Stay Low, Lawyer Up by Pat Conrad MD
Up front, let me state that we only have one side of the story here. I am not naive, and, libertarian as I am, do not, will not justify the dumb act of ordering “a bottle of Xanax from a wholesaler” for oneself.
This physician did the wrong thing, and word got to the Ohio state medical board, which determined her to be “an unregistered terminal distributor of dangerous drugs.” Once on the state’s radar, the hits kept coming. The Board determined that she was unfit to practice due to possible mental illness and ordered her to submit to a psychiatric exam. Failure to so submit would be considered an admission of guilt. The target passed the test but to no avail. She then had to endure an in-patient addiction eval, and was told that the prescribed 72-hours would be lengthened to the clichéd 28 days. The doctor refused, and had her license suspended. When the smoke cleared, she had lost her license, her board certification, her DEA license, and her livelihood.
I hear what you are thinking: she really was an addict mired in denial, would not comply with the program that justly evaluated her, and is playing woe-is-me when there was evidence that she had become unsafe for patients. Maybe so.
But it is also quite possible that for the dumb act of ordering one bottle of Xanax, her career was destroyed through a series of board hearings and determinations that did not afford her the due process that we like to think citizens receive. “I was offered a chance to face my accusers, the eight members of the state medical board, for five minutes at a public hearing. I took the offer. Three and a half minutes into my statement, the Board’s spokesman interrupted me and read a perfunctory statement echoing their lawyer’s sentiments. I was numb.”
I never realized going into medicine that all physicians have a target on their backs for the rest of their lives. Point One: We do not have the same protections that normal citizens have and deserve to be paranoid. As depressing and infuriating as this is, it is reality.
Point Two: Spend the money. None of us should ever, ever respond in any way to a state medical board except through our attorney.
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State medical boards are created by state legislatures who provide no oversight of the goings on of these boards. There is no due process. Independent physicians are targets, often because larger corporate medical entities want to clear the field of competition. The real cases of medical malpractice never see the light of day because corporate medicine prevents the incidents from ever going beyond their corporate doors, with staff decisions such as “difficult case handled well.”
The Federation of State Medical Boards used to give a prize every year for the most physician pelts taken. Alaska and North Dakota, two states with few physicians, won the prize more often than other states.
The public needs to become aware of the fact that medical boards (and indeed, many state licensing boards) are now political bodies and behave in many way like political entities. Pat Conrad’s BFM comes to mind. Those groups which used to represent and advocate for physicians are now in many cases dancing for the highest bidder.
My experience with the Tennessee and particularly the Kentucky medical boards is that they are very lax in enforcing what I consider basic professional standards. I personally know about a case of a physician who assaulted a patient (she wasn’t his patient) while she was in the hospital by putting a needle into her pain pump reservoir and removing the medication for his personal use. Then he called the pharmacy to order a vial of dilaudid to ostensibly refill the pain pump and instead stuck the vial in his sock, again for his personal use. This guy still has a medical license! I also am acquainted with another physician who was found to be prescribing narcotic pain medication to a former patient in exchange for sex, then he eventually assaulted her by pushing her down a stairs. This guy also still has a license in Kentucky.
The infamous David Dao made sexual advances on a patient while he was examining him. Then he hired said patient to work in his office and entered into a consensual sexual relationship with him that also included Dr. Dao prescribing controlled substances to said patient (both under his real name and using aliases) who would then share them with Dr. Dao. Dr. Dao still has a license to practice medicine in Kentucky.
You have to lawyer up because these bastids can call one to the carpet for the way one practices.
Needless to say, I got called, had the support of my colleagues, hospital and lawyer.
You are guilty until innocent. We prevailed with a slap on the wrist whereas I could have lost my livelihood for 2 years. Granted, this wasn’t over personal behavior or substance abuse issues but over the way a case was handled on medical judgement alone.
Yeah, don’t prescribe stuff to yourself. You need a personal physician. That wasn’t what my situation was.
Those are great points, and you certainly dug more on this physician than did I. I did however, repeatedly point out that ordering a bottle of Xanax was dumb, and that there might be “evidence that she had become unsafe for patients.”
The point of this piece is that state medical boards can be abusive, and that physicians don’t have the same due process that others have. Maybe you agree with that, but I don’t. I will never forget the lecture I heard from one doc while I was in med school; he charged an employee with embezzlement, and the very day that she was convicted, she made a anonymous call to the Florida Medical Board alleging that her now-former employer was a drug addict and drunk. The very next day he was met by agents who told him he would have to shut his office for up to 5 weeks for an evaluation, based on NO evidence at all. This physician had to lawyer up, spend thousands, and the complaint was found to be totally false (and he thereafter continued to enjoy an impeccable reputation in the local medical community, ZERO complaints).
That is only one story, but there are plenty of others. Yes, we all know that it is “dumb” – DUMB ! – to self-prescribe a controlled substance, so I really wasn’t trying to reiterate that. My point is that state medical boards assume that physicians are guilty, and we should be accordingly fearful.
Your defense of this physician angers me. I see my own states medical board give doctors second and third chances all the time when I feel they should permanently revoke their licenses. Case in point is the notorious physician from Louisville who got into an infamous altercation with police on an United Airlines plane about a year ago (Dr. David Dao). You should go read the story of his state board actions. The fact that this guy still had a medical license was a travesty.
It seems that this physician received harsher punishment than I have ever seen given to any physician for what she did. This makes me think there is more to the story than she reveals. I reviewed the public documents related to her suspension. She doesn’t reveal in her published story the facts that she also prescribed soma to herself and was twice hospitalized with drug and alcohol overdose.
The actual lesson here is that if you are a physician IT IS ABSOLUTELY FORBIDDEN TO PRESCRIBE A CONTROLLED SUBSTANCE TO YOURSELF!!! You don’t need any sort of course in professional boundaries to understand this. I think anyone who violates this rule should permanently lose their license with no second chances, but I am not in charge. Instead the medical board gave her some unpleasant, but achievable steps to take to restore the public trust in her and she refused to do it. I am not sorry for her; she should find another career.