Josh -
Yes I am "in the field" but dont know all about it. I am familiar with many drug regulations. What you are describing is doc shopping.
You have to remember the physician only knows what you tell them and they do not know if you are lying or not. No physician is going to write scrips that place a patient in danger or at risk for addiction without some presentation of symptoms or complaint by the patient. Granted, there are some physicians out there who will do anything for a buck, but those are few and far between.
You asked about generalist physicians being able to write all drugs.
Most physicians these days are Board Certified in something including Family Practice - they are not the General Practicioner from the days gone by. These physicians have more access to more knowledge than any physicians in the past (electronic PDRs, orders written from a PDA and delivered directly to the Pharmacy). Today the pharmacist is better trained, better equipped and is more a part of the process than ever before. The pharmacist has computer programs that can track patients across locations (docs do not), and they can notify physicians rapidly if something seems strange.
More regulation is not needed, More limiting of access is not needed. The current metropolitan provision of care practice is to keep all you can at the Primary Care level - think referrals from HMOs.
If you went to your doc, who determines what is wrong and what you need but turns to you and says - Mr. Josh, you are suffering from insomnia secondary to your stress of learing all your work for your A cert. I cannot help you because some guy from Lake Worth thought it would be a good idea to limit my access to treatments. We called the specialist, who is right next door, who I went to the same medical school with but took another test to get the drug stamp on his medical license.
The good news? Your condition can be treated with one med and you will see immediate results and it will control this issue in little more than a week of treatment.
The bad news? He can see you - - in 2 months, AND he will need to repeat the studies we have already done because by then they will be over 90 days old- - AND you will have taken your Cert exam 3 weeks before his first available appointment IF - you can get your insurance company to give you a referral.
Not real practical and the issue you wrote about was not caused by, precipitated by or the fault of the physician - it was the patients who caused this problem.
This has gone on forever - your kids even do it - "Dad can I have an Ice cream?" do you answer it (not being home all week and tickled they asked you) or do you say, "did you ask your Mother?" Same deal with the patient, except the physician has 600 kids, a staff of 7, a life and 30 different insurance company guidelines to follow and doesnt always think to ask. Perspective is a wonderful thing.
I am too Libertarian to ever want to expand governmental rules