Health Care

Greitens aiming for opioid abuse crackdown as he begins medical board appointments

Missouri Gov. Eric Greitens has made the first of several appointments to fill vacancies on the Missouri medical licensing board. His director of health, Randall Williams, said one of the things the administration is looking for in interviewing candidates is a willingness to crack down on dangerous opioid prescribing.
Missouri Gov. Eric Greitens has made the first of several appointments to fill vacancies on the Missouri medical licensing board. His director of health, Randall Williams, said one of the things the administration is looking for in interviewing candidates is a willingness to crack down on dangerous opioid prescribing.

St. Louis gynecologist Katherine Mathews went to Harvard Medical School, speaks three languages and has climbed Mount Kilimanjaro.

But when Gov. Eric Greitens appointed her to the Missouri medical licensing board last month, one of her most important qualifications was that she’s not worried about being popular with fellow physicians.

“Sometimes doing good work means having the courage to do it even if it’s tough,” Mathews said.

Mathews, who practices at Saint Louis University Hospital and St. Mary’s Hospital, is the first person Greitens has appointed to the Missouri State Board of Registration for the Healing Arts as his administration looks to crack down on doctors who contribute to the state’s opioid problem.

The board disciplines doctors who violate standards of care, and the Greitens administration has said that will be especially important when a new statewide database that will allow the state to identify problem prescribers goes live.

With eight physician members and one “public” member, Missouri’s medical licensing board has more physician influence than most and some of the board’s recent decisions have drawn concerns that it goes too easy on doctors.

In August, the board restored the licenses — on a restricted basis — of two physicians with felony convictions related to misuse of prescription opioids. The board also allowed a 30-day suspension with education on professional boundaries for a physician who it said improperly dispensed or prescribed 39 drugs to an employee in his office with whom he was also having sex.

Concerns about lax enforcement date back at least to December 2010, when the St. Louis Post-Dispatch published a nine-part series on the Missouri medical board called “Who Protects the Patients?”

With three vacancies on the nine-member board, Greitens has the opportunity to shake it up and Randall Williams, Greitens’ director of Health and Senior Services, has been interviewing potential appointees.

After a recent opioid summit in Kansas City, Williams said he’s been stressing in those interviews that getting tougher on opioids might sometimes mean making licensing decisions other doctors won’t like.

“It’s a hard job and we appreciate how hard it is,” Williams said.

“Sometimes it’s thankless, but it’s vital for the patients of Missouri and for other physicians, but also for the (disciplined) physicians themselves. If a physician is doing anything they shouldn’t be doing, it’s in their best interests that it be detected and stopped before it leads to something else.”

Williams said other appointments will be coming soon.

Tom Holloway, the executive vice president of the Missouri State Medical Association, said it’s past time to fill vacancies on the board that Gov. Jay Nixon didn’t fill. He also said it might be time to relieve some of the existing members who have stayed on to keep a voting majority intact even though their terms have expired.

But Holloway said he doesn’t think the board needs to get any tougher than it has been on doctors who don’t meet its standards on prescribing opioids or other controlled substances.

“I think when the board finds evidence of that, they deal with it,” Holloway said.

By law, the Missouri State Medical Association and the Missouri Association of Osteopathic Physicians and Surgeons is able to submit names of potential candidates to the governor. The governor is allowed to choose them, or other doctors forwarded to him by the director of the Missouri Division of Professional Registration.

Mathews said she was not recommended by either medical association. Rather, Williams got her name on the list after she met him during a trip to the Missouri statehouse in Jefferson City arranged by her local state representative.

She said she went to talk to him about the issues she’s passionate about, like disparities in infant mortality and access to cancer screening in different parts of Missouri. Before she left, Williams asked her to read up on the opioid issue.

Mathews will start working on the licensing board immediately and then have an official confirmation hearing in the Missouri Senate when the legislature returns to session in January.

She said she’s prepared to discipline other doctors, depending on what each individual case calls for.

“I think it’s always important to take into account the context for someone,” Mathews said.

“I think Missouri has a really good program in place for physicians who themselves have struggled with addiction. We are all human. Some mistakes are mistakes where someone just needs education. But some patterns of behavior really rise to a higher level of concern and then we have to step in.”

Andy Marso: 816-234-4055, @andymarso

  Comments