors and patients, facts and logic be damned.

Anonymous said...

If Dr. Easterling & the rest of the board could experience what it's like to be a REAL patient w/ pain, not one with connections, their outlook on how this is handled would be far different.

Anonymous said...

Test

Anonymous said...

Hate Easterling all you want, he brings it on himself. But the Board is dealing with a real problem; not that their solution in and of itself is the final answer. But Bomgar's solution which appears to be to continue to prescribe to addicts is not the solution either. In fact, its against all medical practice.

Yes, there are addicts using these pills. Some are getting them legitimately, and some are gaining the system, with occasional 'doctors' who are participating with them in their gaining of the current processes. Many folks who "are in pain" need to learn to deal with their "so called" pain other than covering it up with meds. Some folks who are bitching need to read the regs themselves, not just believe what JJ and readers quote as being the terrible injustices brought on by this attention to the problem.

If someone needs meds after an initial three week supply, they need to see their doctor again. If someone is obtaining scripts from multiple doctors, the existing system should be used by docs and pharmacists to put a stop to the abuse. Granted, some docs and some pharmacies don't want to put a stop to it - but that is the minority (and a large part of the problem attempting to be addressed). But for docs to claim it is too much paperwork is crap. They have to check Medicaid's system to determine if a patient can get another script this month, or if the generic is required for the particular patient - why is it a problem to check and see if the patient has gotten "pain meds" from another doc recently?

Chronic pain at times is mistaken as drug addition. Hate to say the truth among all those here that like to bitch, but its time to face the reality here and quit the stretching of the regs. Just like Schumer and Pelosi are lying about the potential benefits of the tax reform, there are many false narratives going about (and stated in comments above) about the world collapsing on those that have just got to have their meds. Hell, you would think its a bunch of Madison County women on here bitching about not being able to sleep or needing a xanax to calm their nerves every day due to their excess anxiety.

Anonymous said...

WOW- so if Doctors can't prescribe opiods whenever they want then "hundreds or thousands of Mississippians will die". What kind of doctors prescribe pain meds that will kill the patient if they have to stop taking them?

That is what I understood Mr. Bomgar to say. Is this guy a Doctor?

Anonymous said...

I think Bomgar does not know the facts. I personally know many people who "doctor hop" to get their pain medicine. Think about that.

Words Have Meanings said...

8:00 - Are you trying to say 'gaming'?

Anonymous said...

Actually Bomgar stated nothing but facts. He quoted stats from five other states that did what MS is trying to do. Deaths from opoid overdose went up as a result. Its just data, not opinion.

Anonymous said...

734, it may be a fact, but facts are like crap - they come in all sizes,and shapes and when examined often smell bad. Fourteen states had a significant increase in drug overdose deaths according to the latest study. (Because of differing autopsy processes, not all drug overdose deaths can or are attributed to opioids.) The five you refer to are part of the fourteen, but the other nine states did not enact rules,such as this. Neither you nor Joel include this 'fact' to justify your claim of causation.

Illicit fentanyl is attributed to be a major cause of the increase. Over prescription is considered to be the cause of the 200%increase from 2000 to 2016 (6.5/100k to 14.7/100k). Socioeconomic conditions are felt to be an underlying fact in the states where the increase has been significant, with the largest increases having been in WV and OH.

Just because you or Joel state a fact - five states have had an increase that have done what is being proposed here - does not create a cause and effect. What about the other states that haven't taken action that have seen similiar, or more, increases in deaths?

Anonymous said...

December 29, 2017 at 8:00 PM = Blah, blah, blah, blah

Just like Schumer and Pelosi? ROFLMAO Give us a freakin' break.

Anonymous said...

@8:00 PM tell us why young children under the care of their Pediatrician and who are not taking opioids should have to be drug tested quarterly.

Anonymous said...

Illicit fentanyl is attributed to be a major cause of the increase.

Attribution? Major? According to whom?

Over prescription is considered to be the cause of the 200%increase from 2000 to 2016 (6.5/100k to 14.7/100k).

Link?

Socioeconomic conditions are felt to be an underlying fact in the states where the increase has been significant ...

Felt?

Anonymous said...

Cdc.gov/deaths/states

Google can be your friend. You want sources, maybe you should also provide your sources rather than just state 'facts' as such.and yes, CDC used the word 'felt'.

Go back and 3at your cocoa puffs and let the adults talk.

Anonymous said...

9:14 because their parents may be taking their prescription.

Anonymous said...

It's interesting that everyone is saying the board does not have the authority to enact these rules.

§ 73-43-11. Powers and duties of board.
The State Board of Medical Licensure shall have the following powers and responsibilities:
(a) Setting policies and professional standards regarding the medical practice of physicians, osteopaths, podiatrists and physician assistants practicing with physician supervision; . . .
(g) To promulgate and publish reasonable rules and regulations necessary to enable it to discharge its functions and to enforce the provisions of law regulating the practice of medicine; . . .

If they have the power to set professional standards of medical practice, surely they have the power to enact these rules.

Anonymous said...

Mississippi Republicans = Control freaks

Anonymous said...

9:45, typical non-substantiated BS.

Anonymous said...

You can pass all the laws you want, but criminals don't follow the law. All this is doing is just hurting the law abiding citizens. Criminals can still get their stuff on the black market. Why not enforce the laws we have now? I have a constitutional right to possess... Sorry. I got my gun nonsense and opiod nonsense blather mixed up.

Anonymous said...

It’s not just opioids they are attacking. It is also anti anxiety meds, ADHD meds, anything that is schedule 2. If it were strictly opioids I wouldn’t be as violently opposed, although I think it is poorly thought out, either way. I do think my 8 year old should have to be drug tested, monthly for ADD medicine, nor should anyone. Before some idiot blames me for his ADD, you should know he was adopted at birth from a heroin addicted mother who was on a methadone program during her pregnancy. Had that not been an option, I don’t believe she would have lived to give birth to my precious boy. She was a hardcore junkie. He was born addicted to methadone. Agency told me that he would never function independently, would have severe behavioral problem, borderline retarded IQ and that I should get him on disability, immediately. If his mother would have had to go back onto streets, this sweet, kind, straight A child would t be here, I feel certain.

Anonymous said...

Wouldn’t the sensible thing be to find the doctors whose prescribing habits don’t match their specialty and look not punishing the offenders, instead f the entire state?

Anonymous said...

@10:37 am. This is not “setting policies and professional standards regarding the medical practice of physicians.” This is regulating the availability and distribution of certain controlled substances. The board doesn’t have that authority, only the legislature does. This is no different than if the Mississippi Bar tried to change the rules of civil or criminal procedure. Only the MS Supreme Court has that authority.

Anonymous said...

This is the very reason Easterling couldn’t even get elected in his own House district. He is just wholly unlikable. What’s really laughable in this example is just how superior Bomgar is in intelligence, manners, and accomplishment. Easterling acting arrogant to Bomgar really is embarrassing for Easterling.

Anonymous said...

11;24 - Unsubstantiated BS? You think the report of the CDC on the specific topic is unsubstantiated? Guess you think all these commentators/experts on JJ are detailed, factual statements, but the Center for Disease Control study is not?

Let me suggest again, go back to your cocoa puffs; leave the educated discussion to the adults.

Anonymous said...

Since Easterling saw fit to lecture Bomgar about what Bomgar isn't, it's worth noting what Bomgar is that Easterling isn't: a legislator. Here's another: successful. Easterling is a pompous career bureaucrat at this point in his life. Coming off his recent political campaign, he's also bitter. The opioid crisis is a real thing, but as positive as the board's intent may be, the proposed rule is hamhanded and directly interferes with physicians' ability to treat their patients. It's fundamentally unfair to create these sort of universal restrictions that punish the masses instead of the offenders. The board decided it would gut telemedicine under the guise of an opioid solution to boot. Physicians and legitimate pain patients are up in arms. The board is not representing them. Employers & people in underserved areas should be up in arms about telemedicine. This board is setting itself up for long term political failure.

Kingfish said...

There are good points being raised by both sides in this thread. Mr. Bomgar may not be correct, he may indeed be making some false assumptions and is not a medical expert. However, he has every right to research this issued, study the data, and ask some very relevant questions. He asked questions that no one on that board or task force bothered to ask and frankly, the public has a right to hear them answered.

As wrong or as right as he may be, it is rather galling for one of these bureaucrats to tell him he is irresponsible of daring to question their proposals and speak his mind.

The board has forgotten that it works for us and serves us as does Representative Joel Bomgar.

This is the same board that gives short notices for special meetings, doesn't put on the agenda that it is going to vote on these amendments, and bitches that the meetings have to be open to the public. One can agree with the board's proposals and amendments and still disagree with how they are going about its business.

Bomgar may indeed by 100% wrong but that doesn't mean he has to shut the hell up either.

Anonymous said...

Sorry to be a little indigent about it Randy, but an extra 100 hours of anti-opiate CME for the privilege of treating chronic pain is total bullshit. I have been to my 5 hours of controlled substance Maoist indoctrination and it was all recovery addicts and anti opiate addictionologist propaganda. Do you think for a minute that 100 hours of “narcotic prescribing CME” won’t have an anti opiate slant? This is in addition to our already large amount of regular CME required by the state and whatever specialty board your are credential through is ridiculous. So a pain management doctor, internist, or general practitioner will have to get arounf 150 hours of continuing medical education hours a year. Last time I checked that is like 4 years of colllege credit and is meant to be punitive and purposefully makes it too much work to write chronic pain meds. So yes, how irresponsible of me to be both concerned for my patients and my own livelihood you arrogant bastard.

Anonymous said...

Imagine. A board that doesn't post agenda, doesn't let public know what is going on. Only worse would be a board that doesn't allow anybody to know anything, even it's own board members, while it spends taxpayer dollars. And if the board (non-exec committee members) do actually learn anything, they are not allowed to tell anyone what is being done with those tax dollars. Oh, the horror.

Anonymous said...

Arrogant and ignorant. Amazes me that no one has reigned Easterling in. Hurting patients and doctors..

Anonymous said...

Hopefully, the proponents of this insanity will find themselves in need of pain medicine and denied any relief. Maybe a hip replacement or spinal surgery that ordinarily requires weeks of meds, that they must beg for that 2nd or 3rd week. I don’t take opiates, but have done so for surgery. Easterling is a loser who deserves to suffer what he is inflicting.

Anonymous said...

9;52. You would not be referencing the notorious Jackson Zoo board, perchance? Sounds like their modus operandi - at least it was so a few years ago.

Anonymous said...

There isn't one single person at the Capitol that doesn't think Joel is a complete moron. How Easterling spoke to him is nothing compared to how others have at the legislature. Some of it is even on tape.

Anonymous said...

There isn't one single person at the Capitol that doesn't think Joel is a complete moron

How do you know? Only a moron would make such an buffoonish claim.

Some of it is even on tape.

Link?

Anonymous said...

1:10. obviously you are never around the Capitol. Rep. Baker has shut him down several times in a much harsher manner, once in the floor and in a committee hearing. And it's common knowledge that Joel is so disliked he can't get any legislation passed with his name on it. Call the Lt. Guv or Speaker office and they will tell you the same thing. The Desoto delegation is the second most disliked. They can't get anything passed either

Anonymous said...

I served with Joel in the MS Air National Guard. I can tell you first hand the man is a genius. Social skills. Lacking

Kingfish said...

What some readers are referring to is that the Representative has been somewhat blackballed at the legislature. Some of it is because of the Desoto delegation getting beat in 2015. Some of it is because of the Continental Tire legislation and yes, Baker jumped all over him for voting against it. He probably didn't help himself when he voted against several local & private bills. He is probably one of the smartest people in the legislature. However, the word went out among the good ole boys that he was not to be helped. His bills are going to have a tough time seeing the light of day.

Anonymous said...

JJ, you and 6:45 hit upon it. Joel is a genius; but one does not succeed legislatively because he is a genius. One succeeds in a legislative body because he has the necessary social skills and some brains. You're dealing with people not automatons.

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