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Busted in South Florida......rx for out of state patients

Discussion in 'Pain Medicine' started by Doctodd, Apr 6, 2009.

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  1. Doctodd

    Doctodd

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    Im so happy i dont have to deal with this type of thing.......

    http://www.miamiherald.com/467/story/986161.html
  2. pmrmd

    pmrmd

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    the things that go on in south florida never cease to amaze.
  3. geauxg8rs

    geauxg8rs

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    South Fla
    Wordwide leader in blind facets


    I love getting patients from down south who come in and state " I just need you to refill my oxycodone. I don't need all this exam stuff." I confront them about their normal films and normal MRI. I see that their "pain doc from Myhammi" never tried anything other than oxycodone. I say to try something non narcotic and they never follow back up.
    Makes life simple.
  4. PMR 4 MSK

    PMR 4 MSK Large Member SDN Advisor

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    The key is the "my". They personalize the medication. It belongs to them, you are just the neccesary evil who has to write a note allowing the pharmacist to give them what is rightfully "theirs". To me it shows at least a psychological dependency on the medication, usually a chemical coper.

    I get things like "You took away my Soma!" No I didn't, I just declined the opportunity to prescribe it to you.

    Or, "My family doc says he won't give me my vicodin any more. He says you are going to give it to me from now on." Oh he did, did he? Well, that was nice of him to make that medical decision for me. Well, since he already knows what you need, he doesn't need my input and should be quite capable of giving you "your" medication.
  5. Tenesma

    Tenesma Senior Member

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    so far... for 2009... i have not had ANY consults where anybody is requesting narcotics or that i prescribe the narcotics in lieu of PCP/specialist.... i have had less than a handful of referrals for narcotic recommendations...

    it is amazing how NOT prescribing narcotics has become a self-fulfilling practice

    i personally think that the docs in Florida should be treated like the drug dealers they are....
  6. Xardas

    Xardas

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    The docs that do this usually have other deep seated problems... this is the guy that was busted in the article.

    [FONT=Arial, Helvetica, sans-serif]April 13, 2007: Sexual Battery Attempt (Dr. Roger Brown).[FONT=Arial, Helvetica, sans-serif]Coral Springs Police Department announced the arrest of a local medical doctor for an attempted sexual battery against an intern in his office. On the evening of April 10, 2007, the doctor and victim went to a local restaurant for appetizers and drinks after closing the office. At approximately 11:00 pm, they returned to the office parking lot in the doctor vehicle due to the rain. While in the vehicle the doctor made several advances towards the victim to include fondling the victim and with the doctor masturbating while on top of the victim. The victim made several attempts to stop the doctor to no avail. The victim was able to leave the vehicle and reported the incident to the Coral Springs Police Department.

    The doctor was identified as Roger A. Browne, age 51, of Pembroke Pines, Florida. The office where the doctor conducted his medical practice and where the victim was an intern is the Americare Health Center, 6263 West Sample Road, Coral Springs. The doctor was arrested and charged with Sexual Battery – Attempt. The doctor was later turned over to the Broward Sheriff Jail.

    The suspect is an employee of the clinic, not the owner or partner of Americare Health Center.

    Probable Cause affidavit available upon request; arrest photo may be obtained through the Broward Sheriff’s Office upon availability.
    .
  7. Kwijibo

    Kwijibo Member

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  8. algosdoc

    algosdoc algosdoc

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    Our office has been approached by 2 different companies asking us to set up in office drug dispensing. The practice is not new and I worked in an office 25 years ago where this was done, but the dispensing of drugs in this era is fraught with many issues that were ignored in 1984. The use of pharmacists with their computerized drug cross checks, their familiarity with substance abusers, their connections with other pharmacists in different chains, and their close adherence to the state and federal drug laws are imperatives in my book. They provide a layer of insulation and cross checks between prescribers (of which there may be many) and the recipient, and may refuse to fill scripts or will call physicians regarding the wisdom of scripts given the proclivity of some patients to doctor shop. The placement of dispensing devices for potent opiates in an office serves to disable the cross check system we rely on by pharmacists and move the physician one step closer to being a drug dealer, especially when there is a monetary volume incentive. It is prudent therefore to eschew the acceptance of in-office opioid dispensing and instead maintain an arms-length transaction between prescriber and dispenser of these potentially lethal drugs. Clearly it is poor form to prescribe opiates to large numbers of patients that are several states away, and unless there is a compelling reason to do so, is unwise in patients from adjacent states.
  9. Doctodd

    Doctodd

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    this is Darwin's theory at work
  10. PMR 4 MSK

    PMR 4 MSK Large Member SDN Advisor

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    How much you want to bet people are getting several guys/gals together, driving down there, hitting as many of the clinics as they can, and leaving, with literally thousands of pills, worth tens to hundreds of thousands of dollars?

    How much you think these clinic are benefitting from all the free press?

    DEA can bust the doctors, but if it's non-docs owning the clinics, they'll just hire someone else who's shady enough to do it.

    For those of you in Houston (Gorback, still here?) is the I-10 medical clinic still there on the far east side? It was run a lot like the desciption in this article. Armed gaurd. 100's of pts/day. Pills sold through pharmacy in same building. They were at least willing to help bust doctor-shoppers by sending out a list of pt's they had on opioids.
  11. Tenesma

    Tenesma Senior Member

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    totally agree w/ algos on this one....
  12. AviatorDoc

    AviatorDoc fizz ee at' rist

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  13. algosdoc

    algosdoc algosdoc

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    I am so incensed over this I wrote the FL Medical Board today...they have the power to regulate practice of physicians by requiring standards of practice by fiat rather than having to resort to the cumbersome and several year long process of legislative intervention. Some of their physicians are out of control and are simply drug pushers.
  14. Doctodd

    Doctodd

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    i for one appreciate that algos......i know FSIPP has been fighting a long battle over this
  15. algosdoc

    algosdoc algosdoc

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    The executive director kindly responded to my query stating that there are numerous legislative initiatives in progress for a state prescription monitoring program. Unfortunately, this would not deter those practicing as drug dealers from continuing to advertise for out of state addicts and those that would divert the drugs to come to sunny florida for narcotics. This is one of the greatest dangers of a narcotic only pain practice: everyone needs narcotics and usually in high doses, and with no local physician-patient relationship and no contact with law enforcement where the patients live, this is a recipe for disaster. Hopefully the medical board will initiate a RULE that would curtail these practices rather than wait for the legislature to try to figure out what ethical practice is for physicians.
  16. Doctodd

    Doctodd

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    I received a postcard in my PO box last week with the headline "FLorida Prescription Drug Monitoring Program has Been Hijacked by FSIPP"......apparently one of the Pain Clinic owners in Venice, FL (no MD behind his name) has started a website opposing closing down his type of business. FSIPP has requested and was approved changing the wording to give more power to the board when imposing regulations and the "fine print" of the law....i dont have too much sympathy for his type of pain clinic. He seems to think Medicaid patients are being left out in the cold with this legislation and he is standing up for their rights....how sweet.

    http://flpainnews.com/
  17. Doctodd

    Doctodd

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    Tunrs out karma may have bitten me for my sarcasm....my godfather just called me saying his daughter is addicted due to a doc disopensing oxyc and xanax and more. Apparently part of his h and p was to ask how much she thought she needed.
  18. PMR 4 MSK

    PMR 4 MSK Large Member SDN Advisor

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    A state prescription monitoring program will only work if the docs check it, which the drug dealers won't.
  19. PMR 4 MSK

    PMR 4 MSK Large Member SDN Advisor

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    Doctors don't make addicts. Addiction is complex biopsychosocial disease werein the primary problem lies with the addict and their maladaptive use of the substance. The "4 C's", denial, deterioration, etc.

    Doctors can be complicit in the maintenance and worsening of addiction, either by poor training, ignorance, neglect or malice. But they don't make someone addicted - that happens as the patient loses control over their use of the drug. Failure to recognize and treat the addiction is the doctor's problem.

    I've had patients who have shown themselves to be addicts, and when confronted/approached about it, used the defense mechanism "You made me into an addict!" No, you chose to take more medication than I prescribed, and/or to take it for reasons other than pain. I'm trying to help you, before to provide pain releif, now to treat a new diagnosis.

    I got a patient into rehab once(one of the few who ever went). 6 months later, not having seen me since rehab, she OD'd and died. Her sister reported me, her other pain med-prescribing docs, her PCP and her pharmacy to the state boards. My records proved me innocent and the case was dropped against me with no action. 2 of the other docs surrendered their licenses and another was sanctioned. The pharmacy and pharmacist, I believe were also found to be not at fault.

    The sister also asked for a copy of the records as the next-of-kin. I assume she took them to a lawyer, but no case was ever brought against me for it. Then, in a newspaper report after her sister's funeral, "She places the blame for her sister's death squarely on the shoulders of the doctors who were feeding her sister pain pills." Not the boyfriend who went to jail shortly before that for drug dealing. Not the patient who chose how many pills to take that day. Musta been the doctors. The fact that she (the pt) was getting drugs from at least 4 different docs (at least prior to rehab) didn't matter to her (the sister).

    That one case went a really long way toward my current approach to treating chronic pain patients with opioids.
  20. Doctodd

    Doctodd

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    i know what u mean, and i know the patient has responisiblity too. But this doc isnt an oncologist giving out palliative Oxycontin. He is exactly what is being described in the press.

    I dont consider your experience as remotely similar to this situation. This doc is prescribing narcotics out of his office, paid in cash, and not doing what you or me would call an H+P for each visit. He is prescribing more than the standard of care (i was told 240 pills of Oxyc and alot more) each month and not doing any urine screens. As far as i know there is no MRI or other objective evidence. Im leaving certain details out.....Sorry if im being defensive, but hopefully you understand.

    All that being said, this is an opportunity for a sting operation.
    Last edited: Apr 14, 2009

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