White Coat Underground

Since I abhor the entombment of real news beneath the Michael Jackson story, I didn’t think I’d be posting about it, but here I am. You see, Jackson was reportedly under the “care” of a privately hired physician when he died, and was being treated with medications not normally used outside the hospital. I have a problem with this.

According to the Times
, authorities are looking for records at the doctor’s Houston office. That’s not a bad idea.

I’m not a lawyer, and I don’t know if: 1) the doctor was licensed to practice in California, or 2) if a doctor from Texas may practice in California on a Texas license (doubtful). Certainly, a doctor may render emergency care to someone, one human being to another, but the use of injectable medications such as propofol and merperidine in an unmonitored setting seems pretty outside the norm no matter where your license is from.

In order to practice medicine legally in my state, I must hold a valid physician’s license, a valid controlled substance license, and in order to prescribe medications, a valid DEA license. In order to avoid disciplinary actions, I must also practice in a way congruent with standard medical practice, for example, maintaining proper documentation. The specific section of the Public Health Code says:

An individual licensed under this article shall keep and maintain a record for each patient for whom he or she has provided medical services, including a full and complete record of tests and examinations performed, observations made, and treatments provided.

If this doc was treating Jackson, he should have been recording Jackson’s complaints, his own physical exam findings including vital signs, medication administration including amount, route, and timing—really, everything. This is Medicine 101. Of course, if he was practicing without a valid license, who knows what kind of paper trail he would or would not wish to have.

In the news crapnami that is the Michael Jackson story, one useful lesson might be learned; that of the fatal intersection of power, fame, and medicine. It’s not a new lesson, but one that may require quite a bit of repetition. Unfortunately, I think we will have many future opportunities for review.

Comments

  1. #1 PalMD
    July 22, 2009

    testing

  2. #2 DVMKurmes
    July 22, 2009

    When I heard that propofol was potentially used to help Michael Jackson sleep, I was shocked. I use it all the time to anesthetize animals for short periods, and I would never do it without monitoring equipment and oxygen and the ability to assist ventilation. Those are the minimum requirements to administer injectable anesthetics to animals. Jeez.

  3. #3 drcharles
    July 23, 2009

    very true. i think the more celebrity power someone has, the more star struck some of these doctors get. their willingness to please and satisfy every bizarre and potentially dangerous “patient” request stems from their utter replaceability if they don’t bend to the celebrity’s demands for drugs, see ya. a sharing of power in the doctor-patient relationship keeps it healthy i think.
    plus, MJ was paying this doctor like 150K a month I heard!

  4. #4 Jon H
    July 28, 2009

    “plus, MJ was paying this doctor like 150K a month I heard!”

    I think it’s more about the money than about being ‘star-struck’. In fact, they’re probably the opposite of ‘star-struck’, and see celebrities as sheltered, isolated, ignorant marks ready to be fleeced.

    I think that’s especially the case with people like Jackson’s doctor, who latch onto a particular celeb.

  5. #5 James Sweet
    July 30, 2009

    I’m going to reserve judgment on Jackson’s doctor for the time-being, but the fact that the warrant that was recently executed on his office and his computers made reference to “manslaughter” is not a good sign for him. Yikes…

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