Tuesday, August 31, 2010

When DEA Plays Doctor, the Patients Are Always the Loser

Last year a local pain management physician was arrested by DEA's Tactical Diversion Squad and charged with not only improperly prescribing drugs, but also money laundering, conspiracy and assisting in a criminal syndicate. Attention was focused on him partly because he had patients from several states.

It’s not uncommon for pain management specialists, or any medical specialist to have a large practice with patients form a wide geographical area. So few doctors are willing to treat pain today, any physician willing to do pain management ends up with not only the pain patients from their local area, but usually from hundreds of miles away.

When DEA arrests a pain management physician, or the state medical board suspends a pain physician’s medical license, the media concentrates on the charges filed against the doctor, when the story should be about what happens to the physician’s patients.

When a pain management specialist is arrested by DEA, their DEA registration is suspended, and their practice is shut down. Patients end up abandoned, stigmatized, and neglected by the whole medical community, because no other physician wants to be associated with doctor so-and-so patients.

I know because I was one of these patients. I can’t tell you how many doctors told me, "I can’t give you pain medication because I’ll lose my medical license if I do."

Medical boards tell us that patient abandonment is a serious charge against a physician, and can lead to malpractice law suits. Patient abandonment is defined as the termination of the professional relationship between the physician and the patient at an unreasonable time or without affording the patient the opportunity to find a new physician.

While there are no laws related to patient abandonment in Arizona, the American Medical Association has some guidance for physicians on how to close a medical practice without abandoning patients. Physicians are told to notify patients well in advance to ensure continuity of care, and send a letter to each active patient at least 3 months prior to closure. Avoiding abandonment complaints can be avoided by notifying patients of the physician’s intent to terminate their care in writing, and give the patient sufficient time to arrange for care by another physician.

Yet state medical boards that are supposedly run by physicians create situations themselves where hundreds of patients are abandoned by their actions when a pain management practice is closed. It time state medical boards consider continuity of care and patient abandonment when shut down a pain management practice.

Investigations into a pain management physicians practice go on for months or years, all the time allowing the physician to prescribe medications to their patients. So what would be the harm in allowing the physician to write pain patients at least a 30 day supply of medication to allow them time to find a new pain management specialist?

If shutting down the practice to protect patients was the priority, they would shut the practice down as soon as they have evidence of wrong doing rather than allow the physician to continue practicing for months. Who’s protecting the hundreds of patients abandoned by the actions of DEA or the state medical board it’s self.

Pain management specialists are often charged with murder when a patient overdoses from taking medications they prescribe. So why don’t we hold DEA and state medical boards responsible when they create a situation where patients are abandoned because of their actions, and commit suicide due to uncontrolled pain.

9 comments:

  1. It is more likely related to politics and the attitude of "We don't do that way here!" Practice the medical care suggested by Dr Portenoy and others in the field of chronic pain management field, anywhere, and you will find yourself unemployed. Not because you are not practicing modern medicine, as established by, specific, published, research, but because "you don't do it our way!" Believe me, I would like to have my job back!

    ReplyDelete
  2. Jay, as I read your piece I couldn't help but think of the "walk it off" types. My sense is some people are:
    • so galled by the thought of people lying to their doctors
    • so far removed from people in chronic pain
    • so far removed from having experienced intense pain themselves

    that they would rather err on the side of people suffering than let a few fakers have pills to get their jollies or illegally sell. Ironically as they try (in vain) to make the world a perfect place, they make it insufferable.

    You point out many sad ironies, particularly how it seems non-doctors (DEA) has bullied doctors to go against their oaths. But perhaps this is just the logical outcome since it seems the DEA and many in govt. take oaths to defend our Constitution, but actively and violently trash it.

    With regard to your last paragraph, if humans can't bring them to justice, God does. We have a law, conservation of mass/energy; there is a similar law in the spirit world.

    Those bullied doctors need to rally together with the courage of Mattew Fogg, to challenge and throw off their oppressors; it's a whole lot easier when they do it together (think Vienna Declaration) vs. being picked off one-by-one, and left hanging to dry like mlang52. Here are some quotes from the conned:
    “Go along, to get along”
    "Don't fight the system it will change in time"
    "Blacks employees must work hard and prove themselves as managers"
    "Just turn your head when you see injustice against citizens, you can't police everything"
    “It’s a good-old-boy network and they don't want minorities in the network”
    "You have a great career, please don't destroy it on a crusade against bad cops”
    "If you testify against the Marshals Service on Capitol Hill, management will destroy your career for sure"
    "The US Justice Department is too big with too many resources, you can’t win "
    "400 years of oppression is not going to change overnight with your complaints"
    "Being called a ‘Coon or Nigger’ by white employees is not all that bad"
    "Just continue to arrest those who we direct you to arrest even if they are all black"
    "I love you brother but if you go forward with your EEO Complaints then I can't be associated with you”
    "I have a family I must feed and these people will destroy you with there mighty power"
    "Take their settlement offer and take care of yourself because the black Marshals that you are standing up for are afraid and care about only themselves”
    "The Marshal Service will set you up and get you arrested or killed in the line of duty"
    "Please take the settlement money and run, they don’t need to admit to discrimination and just let your GOD handle the rest"

    ReplyDelete
  3. This comment has been removed by the author.

    ReplyDelete
  4. Jay, as I read your piece I couldn't help but think of the "walk it off" types. My sense is some people are:
    • so galled by the thought of people lying to their doctors
    • so far removed from people in chronic pain
    • so far removed from having experienced intense pain themselves

    that they would rather err on the side of people suffering than let a few fakers have pills to get their jollies or illegally sell. Ironically as they try (in vain) to make the world a perfect place, they make it insufferable.

    You point out many sad ironies, particularly how it seems non-doctors (DEA) has bullied doctors to go against their oaths. But perhaps this is just the logical outcome since it seems the DEA and many in govt. take oaths to defend our Constitution, but actively and violently trash it.

    With regard to your last paragraph, if humans can't bring them to justice, God does. We have a law, conservation of mass/energy; there is a similar law in the spirit world.

    Those bullied doctors need to rally together with the courage of Mattew Fogg, to challenge and throw off their oppressors; it's a whole lot easier when they do it together (think Vienna Declaration) vs. being picked off one-by-one, and left hanging to dry like mlang52. Here are some quotes from the conned:
    “Go along, to get along”
    "Don't fight the system it will change in time"
    "Blacks employees must work hard and prove themselves as managers"
    "Just turn your head when you see injustice against citizens, you can't police everything"
    “It’s a good-old-boy network and they don't want minorities in the network”
    "You have a great career, please don't destroy it on a crusade against bad cops”
    "If you testify against the Marshals Service on Capitol Hill, management will destroy your career for sure"
    "The US Justice Department is too big with too many resources, you can’t win "
    "400 years of oppression is not going to change overnight with your complaints"
    "Being called a ‘Coon or Nigger’ by white employees is not all that bad"
    "Just continue to arrest those who we direct you to arrest even if they are all black"
    "I love you brother but if you go forward with your EEO Complaints then I can't be associated with you”
    "I have a family I must feed and these people will destroy you with there mighty power"
    "Take their settlement offer and take care of yourself because the black Marshals that you are standing up for are afraid and care about only themselves”
    "The Marshal Service will set you up and get you arrested or killed in the line of duty"
    "Please take the settlement money and run, they don’t need to admit to discrimination and just let your GOD handle the rest"

    ReplyDelete
  5. Jay, as I read your piece I couldn't help but think of the "walk it off" types. My sense is some people are:
    • so galled by the thought of people lying to their doctors
    • so far removed from people in chronic pain
    • so far removed from having experienced intense pain themselves

    that they would rather err on the side of people suffering than let a few fakers have pills to get their jollies or illegally sell. Ironically as they try (in vain) to make the world a perfect place, they make it insufferable.

    You point out many sad ironies, particularly how it seems non-doctors (DEA) has bullied doctors to go against their oaths. But perhaps this is just the logical outcome since it seems the DEA and many in govt. take oaths to defend our Constitution, but actively and violently trash it.

    With regard to your last paragraph, if humans can't bring them to justice, God does. We have a law, conservation of mass/energy; there is a similar law in the spirit world.

    Those bullied doctors need to rally together with the courage of Mattew Fogg, to challenge and throw off their oppressors; it's a whole lot easier when they do it together (think Vienna Declaration) vs. being picked off one-by-one, and left hanging to dry like mlang52. Here are some quotes from the conned:
    “Go along, to get along”
    "Don't fight the system it will change in time"
    "Blacks employees must work hard and prove themselves as managers"
    "Just turn your head when you see injustice against citizens, you can't police everything"
    “It’s a good-old-boy network and they don't want minorities in the network”
    "You have a great career, please don't destroy it on a crusade against bad cops”
    "If you testify against the Marshals Service on Capitol Hill, management will destroy your career for sure"
    "The US Justice Department is too big with too many resources, you can’t win "
    "400 years of oppression is not going to change overnight with your complaints"
    "Being called a ‘Coon or Nigger’ by white employees is not all that bad"
    "Just continue to arrest those who we direct you to arrest even if they are all black"
    "I love you brother but if you go forward with your EEO Complaints then I can't be associated with you”
    "I have a family I must feed and these people will destroy you with there mighty power"
    "Take their settlement offer and take care of yourself because the black Marshals that you are standing up for are afraid and care about only themselves”
    "The Marshal Service will set you up and get you arrested or killed in the line of duty"
    "Please take the settlement money and run, they don’t need to admit to discrimination and just let your GOD handle the rest"

    ReplyDelete
  6. Jay, as I read your piece I couldn't help but think of the "walk it off" types. My sense is some people are:
    • so galled by the thought of people lying to their doctors
    • so far removed from people in chronic pain
    • so far removed from having experienced intense pain themselves

    that they would rather err on the side of people suffering than let a few fakers have pills to get their jollies or illegally sell. Ironically as they try (in vain) to make the world a perfect place, they make it insufferable.

    You point out many sad ironies, particularly how it seems non-doctors (DEA) has bullied doctors to go against their oaths. But perhaps this is just the logical outcome since it seems the DEA and many in govt. take oaths to defend our Constitution, but actively and violently trash it.

    With regard to your last paragraph, if humans can't bring them to justice, God does. We have a law, conservation of mass/energy; there is a similar law in the spirit world.

    Those bullied doctors need to rally together with the courage of Mattew Fogg, to challenge and throw off their oppressors; it's a whole lot easier when they do it together (think Vienna Declaration) vs. being picked off one-by-one, and left hanging to dry like mlang52. Here are some quotes from the conned:
    “Go along, to get along”
    "Don't fight the system it will change in time"
    "Blacks employees must work hard and prove themselves as managers"
    "Just turn your head when you see injustice against citizens, you can't police everything"
    “It’s a good-old-boy network and they don't want minorities in the network”
    "You have a great career, please don't destroy it on a crusade against bad cops”
    "If you testify against the Marshals Service on Capitol Hill, management will destroy your career for sure"
    "The US Justice Department is too big with too many resources, you can’t win "
    "400 years of oppression is not going to change overnight with your complaints"
    "Being called a ‘Coon or Ni--er’ by white employees is not all that bad"
    "Just continue to arrest those who we direct you to arrest even if they are all black"
    "I love you brother but if you go forward with your EEO Complaints then I can't be associated with you”
    "I have a family I must feed and these people will destroy you with there mighty power"
    "Take their settlement offer and take care of yourself because the black Marshals that you are standing up for are afraid and care about only themselves”
    "The Marshal Service will set you up and get you arrested or killed in the line of duty"
    "Please take the settlement money and run, they don’t need to admit to discrimination and just let your GOD handle the rest"

    ReplyDelete
  7. Jay, as I read your piece I couldn't help but think of the "walk it off" types. My sense is some people are:
    • so galled by the thought of people lying to their doctors
    • so far removed from people in chronic pain
    • so far removed from having experienced intense pain themselves

    that they would rather err on the side of people suffering than let a few fakers have pills to get their jollies or illegally sell. Ironically as they try (in vain) to make the world a perfect place, they make it insufferable.

    You point out many sad ironies, particularly how it seems non-doctors (DEA) has bullied doctors to go against their oaths. But perhaps this is just the logical outcome since it seems the DEA and many in govt. take oaths to defend our Constitution, but actively and violently trash it.

    With regard to your last paragraph, if humans can't bring them to justice, God does. We have a law, conservation of mass/energy; there is a similar law in the spirit world.

    Those bullied doctors need to rally together with the courage of Mattew Fogg, to challenge and throw off their oppressors; it's a whole lot easier when they do it together (think Vienna Declaration) vs. being picked off one-by-one, and left hanging to dry like mlang52. Here are some quotes from the conned:
    “Go along, to get along”
    "Don't fight the system it will change in time"
    "Blacks employees must work hard and prove themselves as managers"
    "Just turn your head when you see injustice against citizens, you can't police everything"
    “It’s a good-old-boy network and they don't want minorities in the network”
    "You have a great career, please don't destroy it on a crusade against bad cops”
    "If you testify against the Marshals Service on Capitol Hill, management will destroy your career for sure"
    "The US Justice Department is too big with too many resources, you can’t win "
    "400 years of oppression is not going to change overnight with your complaints"
    "Being called a ‘C--n or Ni--er’ by white employees is not all that bad"
    "Just continue to arrest those who we direct you to arrest even if they are all black"
    "I love you brother but if you go forward with your EEO Complaints then I can't be associated with you”
    "I have a family I must feed and these people will destroy you with there mighty power"
    "Take their settlement offer and take care of yourself because the black Marshals that you are standing up for are afraid and care about only themselves”
    "The Marshal Service will set you up and get you arrested or killed in the line of duty"
    "Please take the settlement money and run, they don’t need to admit to discrimination and just let your GOD handle the rest"

    ReplyDelete
  8. Jay, as I read your piece I couldn't help but think of the "walk it off" types. My sense is some people are:
    • so galled by the thought of people lying to their doctors
    • so far removed from people in chronic pain
    • so far removed from having experienced intense pain themselves

    that they would rather err on the side of people suffering than let a few fakers have pills to get their jollies or illegally sell. Ironically as they try (in vain) to make the world a perfect place, they make it insufferable.

    You point out many sad ironies, particularly how it seems non-doctors (DEA) has bullied doctors to go against their oaths. But perhaps this is just the logical outcome since it seems the DEA and many in govt. take oaths to defend our Constitution, but actively and violently trash it.

    With regard to your last paragraph, if humans can't bring them to justice, God does. We have a law, conservation of mass/energy; there is a similar law in the spirit world.

    Those bullied doctors need to rally together with the courage of Mattew Fogg, to challenge and throw off their oppressors; it's a whole lot easier when they do it together (think Vienna Declaration) vs. being picked off one-by-one, and left hanging to dry like mlang52. Here are some quotes from the conned: (Hm, Google keeps censoring my post :-(, use that link to read the list.)

    ReplyDelete
  9. This line (see link above), "Take their settlement offer and take care of yourself because the black Marshals that you are standing up for are afraid and care about only themselves” makes me think of "it's the principle of the matter." I even recall hearing a very prominent man use that word, "principle." I guess the question is are your principles causing more pain and injustice or reducing pain and injustice. It's clear to me that those who fight the Drug War on principle are hacking away at the very roots of their being; ironically they can't feel it because they've numbed themselves with the pleasures of this world: power over others and self-righteous feedback loops (see quotes above from some of the "yes men"), money, fast cars, etc…

    I just hope that the people who are being bullied to go along with this Drug War madness realize, and soon, how they've been taken for a ride. I'm thinking (too) of the court that recently ruled in favor of warrant-less GPS tracking. I have no doubt that the Drug War (and War on Terror) fear mongers are back-room scaring (or bullying) leaders and people with authority, to go along with the anti-Constitutional madness; accusing them (the irony) of being part of the downfall of society. Ironic because it seems to me ALL (or nearly all) the worst periods (or societies) in history were when vicious madmen (and madwomen) did their best to "prevent a downfall" of society and subjected everyone to various "purity" and loyalty tests.

    ReplyDelete

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