Going to Jail for Writing Narcs

lisa-tseng-prelim

Here is another reason NOT to get into the habit of just trusting patients with the judicial use of their narcotics.  Dr. Hsiu-Ying “Lisa” Tseng, a general practitioner, is the first California doctor ever charged with murdering patients who overdosed merely for prescribing them medication.  Yes, you read that right.  MURDER.  The article goes on:

It’s an understandable message, Smith said, considering the country’s prescription drug overdose epidemic. But he and other medical and legal experts are worried that if Tseng is convicted, it will have “a chilling effect,” making good doctors reluctant to prescribe painkillers to patients, who will suffer unnecessarily.

To be fair, Tseng had issues. The “coroner’s or law enforcement officials had called Tseng more than a dozen times and informed her that patients of hers had died of an overdose or potential overdose. Despite those calls — and various other “red flags,” which Niedermann said included a patient overdosing in the hallway of her clinic — Tseng didn’t change her prescribing practice.”  Yeah, that’s not good.  But then there is this:

Tseng’s receptionist will testify, Niedermann said, that she once overheard someone talking on the phone with Tseng on a day the doctor was late to work. The person told Tseng that the waiting room at her Rowland Heights office had filled up and patients were getting anxious. Niedermann said the receptionist will testify that she overhead Tseng respond: “They’re druggies, they can wait.” Addicts and former patients will also testify, Niedermann said, including a man who will say that Tseng merely glanced at his chart and asked him what he wanted.

Well, that may not sound professional, but this doc knew her patients and gave them what they wanted. Does that make her a murderer?

Some more from the article:

Tseng is charged with second-degree murder for the deaths of Vu Nguyen, 28, of Lake Forest; Steven Ogle, 25, of Palm Desert; and Joey Rovero, 21, an Arizona State University student, who prosecutors say traveled more than 300 miles with friends from Tempe, Ariz., to get prescriptions from Tseng.

Yup, they traveled more than 300 miles to get scripts from her. The word gets out about narc giving docs. When I started, the word would get out locally as all these seekers would talk to each other.  Nowadays, the work gets out even more via social media.  So are these “victims” so innocent.  Well, you decide.  They describe how one sweet brown-eyed boy who loves soccer and fantasy football died because he mixed alcohol with Xanax and Oxycodone.  Yup, that was the testimony.  The mother said “she remembers the detective’s voice on the phone describing Joey’s room littered with near-empty vials of his medicine. The name of the doctor on the bottles, she said, was Tseng.” The kid was not a cub scout crossing old ladies across the street.

I am not defending the doctor but she is not the only guilty party.  Her clients were narc seekers coming as far as 300 miles away to get their drugs and either sell them or party with them. They are guilty as well.  Don’t get me wrong, Tseng should lose her license but she is not murderer.  That being said, as this article says, doctors need to be careful and not get reckless, greedy or ambivalent in their narcotic prescription habit.  Oh, and just know that you could get sued for NOT doing enough for patients’ pain either.  Got to love this job!

 

Douglas Farrago MD

Douglas Farrago MD is a full-time practicing family doc in Forest, Va. He started Forest Direct Primary Care where he takes no insurance and bills patients a monthly fee. He is board certified in the specialty of Family Practice. He is the inventor of a product called the Knee Saver which is currently in the Baseball Hall of Fame. The Knee Saver and its knock-offs are worn by many major league baseball catchers. He is also the inventor of the CryoHelmet used by athletes for head injuries as well as migraine sufferers. Dr. Farrago is the author of four books, two of which are the top two most popular DPC books. From 2001 – 2011, Dr. Farrago was the editor and creator of the Placebo Journal which ran for 10 full years. Described as the Mad Magazine for doctors, he and the Placebo Journal were featured in the Washington Post, US News and World Report, the AP, and the NY Times. Dr. Farrago is also the editor of the blog Authentic Medicine which was born out of concern about where the direction of healthcare is heading and the belief that the wrong people are in charge. This blog has been going daily for more than 15 years Article about Dr. Farrago in Doximity Email Dr. Farrago – [email protected] 

  9 comments for “Going to Jail for Writing Narcs

  1. Sam Weinberg
    September 9, 2015 at 11:29 am

    If paients always blame the doctor, apparently doctors blame the patient (see above). One healer up there says it’s all Obama’s fault

    • Bill Ameen MD
      September 9, 2015 at 2:09 pm

      It IS too easy to blame the patient, but as someone pointed out on NPR today, and as I know from my own practice, even prescribed use often results in tolerance. Medical science has failed us in providing an adequate substitute for opioids and now society is paying the price. Since pain can’t be measured like renal function or whatever, we have to rely on those ridiculous little smiley/frowny faces on our charts. Even somebody with a poorly-defined disease like fibromyalgia can tell us the pain is “killing” them and we become pricks if we don’t believe them or treat them with the crappy drugs at our disposal.

  2. Private Doc
    September 6, 2015 at 7:50 pm

    Let’s not forget that our own gubment created this problem with the “pain is the fifth vital sign” crap and all the lawsuits for inadequate pain control. A friend of mine who is a Family Medicine doctor was actually sued when one of his patients said in his suicide note that he just couldn’t stand his chronic pain any more because his doctors didn’t give him enough meds. Pat for the course the gubment creates a problem so they can mandate a solution that gives them more power and now we must do the prescribing CMEs

  3. Pat
    September 6, 2015 at 12:35 pm

    The idiot mother, “Rovero, who launched the National Coalition Against Prescription Drug Abuse after her son’s death, said she hopes Tseng is convicted, sending a message to every doctor’s office across the country: “Don’t think you’re going to get away with it.””

    So her dunk, drugged son’s misbehavior is the solely the fault of a negligent piece of garbage doc?

    Modern medicine is not primarily about healing – it is about conflict. Getting a medical degree means signing your life over as a public commodity, liable to every judgment, whim, and sanction from anyone for any reason they wish. I disagree with those who say patients still trust their docs – those same smiling, grateful people and their families will turn on a dime to rip the physician in the event of a bad outcome, unrealized expectation, or for any number of secondary gain opportunities. Going into the medical profession (industry) – means that you will be in a fight with insurers, the government, negative public stereotypes, patients, and their families, and helpful, compassionate lawyers always, until you get out.

    That this sorry ass pill pusher is being charged as a murderer is evidence of a larger dynamic, that the public is schizophrenic and that doctors are and will be presumed to be at fault and the primary cause of bad outcomes.

    • Joe
      September 7, 2015 at 4:56 pm

      The “idiot’s Mother” is trying to prevent other families from suffering the loss of a loved one by creating awareness about prescription drug abuse nothing more. The drunken boy who was partying has already received the death penalty by lethal drug ingestion. The victims are not on trial since they have already been convicted and sentenced to death. So that only leaves their executioner (the doctor) who knowingly new her patients were dying by taking the drugs she was prescribing and with malice continued to do so until her license was revoked.

      • Pat
        September 7, 2015 at 11:24 pm

        Thanks for further proving my point.

  4. Bill Ameen MD
    September 6, 2015 at 10:25 am

    Some may call it murder, I call it Darwinism. Wasn’t California the state that prosecuted another physician [also Asian, as I recall, coincidentally] for NOT prescribing enough pain medication to a dying patient?

  5. Steve O'
    September 6, 2015 at 9:50 am

    PS: Just to put things in perspective online:
    Dr. Tseng had a 2.5-star rating out of five stars.
    The individual categories were – Patient Ratings: ; Ease of Appointment, 3.2 ; Promptness, 2.3 ; Courteous Staff, 2.3 ; Accurate Diagnosis, 2.4 ; Bedside Manner, 2.7 ; Spends Time with Me, 2.6 ; Follows Up After Visit, 2.6

    Search for yourself. I swear that I am not making this up. That is not some wiseguy comment – that’s the online ‘facts.’

  6. Steve O'
    September 6, 2015 at 9:42 am

    Murder, she wrote. Well, it is a tradition in the common law in many states, that a death that is the consequence of the commission of a felony can draw the charge of murder. That has been a topic of debate. Right there in Berkeley, California, a student researching the topic wrote – “Our results indicate that the (California) felony murder rule does not have a significant effect on crime rates or crime-related death rates.” Daniel Ganz, UC Berkeley, Spring 2012, Legal Studies Honors Thesis
    A study from the U. of Va. using FBI crime data states:

    Policymakers should draw one conclusion from this paper: the felony-murder rule does not substantially improve crime rates. If the main reason a state retains the rule is to reduce crime, it should reconsider the rule. The (felony-murder) rule seems to increase the number of felony deaths in a state.

    There is a lot to be said about how Dr. Tseng did wrong and how the Board of Medicine may have been lax in their duty to intervene.
    Finally, many people will just blip out the meme of “bad doctor-hurt patient” rather than seeing the substance abuse problem ongoing in America and its twenty-year turn from street drugs to prescription medications. Tseng looks to be a bad apple, but, like everything, nothing is as simple as we wish it to be.

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