NP pill mill

learn how to start a private practice
This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.
Members do not see this ad.
TikiTorches said:
Like I said, theres a nurse with a felony. Thats a pretty low bar. The licenses from state to state are not connected for any professions. Sometimes people sneak until they get caught. The bar for criminal prosecution is high so it takes time to get the proof together.
Click to expand...

And here we have a neurosurgeon who performed surgery while high on cocaine on residency and he still got licensed and a job. Also a pretty low bar. Bottom line, the standards for almost all healthcare professions is pretty low. I don't think anyone can honestly make a claim that their specific specialty has a board that is any better or worse than others for the most part. I'd imagine a 30 second google search, or quick perusal of state board sanctions will show pretty much every profession has examples of people who have been allowed to practice despite some pretty heinous and/or dangerous behavior.
 
WisNeuro said:
And here we have a neurosurgeon who performed surgery while high on cocaine on residency and he still got licensed and a job. Also a pretty low bar. Bottom line, the standards for almost all healthcare professions is pretty low. I don't think anyone can honestly make a claim that their specific specialty has a board that is any better or worse than others for the most part. I'd imagine a 30 second google search, or quick perusal of state board sanctions will show pretty much every profession has examples of people who have been allowed to practice despite some pretty heinous and/or dangerous behavior.
Click to expand...

Substance abuse is a disease. Many professionals in many disciples find themselves in rehab. Professional boards have discovered that heavily punishing addicts prevents seeking treatment. While the physician or other professional may be monitored after rehab, I am not surprised by a surgeon with an addiction returning to practice. I’ve met many in my line of work.
 
TexasPhysician said:
Substance abuse is a disease. Many professionals in many disciples find themselves in rehab. Professional boards have discovered that heavily punishing addicts prevents seeking treatment. While the physician or other professional may be monitored after rehab, I am not surprised by a surgeon with an addiction returning to practice. I’ve met many in my line of work.
Click to expand...

Abusing substances is one thing, doing it in a situation in which you could likely kill someone is another. Kind of besides the point in this case. I'm sure we could find a variety of non substance abuse examples to draw from in a cursory search. Fact is, standards of practice in most healthcare professions is varied, and often pretty low. We are not some paragons of virtue and integrity as professions relative to others. Just like others, most tend to protect their own, often at the expense of public safety.
 
WisNeuro said:
Abusing substances is one thing, doing it in a situation in which you could likely kill someone is another.
Click to expand...

The disease aspect doesn’t allow them to make appropriate decisions on when and where.

I’ve seen physicians lose licenses for prescribing opiates with no known deaths, not supervising a midlevel closely enough, consensual relations with a patient, and criminal activity outside of medicine. A less severe but more commonly punished issue is prescribing to friends/relatives and not retaining a clinical note (no malpractice suspected). Depending on the state board, some are quite strict.
 
TexasPhysician said:
Substance abuse is a disease. Many professionals in many disciples find themselves in rehab. Professional boards have discovered that heavily punishing addicts prevents seeking treatment. While the physician or other professional may be monitored after rehab, I am not surprised by a surgeon with an addiction returning to practice. I’ve met many in my line of work.
Click to expand...

😏
that’s like saying “substance abuse is a disease, so this person shoudnt be held liable for murdering someone while high” or “alcohol abuse is a disease so that alcoholic shouldn’t be charged for hitting someone while driving drunk”. Sorry but at some level people have their own agency too.

It doesn’t sound like you may be too familiar with the Duntsch case as well which is what the poster was referring to. It was a pretty egregious case.
 
calvnandhobbs68 said:
😏
that’s like saying “substance abuse is a disease, so this person shoudnt be held liable for murdering someone while high” or “alcohol abuse is a disease so that alcoholic shouldn’t be charged for hitting someone while driving drunk”. Sorry but at some level people have their own agency too.

It doesn’t sound like you may be too familiar with the Duntsch case as well which is what the poster was referring to. It was a pretty egregious case.
Click to expand...

I’m not referring to the Duntsch case, but it seemed like posts were moving toward how boards aren’t strict enough. I’ve seen just the opposite.

Legally I agree that substances are not an excuse to avoid charges, but I do believe state boards should help physicians treat any medical condition to safely get back to work. You can protect the public and the physician simultaneously in many cases.
 
Kind of off topic, but from what I understand William Halstead did most of his operating while on cocaine. Apparently he typically had incredible results. I’m not, however, suggesting it should be the standard of care.
 
TexasPhysician said:
If we punish every physician, NP, PA, counselor, etc for every alleged complaint by a psych patient, there would be none left. Your situation may have proof - I have no idea how serious to take it. I have no doubt that some are real victims. The counseling board gets these complaints more frequently. I’ve had a complaint against me for assault. Further research revealed that I prescribed a medication that was the color red. The devil hid in the red pill and caused stomach pain. The stomach pain was a result of my prescribing, hence I assaulted his abdominal area.

We can debate alleged complaints all day, but prescribing history and notes don’t lie.
Click to expand...
I don't think notes lie on purpose most of the time (maybe sometimes or are written defensively).

But notes do suffer accuracy problems, which is to be expected given the amount of information being dispensed and the amount taken down. I've looked through my own progress notes and found really big errors of understanding that were not malicious at all but just totally missed the mark.

There's also the issue that notes are often aspirational. They are called progress notes after all. If a practitioner were to write realistically that a patient continues to languish they would have to call into question their rationale for continuing to see said patient. And so instead they often tend to focus on a technique the patient might intend to use in the future when faced with a similar problem. If you look at progress notes as a whole, like over a year, they often tend to paint a rosier picture than if you look at that year statically at one moment in time and assess progress from point A to B. Week to week or month to month, it might seem like iterative progress is being made (or could be made) when none might be at all or might even be backsliding.
 
TexasPhysician said:
I’m not referring to the Duntsch case, but it seemed like posts were moving toward how boards aren’t strict enough. I’ve seen just the opposite.

Legally I agree that substances are not an excuse to avoid charges, but I do believe state boards should help physicians treat any medical condition to safely get back to work. You can protect the public and the physician simultaneously in many cases.
Click to expand...
"getting back to work" is not, and shouldn't be, the primary goal of a medical board
 
VA Hopeful Dr said:
Don't believe he said it was, hence the last part of his post.
Click to expand...
It seemed to me they were implying that anything related to medical could be worked past, if your addiction had you putting patients at risk I'm fine with a doctor being done with medicine
 
sb247 said:
It seemed to me they were implying that anything related to medical could be worked past, if your addiction had you putting patients at risk I'm fine with a doctor being done with medicine
Click to expand...
And that's your right to think that. But, if we are subscribing to the idea that addiction is a chronic disease it's no more reasonable to permanently revoke a license because of addiction than it would be to revoke one because a diabetic had a hypoglycemic episode and put patients at risk during that.
 
sb247 said:
It seemed to me they were implying that anything related to medical could be worked past, if your addiction had you putting patients at risk I'm fine with a doctor being done with medicine
Click to expand...

If it’s any help, my licensing board considers 1 alcoholic beverage while on home call to be considered endangering patients and requires inpatient rehab to restart practicing.
 
VA Hopeful Dr said:
And that's your right to think that. But, if we are subscribing to the idea that addiction is a chronic disease it's no more reasonable to permanently revoke a license because of addiction than it would be to revoke one because a diabetic had a hypoglycemic episode and put patients at risk during that.
Click to expand...
I’m not proposing it over a diagnosis of addiction but over an incidence of practicing while under the influence, those are different
 
VA Hopeful Dr said:
And that's your right to think that. But, if we are subscribing to the idea that addiction is a chronic disease it's no more reasonable to permanently revoke a license because of addiction than it would be to revoke one because a diabetic had a hypoglycemic episode and put patients at risk during that.
Click to expand...

Just to play devil’s advocate, in either case it kind of depends upon the judgement of the physician involved. If the physician is intentionally overdosing on insulin while at work, that would imply a lack of judgement akin to someone who is drinking on the job.

The medical/chronic disease model of addiction is overly simplistic and ignores the fact that while there is certainly a biological/physiological component to addiction, there is also a behavioral component. The idea that people who suffer from addiction no longer have agency or control over their behavior is both wrong and disempowering to people with addiction.

No one should be punished because they suffer from addiction per se, but regardless of our medical and psychiatric conditions we are responsible for self-monitoring our ability to safely care for patients (and seek help/take a break from practice before we put people at risk)
 
Old&InTheWay said:
Just to play devil’s advocate, in either case it kind of depends upon the judgement of the physician involved. If the physician is intentionally overdosing on insulin while at work, that would imply a lack of judgement akin to someone who is drinking on the job.

The medical/chronic disease model of addiction is overly simplistic and ignores the fact that while there is certainly a biological/physiological component to addiction, there is also a behavioral component. The idea that people who suffer from addiction no longer have agency or control over their behavior is both wrong and disempowering to people with addiction.

No one should be punished because they suffer from addiction per se, but regardless of our medical and psychiatric conditions we are responsible for self-monitoring our ability to safely care for patients (and seek help/take a break from practice before we put people at risk)
Click to expand...
I agree, but it is well established that people suffering from addiction have impaired judgement so while it's unwise to completely absolve them of all responsibility neither is it reasonable to assume they have the same capacity for sound judgement that you and I do.

It's why I think the current way it's usually handled is pretty good: lose your license temporarily until you've shown you have things under control.
 
sb247 said:
Why don’t you share what you think I should know that would change my opinion and we’ll discuss it.
Click to expand...
You come off as having a very narrow perspective of addiction pathology, and your posts seem to imply that you believe there’s an inherent moral and/or character pathology underlying addiction.
 
Taddy Mason said:
You come off as having a very narrow perspective of addiction pathology, and your posts seem to imply that you believe there’s an inherent moral and/or character pathology underlying addiction.
Click to expand...
You misunderstand. I literally don't care why someone showed up to work altered on a substance.

If it's some moral failure and your made a conscious decision, you shouldn't be trusted because you chose to make bad decisions..
If it's because some disease literally precludes you from being able to make good decisions, you shouldn't be trusted because your disease overrides your ability to make decisions at all.

Either way, if a doc came in and risked a patient I am fine with their medical career being over. I get that not everyone feels that way
 
sb247 said:
You misunderstand. I literally don't care why someone showed up to work altered on a substance.

If it's some moral failure and your made a conscious decision, you shouldn't be trusted because you chose to make bad decisions..
If it's because some disease literally precludes you from being able to make good decisions, you shouldn't be trusted because your disease overrides your ability to make decisions at all.

Either way, if a doc came in and risked a patient I am fine with their medical career being over. I get that not everyone feels that way
Click to expand...
I do understand. The world isn’t black and white.
 
sb247 said:
You misunderstand. I literally don't care why someone showed up to work altered on a substance.

If it's some moral failure and your made a conscious decision, you shouldn't be trusted because you chose to make bad decisions..
If it's because some disease literally precludes you from being able to make good decisions, you shouldn't be trusted because your disease overrides your ability to make decisions at all.

Either way, if a doc came in and risked a patient I am fine with their medical career being over. I get that not everyone feels that way
Click to expand...
Good thing you’re not the one making decisions regarding who’s career is over
 
Jules A said:
He admitted it and yeah prescribing history was terrible also.
Click to expand...

I know of a case very similar. The guy admitted to sex with a patient as well as diverting a controlled substance to that patient and others. He had his license suspended for <5 yrs during which he tried pretty much every 12-18 mos via lawyers to get it back until he got it back (or as the board put it, he demonstrated remediation and fulfilled required treatment). He saw no jail time. He was also allowed to keep his current highly lucrative practice with lots of other psychiatrists, psychologists, and PNPs, but simply barred from any associated patient contact.

All of the information is public record in the meeting minutes of the medical board.

I'm not saying boards are soft, but like anything else, if you have the right connections and the right money, there are always ways to get back to practicing. Not sure if Duntsch would be able to ever get back though given how high profile that case was.
 
sb247 said:
You misunderstand. I literally don't care why someone showed up to work altered on a substance.

If it's some moral failure and your made a conscious decision, you shouldn't be trusted because you chose to make bad decisions..
If it's because some disease literally precludes you from being able to make good decisions, you shouldn't be trusted because your disease overrides your ability to make decisions at all.

Either way, if a doc came in and risked a patient I am fine with their medical career being over. I get that not everyone feels that way
Click to expand...

So if a surgeon with relapsing remitting MS that they think is managed with their current treatment acutely loses muscle control during a surgery (and injures their patient) their career is over? Or is this line-in-the-sand specifically for working altered on substances and not other medical disorders?
 
TexasPhysician said:
If it’s any help, my licensing board considers 1 alcoholic beverage while on home call to be considered endangering patients and requires inpatient rehab to restart practicing.
Click to expand...
That's pretty intense. So do you think it keeps people from having a beer when they're on home call, or do they just end up hiding the behavior?
 
Merovinge said:
So if a surgeon with relapsing remitting MS that they think is managed with their current treatment acutely loses muscle control during a surgery (and injures their patient) their career is over? Or is this line-in-the-sand specifically for working altered on substances and not other medical disorders?
Click to expand...

Not the person you were asking but I'd have to say that yes in the above case since there was an adverse incident that surgeon should no longer be working in that exact capacity. Sadly life doesn't come with guarantees and many things could cause our careers to be altered or even ended. I would hope the process is thoughtful and fair but bottom line physicians aren't immune simply because of the time, effort and money spent on their career choice.
 
FlowRate said:
That's pretty intense. So do you think it keeps people from having a beer when they're on home call, or do they just end up hiding the behavior?
Click to expand...

Not sure. An anesthesiologist I know pushed the limit by having a beer at a holiday party while on home call. Nurse snapped a photo. About $60k for addiction treatment before he could restart monitored care.
 
TexasPhysician said:
Not sure. An anesthesiologist I know pushed the limit by having a beer at a holiday party while on home call. Nurse snapped a photo. About $60k for addiction treatment before he could restart monitored care.
Click to expand...

This is why i never do any social media EVER or associate with any work related personnel outside of work activities. It is all a way to either get robbed or get yourself into some type of trouble.
 
Merovinge said:
So if a surgeon with relapsing remitting MS that they think is managed with their current treatment acutely loses muscle control during a surgery (and injures their patient) their career is over? Or is this line-in-the-sand specifically for working altered on substances and not other medical disorders?
Click to expand...
That is not the same as intentionally taking an altering substance and you know it
 
finalpsychyear said:
This is why i never do any social media EVER or associate with any work related personnel outside of work activities. It is all a way to either get robbed or get yourself into some type of trouble.
Click to expand...
You could also just have a good time without drinking while on call. Some work parties are actually just a decent time with decent people.
 
You must log in or register to reply here.

Similar threads

A
Np supervision stipend
Replies
27
Views
2K
psydocc
psydocc
W
Hiring a NP in Texas
Replies
5
Views
1K
michaelrack
M
wolfvgang22
NP "collaboration"
2
Replies
75
Views
5K
FlowRate
FlowRate
W
WSJ Article about ADHD Pill Mills
Replies
44
Views
4K
MacDonaldTriad
MacDonaldTriad
D
Supervising NP- does it normally take this long?
Replies
43
Views
3K
ObsequiousAplomb
O
Top