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.