In a recent Medical Board of California meeting, significant concerns were raised regarding the treatment practices of a physician who failed to monitor a patient prescribed methadone for six years. The board highlighted that the physician, referred to as the respondent, did not perform any EKGs to monitor the patient for QT prolongation, a serious risk associated with methadone use. This lack of monitoring is particularly alarming given that methadone can cause abnormal cardiac rhythms, which may lead to sudden death, even in patients without prior heart issues.

Expert testimony from Dr. Chong, a fellowship-trained pain management specialist, underscored the importance of regular EKGs for patients on methadone. Dr. Chong explained that the standard of care dictates an initial EKG and periodic follow-ups to ensure patient safety. He noted that the FDA has issued a black box warning about the cardiac risks associated with methadone, emphasizing the necessity of monitoring.

In contrast, the respondent's expert witness argued that EKGs were not required, despite acknowledging that he performs them for all his own patients on methadone. The respondent claimed to have relied on verbal assurances from the patient that previous EKGs were normal, without obtaining any written documentation or confirming with other healthcare providers.

This meeting highlighted critical gaps in patient monitoring practices and raised questions about adherence to established medical standards. The board's discussions reflect a growing emphasis on patient safety and the need for rigorous monitoring protocols in the treatment of chronic pain with potentially dangerous medications like methadone. As the Medical Board continues to evaluate these practices, the implications for patient care and physician accountability remain significant.