Coordinated Doctor Take Down

[BAM!]

Here's the next new one about a coordinated multi-state effort to arrest doctors who are over prescribing narcotics. As I understand it, these guys have been painted as pill mills and intentional diverters. Still it makes me wary about prescribing opiates.

DOJ announces charges against 400 people for $1.3 billion in health-care fraud

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[Tenk]

When you do the math on these people it's ridiculous, like they prescribe more opiates in a week to a month than you do in a career. Don't worry about it. This is a good thing.

 

[plick]

"A clinic in Houston allegedly gave out prescriptions for cash. Officials said one doctor at the clinic provided 12,000 opioid prescriptions for over two million illegal painkiller doses. And a rehab facility for drug addicts in Palm Beach that is alleged to have recruited addicts with gift cards, visits to strip clubs and drugs billed the government for over $58 million in false treatments and tests."

If all those allegations are true, then go after those providers. That's actually protective of the medicine profession in general.


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[Status Sciaticus]

cant read the link. WaPo wants me to pay for news... nah.

 

[southerndoc]

Opiate prescriptions are being scrutinized. Many states now run reports that show physician prescribing practices outside the norm (more than 1 SD above the norm) for their specialty. If you're an ophthalmologist writing a lot of opiates, you're going to get scrutinized. I know of one emergency physician in another state who was reprimanded by the state medical board, and that reprimand subsequently put him on probation with at least 2 other neighboring states.

Be strong, resist the urge for opiate seekers. Only write when necessary.

 

[bravotwozero]

Opiate prescriptions are being scrutinized. Many states now run reports that show physician prescribing practices outside the norm (more than 1 SD above the norm) for their specialty. If you're an ophthalmologist writing a lot of opiates, you're going to get scrutinized. I know of one emergency physician in another state who was reprimanded by the state medical board, and that reprimand subsequently put him on probation with at least 2 other neighboring states.

Be strong, resist the urge for opiate seekers. Only write when necessary.

What if I never write for more than 15 Norco tablets at a time for any prescription? Does that put me above the mean?


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[shoal007]

What if I never write for more than 15 Norco tablets at a time for any prescription? Does that put me above the mean?


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no. you will be fine. treat peoples pain. seekers are going to trick you. Until press ganey and hospital admin pain control numbers matter, you will get in more **** by not treating. youre not a detective, youre a doctor.

that said i dont give seekers pain meds. i check the states pmp. i ask.

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[MSmentor018]

as long as you're not writing for powdered oxycodone, you're probably ok!

Pain clinic doctor linked to three patients' deaths has long troubled past

 

[Vandalia]

I keep an eye on the board disciplinary actions in my state. With controlled substances, these are not close cases. There has never been one yet where I have even remotely thought that the physician was prescribing in good faith. Basically, take what you consider appropriate, multiply it by about 5 and you will still be far away from the amounts that currently result in legal/disciplinary action.

There are things I worry about. Board/legal action over controlled substance prescribing does not make the top 10.

With that said, however, if you are a drug dealer masquerading as a physician, you should be worried.

 

[anbuitachi]

as long as you're not writing for powdered oxycodone, you're probably ok!

Pain clinic doctor linked to three patients' deaths has long troubled past

Looks like that guy is a orthopedic surgeon?? is he even a pain boarded doctor?

 

[MSmentor018]

Looks like that guy is a orthopedic surgeon?? is he even a pain boarded doctor?

according to the article, no. I personally don't know this guy. just came up in our local newspaper

 

[RustedFox]

I keep an eye on the board disciplinary actions in my state. With controlled substances, these are not close cases. There has never been one yet where I have even remotely thought that the physician was prescribing in good faith. Basically, take what you consider appropriate, multiply it by about 5 and you will still be far away from the amounts that currently result in legal/disciplinary action.

There are things I worry about. Board/legal action over controlled substance prescribing does not make the top 10.

With that said, however, if you are a drug dealer masquerading as a physician, you should be worried.

Quoted for truth. I've watched a few of these "pain doc" cases on the narcotic highway that is I-75 in Florida.

The (not so remote) spectre of nuclear war bothers me more than prescribing liberal amounts of narcotics.

 

[GeneralVeers]

I am sure I have brought up this guy before but it bears revisiting:
Doctor gets 20 years for operating pill mill clinics

I went to residency with this guy. Also google his name and there are some other interesting criminal accusations. This case should definitely make any EP think twice before joining a pain clinic.

 

[BoardingDoc]

I am sure I have brought up this guy before but it bears revisiting:
Doctor gets 20 years for operating pill mill clinics

I went to residency with this guy. Also google his name and there are some other interesting criminal accusations. This case should definitely make any EP think twice before joining a pain clinic.

Damn man. That residency sounds like a total ****show.
2 Residents at King/Drew Facing Criminal Charges

 

[MSmentor018]

From pill mill to prison, doctor says prescription drug arrest saved his life
Tampa police arrest doctor, owners of pain clinic operation
Pill mill doctor: I was driven by greed
you never know who does it. I Couldn't find this one article about an EM guy that ran his own "clinic" and the residents moonlighted there. the list
it goes on and on.....

 

[southerndoc]

I am sure I have brought up this guy before but it bears revisiting:
Doctor gets 20 years for operating pill mill clinics

I went to residency with this guy. Also google his name and there are some other interesting criminal accusations. This case should definitely make any EP think twice before joining a pain clinic.

I knew this doc when he worked in Atlanta. There were definitely concerns over him that ultimately led to his departure.

 

[gutonc]

Damn man. That residency sounds like a total ****show.
2 Residents at King/Drew Facing Criminal Charges

There's a (thousand) reason(s) it's no longer operating.

 

[Birdstrike]

double post

 

[Birdstrike]

I am sure I have brought up this guy before but it bears revisiting:
Doctor gets 20 years for operating pill mill clinics

I went to residency with this guy. Also google his name and there are some other interesting criminal accusations. This case should definitely make any EP think twice before joining a pain clinic.

Such a person as the one in your link is no more representative of Pain doctors, or Emergency Physicians who go into Pain medicine, than the NY Emergency Physician who was recently arrested for molesting his unconscious patients is representative of all Emergency Physicians.

These people are criminals, not doctors.
Pain is a legitimate field and a subspecialty of Emergency Medicine, now. But that's not what these drug dealers above are practicing.
If you want to do Pain as an EM physician, you don't "join a pain clinic" any more than if you wanted to be a cardiologist, you'd just hop on over and "join a cardiology clinic."
That's nuts.
You'd do an accredited Interventional Pain fellowship, get board certified in Pain and practice it the right way.
You'd focus on procedures (where appropriate), and other non-opiate treatments as much as possible, and only use opiates in a limited, strictly monitored, low-moderate dose fashion, only where appropriate, if at all.
Because that's what's best for people.
If you do a kyphoplasty on an 81 year old with a compression fracture, are you a 'pill mill'?
If you injection a 35 year old tennis player's shoulder with kenalog are you a 'pill mill'?
If you put a spinal cord stimulator in a person who's been maimed by multiple failed back surgeries are you somehow doing something wrong?

No, no, and no.

Don't equate these people with "Pain doctors," "Pain Medicine," "Emergency Medicine" or even "Medicine" in general.
This guy in your article, did no Pain fellowship, had no board certification, just hung a shingle and started trading cash for narcotics for pregnant women so he could get a Ferrari (allegedly.) Per another article he also pocketed the Rolex of a dying patient during a code (allegedly.)

That's not a "Pain" doctor.
That's not a doctor at all.
That's a garden variety drug dealer.