Confidential Doctor-patient relationship? Or suspect criminal conspiracy?
In the Drug War front, the situation in Mexico may have become completely uncontrollable, but not to worry! Our drug enforcement agents are continuing to launch raids on doctors in this country and charge them with overprescribing pain meds. The legal system being the way it is, a charge of overprescribing now translates into racketeering, conspiracy, money-laundering, etc. In other words (in a clear message to other dorctors), if you write a prescription that the DEA thinks you should not have written, you could go to prison for life!
Currently, there's quite a ruckus over a Kansas physician who does not hesitate to treat large numbers of pain patients, some of whom allegedly resold the drugs on the street. So the doctor is being prosecuted.
HAYSVILLE, Kan. -- The Schneider Medical Clinic was once open seven days a week for as many as 11 hours a day. Patients, scheduled 10 minutes apart, often waited hours for an appointment.
OK, right there I see a problem. With that kind of high-volume practice (which will most likely increase under Pelosicare), it would be nearly impossible for doctors to get into the kind of detailed patient policing that the DEA seems to be pushing for by way of these high-profile prosecutions.
Today, its doors are shuttered and the couple who ran the clinic are in jail, charged with allegedly operating a "pill mill" linked to 56 overdose deaths.
But Dr. Stephen Schneider and his wife, nurse Linda Schneider, are getting some high-powered help: An advocacy group for chronic pain patients has taken over their criminal defense.
The New Mexico-based Pain Relief Network hopes to mount what it vows will be a landmark federal case over prescription painkillers.
"It has all the elements we want: an innocent doctor, destroyed vulnerable patients, a wonderful legal team with heart, a family that really hangs together -- right in the Heartland of America. I couldn't ask for more," said Siobhan Reynolds, the network's president.
Reynolds likened the federal indictment against the Schneiders to other high-profile prosecutions of physicians nationwide that it contends have spooked doctors from treating chronic pain patients.
The Schneiders were indicted in December on federal charges including conspiracy, unlawful distribution of a controlled substance resulting in death, health care fraud, illegal money transactions and money laundering. They have vehemently proclaimed their innocence.
Fortunately, there is still a jury system, so the DEA can't imprison doctors merely on their say-so.
But regardless of whether Dr. Schneider is convicted, a message is clearly being sent. Even some of the chief state prosecutors are alarmed.
...experts say high-profile prosecutions of pain management specialists has since spooked medical providers from writing pain medication.
The National Association of Attorneys General, alarmed by stepped up enforcement, sent a letter to the Drug Enforcement Administration in 2005 saying they were exerting "a chilling effect" on the willingness of physicians to treat pain patients. It was signed by the attorneys general of 29 states.
The shuttering of Schneider's clinic has been felt by some of his former patients. Eight held a news conference Tuesday to complain that medical providers have repeatedly refused to treat them out of concern that they could be subjects of similar prosecution.
Roy Ralstin suffers from an enlarged heart and has been out of his high blood pressure medication for a week. He said he can't find anyone to treat him or his wife, Jennifer, who suffers from rheumatoid arthritis.
The couple have called 133 doctor offices, all of whom refused to see them after finding out they were Schneider's patients, Jennifer Ralstin said.
"They are taking away our freedom to be pain free," Jennifer Ralstin said.
So eating away at a patient's right to medicate pain and the right of a doctor to treat a patient as he sees fit may in fact be the whole idea. A patient's need for pain meds has to be balanced against what is considered in the best interests of the "Drug War." Patients who need pain meds must necessarily become suspects.
If you think I am exaggerating, just read what one of the prosecution's experts says:
Dr. Doug Jorgensen, a Massachusetts pain management specialist, testified that the number of patients was "beyond excessive," and the sheer volume would make it difficult to monitor patients. He also said prescription refills were given to patients whose urinary screening tests showed they were not taking their pills, a sign the drugs were being sold.
I'm sorry but patients are not suspects. Testing the urine of patients to monitor whether they are taking their pills is downright Orwellian, and I would not go to a doctor who did that. Nor, I suspect, would most people. Which means that the drug war bureaucrats probably have a plan in mind to make patient urine testing mandatory.
For all I know, such a provision might even be buried somewhere in the thousands of pages of the Pelosicare "law." (In any event, you can be sure that in the near future, dissenters who behave like, say, Joe The Plumber can expect to see their once-confidential prescription records leaked to the media by common bureaucrats.)
"refills were given to patients whose urinary screening tests showed they were not taking their pills, a sign the drugs were being sold"
Is it? Non-compliance with the treatment regime is a well-known phenomenon, even for patients with chronic and/or fatal diseases. I think that much more likely than drug trafficing.
Bob Smith · May 27, 2010 5:34 PM
As a general rule, pain management patients include a non-trivial percentage who are abusing and/or selling drugs. I know nothing about this case but I treat many patients with chronic pain and I can assure you that a 10 minute appointment once a month without any ancillary services for monitoring purposes is borderline malpractice. All patients deserve to have as much pain medication as they need, but the potential for abuse is very significant and the treatment of patients with chronic pain needs to be conducted very carefully.
I'm not thrilled with the government taking on policing of doctors, but this does sound like a Dr. Feelgood operation. Even ignoring the question of whether patients were reselling their pills, this sounds like a doctor who has abandoned his responsibility to his patients.
" Testing the urine of patients to monitor whether they are taking their pills is downright Orwellian"
While you are certainly entitled to your opinion, if you wish to set standards of practice you might want to become a member of the profession. Since it is not being done by the State soes it still qualify as Orwellian? Is it onerous? Yes. Is it undignified? Yes.
"Non-compliance with the treatment regime is a well-known phenomenon, even for patients with chronic and/or fatal diseases. I think that much more likely than drug trafficing."
Look, these too cute by half arguments do not win over anyone. If the patient is non-compliant that is their choice. But if they haven't been taking any of the last prescription then they really shouldn't need another refill now should they?
Let's stop pretending.
Some people seek drugs for non-medicinal purposes. Some of these people attempt to obtain them from medical practitioners through fraud or deception. Whether you agree or disagree with their motives is immaterial. The reality is they exist and it is not appropriate for them to be obtaining these medications from practitioners - that's not what medicine is about.
It is sad and unfortuante that our society has decided to restricts access to such substances, but that is the way it is (at least for now.) By these same laws medical practitioners are allowed legal access to these substances solely for the purpose of treating bona fide medical conditions. That means - whether they agree or disagree with the underlying law - they have a professional obligation to ensure that they only use these substances when medically appropriate.
Nobody likes to deal with a client or customer they don't trust, but we all know that these are human beings and trust but verify is not exactly a new concept on the face of the Earth.
That some practitioners chase easy money by servicing the illicit drug seeker is also nothing new under the Sun. Don't insult anyone's intelligence by pretending they don't exist. Chicken Little claims that the sky is falling might be taken a little more seriously if they didn't involve such an obvious Doctor Feelgood situation.
"this sounds like a doctor who has abandoned his responsibility to his patients."
And his responsibility to his profession.
MountainMain · May 30, 2010 10:14 AM
Ah. Yes. Doctor FeelGood. Except that medicine is supposed to make the patient comfortable if treatment is not available.
People in chronic pain chronically take drugs. Which is why the drug market beyond a point is inelastic. After you chase away the casual users those in chronic pain will pay a lot for pain relief.
It doesn't matter if the pain is from a broken bone or rape memories. The Pain In The Brain
The Anti-Idiotarian Rottweiler
Don?t bang your head!
It's getting scary out there.
The last two paragraphs are chilling.