Family practitioner as pain doc. I had a new patient today that was a victim. Monthly CT guided injections for 5 years!
UNITED STATES OF AMERICA v. PETER TSAI | FindLaw
FindLaw's United States Sixth Circuit case and opinions.
There his career began to slide. Not long after hiring Tsai, the VA fired him for “unprofessional and improper conduct, misuse of government equipment, waste of time and the accessing of unauthorized and pornographic websites.” Tsai and his girlfriend, a psychiatric aide, moved across the Ohio River to start a medical-imaging center in Coal Grove, Ohio. Tsai's parents put up $900,000 for a computerized tomography (CT) scanner and assumed a $600,000 mortgage on an office building. The new Watkins-Tsai Imaging Center floundered: Tsai had trouble showing up to work, and days passed without any patients.
Tsai's parents intervened. They helped him set up a medical practice, Advanced Family Medical Center, across the hall from the imaging center. They also moved to Ohio to oversee operations, and brought in Tsai's cousin to handle patient billing. Advanced Family took off, and the imaging center's fortunes changed for the better. At first, the offices' stock-in-trade was the treatment of purportedly arthritic knees: Tsai would “diagnose” his Advanced Family patients, including teenagers as young as 15, with osteoarthritis after briefly touching their knees. Then he would direct them to the imaging center so that the patients could receive injections of Synvisc (an arthritis medication), guided by unnecessary CT scans of their knees.
After focusing for several years on his patients' knees, Tsai started diagnosing nearly all of his patients with piriformis syndrome, a rare condition that causes pain in the lower back and legs. These diagnoses too would create work for his CT scanner, since piriformis treatments required a general scan of the patient's hip and another scan to guide Tsai's injection of lidocaine and steroids into the patient. Many of Tsai's patients returned for repeated steroid injections and CT scans. One patient received 85 scans over a period of three years. Tsai kept his patients coming back by making their prescriptions for pain medications contingent on more scans and injections. Tsai diagnosed piriformis quickly—usually after a quick touch of the patient's back—and liberally. An Advanced Family employee testified at trial that Tsai once walked into the clinic's waiting room near the end of a workday and went around to each patient, saying “You need a shot”; “You need a shot”; “You need a shot.” One person in the waiting room at that time went to the front desk after Tsai told her she needed a shot and said, “I'm not even a patient here.”
