PBM before Indiana Legislative meeting

Posted on March 10, 2023 by Pharmaciststeve

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Dr. David Suetholz, MD:was convicted by a jury in September, 2022 of prescribing controlled substances to three patients

Posted on March 10, 2023 by Pharmaciststeve

 https://doctorsofcourage.org/david-suetholz-md/

Dr. David Suetholz, MD, 74, is a family medicine doctor who practiced in Ft Mitchell, KY. Suetholz also served in the Kenton County Coroner’s Office for over 40 years, 30 of which he served as coroner. He retired from that position in June 2021 but continued his private practice. He has worked as a family physician for over 45 years

He was convicted by a jury in September, 2022—in spite of the Ruan v. United States decision in June of that year—of 12 counts of prescribing controlled substances — oxycodone, OxyContin and fentanyl — to three patients from September 2018 to February 2020. Ten of those counts are shown:

Chart of 10 prescriptions of opioids

The government’s case was based on their charge that Dr. Suetholtz

“unlawfully prescribed controlled substances to his patients outside the usual course of professional practice and not for a legitimate medical purpose. Some patients were prescribed high doses of medication and in dangerous combinations without justification. Suetholz also prescribed to patients without assessing their risks for addiction or their past history of substance abuse.”

Excuse me!  The prescriptions shown are of low dose and minimum number for effective pain relief. And none of these were filled early, but in actuality many lasted longer than they needed to.  So how could he have been found guilty? Simply by the propaganda that people now believe—that opioids cause addiction, so doctors are drug pushers.

Following his conviction, Dr. Suetholz’s lawyers filed a motion asking the federal court to reverse his conviction or grant him a new trial, saying that, given the evidence presented in court, “no reasonable jury could conclude beyond a reasonable doubt that he knowingly or intentionally violated the law.”

“Not a single witness testified Dr. Suetholz was doing anything other than treating his patients in the best way he knew how,” the lawyers said in court filings. “The evidence painted a picture of a trusting and selfless healer who treated patients like family and would do anything to help those who are struggling.”

In court filings, Suetholz’s lawyers also claimed the court erred during the trial. Those alleged errors include:

  1. Instructing the jury on deliberate ignorance.
  2. Allowing prosecutors to admit evidence of “unrelated” medical licensure board proceedings.
  3. Permitting the admission of “extremely prejudicial” evidence of uncharged patient deaths.
  4. And prohibiting defense lawyers from admitting the government’s recorded statement of one of Suetholz’s patients.

Now why would a government employee for 40 years become a target for the DOJ? Basically for 2 reasons.  His age means that he has assets.  And in Kentucky, a lot of law enforcement jobs depend on the systemic attacks on doctors for prescribing opioids. Since the Ruan SCOTUS decision is falling on deaf ears in the DOJ—which I warned people would happen—they know that the conviction will ride on the propaganda in the jurors’ heads that simply by prescribing opioids the doctor is guilty. Those reaping the benefits of this illegal attack are trial attorneys Dermot Lynch and Maryam Adeyola, Assistant Attorney General Kenneth A. Polite, Jr., U.S. Attorney Carlton S. Shier, IV, FBI, DEA, HHS, and the Kentucky Medicaid Fraud Control Unit, among others.

Just to show the REAL cause of these attacks, here is the forfeiture paperwork in the indictment:  2021 Indictment

Are you getting tired yet, of good, compassionate physicians lose their livelihood and more because of a rogue DOJ?  We have the answer on DoC. I teach the REAL cause of addiction. People just won’t learn it and pass it on. So these attacks will continue and more pain patients will suffer.  I predict that if people don’t join my effort to get the truth out, then there won’t be any opioids by 2030.  But, if you aren’t willing to learn what will stop it, you are doomed to live it. It’s YOUR choice.

Dr. Suetholz is scheduled for sentencing later this month.

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Ankle Docs See Falling Medicare Payments

Posted on March 10, 2023 by Pharmaciststeve

Ankle Docs See Falling Medicare Payments

https://www.medpagetoday.com/meetingcoverage/aaos/103471

Inflation-adjusted reimbursements for fusion, joint replacement slip

LAS VEGAS — From 2000 to 2020, Medicare reimbursements for ankle arthroplasty have fallen more than 30% after adjusting for inflation, and payments for ankle arthrodesis declined nearly 7%, a researcher said here.

Meanwhile, the volume of these procedures has more than doubled over that time, according to Olufunmilola Adeleye, MBA, a medical student with the Mayo Clinic in Scottsdale, Arizona.

“These trends should be understood and considered by surgeons, healthcare administrators, and policy-makers in order to develop and implement agreeable models of reimbursement while ensuring access to quality surgical orthopedic foot and ankle care in the United States,” she told attendees at the American Academy of Orthopaedic Surgeons’ annual meetingopens in a new tab or window.

She noted that, as Medicare moves away from its traditional fee-for-service model, there may be opportunities for exactly such conversations.

Physicians in all specialties have long complained about inadequate and seemingly arbitrary payment schedules in Medicare. Now they may have more ammunition to back that argument.

Adeleye and colleagues pulled Medicare reimbursement data for diagnostic codes related to ankle replacement and joint fusion for 2000-2020, along with changes in the consumer price index that the group used to adjust for inflation.

The researchers counted just over 100,000 such procedures performed during these 2 decades. Rates soared from 0.88 per 10,000 beneficiaries in 2000 to 1.98 per 10,000 in 2020. Adeleye and colleagues also found that arthroplasties increasingly dominated the landscape.

Payments for arthrodesis averaged about $1,200 in 2000, while for total arthroplasty the mean reimbursement was roughly $950. Payments for both procedures declined substantially and steadily at about the same rates through 2010. At that point, the inflation-adjusted means for arthrodesis and arthroplasty were about $950 and $700, respectively.

In the second decade, average reimbursement for arthrodesis recovered somewhat, ending at $1,150. But payment for arthroplasty continued to fall, below $650 as of 2020. Overall, the declines were 6.91% and 30.15%, respectively.

“Your study made me very sad,” quipped session co-moderator Christopher Gross, MD, of the Medical University of South Carolina in Charleston, during the discussion after Adeleye’s presentation.

Gross told MedPage Today that he knew of no real reason for the decline in Medicare reimbursement. If anything, he said, these arthroplasties and arthrodesis procedures are more costly than ever. Implants have become dramatically more expensive and now clinicians may use patient-specific instrumentation. “That’s another $1,500,” he said. He acknowledged that average operative time may be shorter “by maybe 30 minutes,” but that is more than offset by increases in most other costs.

His feeling is that CMS is simply trying to save money with a special focus on procedures for elderly, whose numbers are rapidly growing as Baby Boomers age. Medicare payments don’t appear to reflect actual costs but are merely arbitrary, he said.

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does the body’s metabolism of acetaminophen produce toxic metabolites

Posted on March 9, 2023 by Pharmaciststeve

The article states that they had data from 1998 to 2019, but it is not mentioned any analysis of liver toxicity using the data after the 2016 CDC opioid dosing guidelines until the end of data that they had.  Is a 3-4 yr period not statistically significant enough for a valid comparison  or did the statistics do a “turn around” after the CDC published those dosing guidelines and all too many chronic pain pts’ opiate doses were reduced or completely cut off and the pts were told to take a NSAID and/or Tylenol/Acetaminophen and this group did not want to divulge the reality of liver toxicity associated with the use/abuse of Tylenol/Acetaminophen.

This quote seems to reference that a liver toxic dose can’t be figured out, because: Furthermore, Ghany and Watkins wrote, “doses as low as 200 mg daily have been associated with toxicity, and conversely doses of more than 12 g per day have not.”  This appears to be a “back door” reference to pharmacogenomic testing as to how individualized Tylenol/Acetaminophen dosing and liver toxicity can be linked.  It may also suggest that without pharmacogenomic testing be done on all pts in the study and that test did not start being available until sometime after our DNA was fully mapped and that was around year 2000.

From CHAT GPT:  does the body’s metabolism of acetaminophen produce toxic metabolites

Yes, the metabolism of acetaminophen can produce toxic metabolites if taken in excessive amounts or if the liver’s detoxification pathways are overwhelmed. The primary pathway for the metabolism of acetaminophen is through conjugation with glucuronic acid and sulfate in the liver, which leads to the formation of non-toxic metabolites that are excreted in the urine.

However, when the liver’s capacity to metabolize acetaminophen is exceeded, a small percentage of the drug is metabolized via a different pathway, which leads to the formation of a highly reactive metabolite called N-acetyl-p-benzoquinone imine (NAPQI). NAPQI can cause oxidative damage to liver cells and lead to liver failure if not promptly detoxified by the liver’s antioxidant defense system.

Therefore, it is essential to follow the recommended dosage of acetaminophen to avoid toxicity and to seek medical attention if you experience symptoms such as abdominal pain, nausea, vomiting, or jaundice, which may indicate liver damage.

 

FDA Mandate on Acetaminophen-Opioid Combinations Appeared Effective

https://www.medpagetoday.com/gastroenterology/generalhepatology/103418

Hospitalizations for liver toxicity declined after FDA limited acetaminophen dose

An FDA mandate limiting the amount of acetaminophen in combination with opioids in prescription products was associated with significant declines in hospitalizations due to acute liver failure (ALF), according to an analysis of national medical databases.

The analysis by the U.S. Acute Liver Failure Study Group found that although the percentage of ALF cases involving acetaminophen and opioid toxicity had been increasing by 7% per year before the mandate, the percentage decreased 16% per year afterward (P<0.001), reported Jayme Locke, MD, of the University of Alabama at Birmingham, and colleagues. The mandate was announced in 2011, and manufacturers had until 2014 to comply.

The odds of hospitalization with acetaminophen and opioid toxicity had been increasing by 11% per year prior to the mandate (OR 1.11, 95% CI 1.06-1.15) but decreased by 11% per year afterward (OR 0.89, 95% CI 0.88-0.90, P<0.001 for trend), the study found.

“In contrast, the yearly rate of hospitalizations and proportion per year of ALF cases involving acetaminophen alone increased after the mandate,” the researchers wrote in JAMA, adding that the finding is further evidence that the FDA action targeting acetaminophen-opioid combinations worked.

The mandate limited the amount of acetaminophen in combination products to 325 mg and required manufacturers to label the products with a boxed warning about the risk of severe liver injury. Prior to the FDA action, the combination products could contain as much as 750 mg of acetaminophen.

Locke and co-authors noted that more than 60,000 people in the U.S. are hospitalized each year with acetaminophen toxicity, often due to intentional overdose. However, 40-58% of ALF cases due to acetaminophen hepatotoxicity are unintentional, and many of those involve combination acetaminophen-opioid products.

Furthermore, patients are often unaware that the products they take contain acetaminophen, the researchers said. For example, one survey of opioid users in the general population found that less than half correctly identified acetaminophen-containing products; and in another survey of patients in a general medicine clinic, only 15% correctly identified commonly prescribed combination products as containing acetaminophen.

The FDA should be “heartened” by the results, said Marc Ghany, MD, of the National Institute of Diabetes and Digestive and Kidney Diseases in Bethesda, Maryland, and Paul Watkins, MD, of the Eshelman School of Pharmacy at the University of North Carolina at Chapel Hill, writing in an accompanying editorial.

They added that the agency should continue efforts to improve the safety of acetaminophen through public health policies and that the best solution would be the development of safer, more effective analgesics.

However, Ghany and Watkins said, a safe dose of acetaminophen has not been well established. “The product label advises 4 g per 24 hours. However, the safety of the drug is influenced by many host factors (e.g., age, genetics, nutritional status) and environmental factors (e.g., alcohol) that make it difficult to determine what is a safe dose in a particular individual,” the editorialists said.

One study found that at the recommended dose of 4 g per day, alanine aminotransferase level elevations more than three times the upper limit of normal were seen in 31-44% of persons receiving acetaminophen combined with opioids or acetaminophen alone. Furthermore, Ghany and Watkins wrote, “doses as low as 200 mg daily have been associated with toxicity, and conversely doses of more than 12 g per day have not.”

Locke and co-authors analyzed data from the National Inpatient Sample, a large U.S. hospitalization database, and the Acute Liver Failure Study Group, a cohort of 32 U.S. medical centers. The researchers examined rates of hospitalizations related to acetaminophen-opioid products compared with hospitalizations due to acetaminophen alone before and after the FDA mandate.

The study included data from 1998 through 2019. During that time, there were 39,606 hospitalizations for acetaminophen and opioid toxicity. The median age of patients involved was 42, and 66.8% were women.

One study limitation, the researchers said, was the lack of a clearly defined washout period, because some individuals likely had combination products containing more than 325 mg of acetaminophen between the FDA announcement in 2011 and the mandate deadline in 2014. “This study used several different cut points, although lack of a defined washout period would likely bias toward the null,” the team said.

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5 women sue Texas over denial of appropriate medical care

Posted on March 9, 2023 by Pharmaciststeve

5 women sue Texas over denial of appropriate medical care

https://abcnews.go.com/Health/5-women-sue-texas-abortion-bans-lives-put/story

Five women are suing the state of Texas over its strict abortion laws, saying they were denied the procedure even though their lives were in danger.

The lawsuit — filed in state court Monday by the Center for Reproductive Rights — marks the first time that women, rather than doctors on behalf of their patients or advocacy groups, have taken legal action since the Supreme Court overturned Roe v. Wade.

According to the lawsuit, the women were “denied necessary and potentially life-saving obstetrical care because medical professionals throughout the state fear liability under Texas’s abortion bans.”

MORE: How some providers are working around abortion bans since Roe v. Wade was overturned

“It is now dangerous to be pregnant in Texas,” Nancy Northup, president and CEO of the Center for Reproductive Rights, said during a press conference outside the Texas Capitol. “Doctors and hospitals are turning patients away, even those in medical emergencies. Patients are being denied life-saving obstetrical care.”

Texas does not allow abortions after six weeks of pregnancy except for “medical emergencies,” which is not defined. The suit asks that physicians be allowed to determine what qualifies under the exception.

The five women — Ashley Brandt, Lauren Hall, Lauren Miller, Anna Zargarian and Amanda Zurawski — said they were all excited about their pregnancies but were denied care when their lives were in danger, the lawsuit states.

PHOTO: Lauren Miller, who had to travel to Colorado to have an abortion for one of her twins, at home in Dallas, March 5, 2023.
Lauren Miller, who had to travel to Colorado to have an abortion for one of her twins, at home in Dallas, March 5, 2023. Five women who say they were denied abortions despite grave risks to their lives or the lives of their fetuses sued the state of Texas on March 6.
Nitashia Johnson/The New York Times via Redux

Zurawski, 35, from Austin, was diagnosed with an “incomplete cervix” — which occurs when cervical tissue weakens and prematurely dilates the cervix — at 17 weeks and was told her baby would not survive, according to the lawsuit.

Under Texas’s abortion law, doctors said there wasn’t much they could do for Zurawski because cardiac activity still could be detected.

After she developed sepsis, Zurawski said she was induced so she could deliver the fetus. She developed sepsis again and had so much scar tissue from the infections that one of her fallopian tubes is permanently closed, the lawsuit states.

Hall, 28, from outside Dallas, was told her baby would not survive after a scan revealed the fetus had anencephaly, a condition in which a baby does not develop a skull and had a severely underdeveloped brain.

A maternal-fetal medicine specialist told her continuing the pregnancy could result in hemorrhage or pre-term birth but that she couldn’t have an abortion due to Texas’ laws. Hall was forced to travel to Seattle for the procedure.

MORE: Why doctors say the ‘save the mother’s life’ exception of abortion bans is medically risky

Miller, 35, from Dallas, learned she was carrying twins but a scan at 12 weeks showed one of them had trisomy 18, which is a chromosomal condition that results in severe abnormalities and developmental delays.

According to the lawsuit, she traveled to Colorado to receive a selective fetal reduction, which aborted the fetus with the chromosomal condition. Miller continued her pregnancy with the other twin, who has shown no signs of abnormalities, and she is due the end of the month.

“It shouldn’t be controversial for an individual to make health care decisions for themselves in consultation with their doctor, but you can’t get that in Texas anymore,” she said during the press conference.

Brandt, 31, from Dallas, Texas, also learned she was pregnant in May 2022 with twins. A scan, however, revealed that one had a condition known as acrania, which is when the fetus does not develop a skull, the lawsuit states.

The condition progressed to exencephaly, in which brain tissue is freely floating in amniotic fluid. Continuing the pregnancy could have increased her risk of miscarriage or premature labor. She, too, traveled to Colorado after being unable to obtain an abortion, according to the lawsuit.

The final plaintiff, Zargarian, 33, from Austin, was 19 weeks pregnant when she said she was diagnosed with preterm premature rupture of membranes, which occurs when the membranes break before a woman goes into labor.

PHOTO: Elizabeth Hernandez, a medical assistant at Women's Reproductive Clinic of New Mexico in Santa Teresa, N.M., prepares mifepristone, the first medication in a medical abortion for a patient, Jan. 13, 2023.
Elizabeth Hernandez, a medical assistant at Women’s Reproductive Clinic of New Mexico in Santa Teresa, N.M., prepares mifepristone, the first medication in a medical abortion for a patient, Jan. 13, 2023. The abortion clinic, less than a mile from Texas, wh…
Evelyn Hockstein/Reuters

She was at high risk of sepsis or hemorrhaging if she continued the pregnancy but could not obtain an abortion. Zargarian also went to Colorado to obtain an abortion, legal filings show.

“You never know when you or someone you know will need [an abortion],” Zargarian said during the press conference.

In September 2021, the state passed the so-called Texas Heartbeat Act — better known as SB 8 — which bans abortions after fetal cardiac activity can be detected, which typically occurs around six weeks, before most women know they’re pregnant.

The law does not include exceptions for rape or incest or if the fetus has a fatal or untreatable condition. The only exception is for “medical emergencies,” but it is undefined, making it unclear what qualifies.

SB 8 also allows private citizens to sue anyone who “aids or abets” an abortion.

MORE: If an abortion drug is banned, could misoprostol be used as a safe alternative?

Additionally, after Roe v. Wade was overturned by the Supreme Court, Texas passed a trigger law making abortion a second-degree felony “for a person who knowingly performs, induces, or attempts an abortion.”

If the pregnancy is successfully aborted, the offense becomes a first-degree felony, according to the law.

According to the Texas Penal Code, the punishment for a first-degree penalty could be up to life in prison and a fine of up to $10,000. The penalty for a second-degree felony is up to 20 years in prison and a fine of up to $10,000.

In a statement, Vice President Kamala Harris expressed support fro the lawsuit.

“The lawsuit includes devastating, first-hand accounts of women’s lives almost lost after they were denied the health care they needed, because of extreme efforts by Republican officials to control women’s bodies,” she said.

The statement continued, “Like the overwhelming majority of Americans, the President and I believe women — in consultation with their doctors — should be in charge of their reproductive health care, not politicians.”

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Boards of Medicine Are a Sham

Posted on March 8, 2023 by Pharmaciststeve

Boards of Medicine Are a Sham

https://doctorsofcourage.org/boards-of-medicine-are-a-sham/

Here is a letter from Eric Dover, MD, on the deliberate attacks on doctors by their Boards of Medicine. This was in response to an Oregon ABC affiliate, KATU, media article by Wright Gazaway on Mar.1, 2023 pertaining to the revoking of physician licenses being nationally controlled instead of state controlled. Dr. Dover is an advocate for doctors who have been indiscriminately targeted by their state boards of medicine for removal from practice.

Mr. Gazaway

Where do I begin?

After reading your article it was clear neither you nor Wyden have any clue as to what you are talking about. In reality, Wyden knows the score, so all I can assume is he doesn’t care if he hurts physicians, their families or patients.

Wyden is a big part of the problem regarding the discipline issue you wrote about. He pushed through the HealthCare Quality Improvement Act of 1986 (HCQIA) which has allowed state medical boards and the 501(c)6 Federation of State Medical Boards (FSMB) to have absolute control over physician licensees. Typically, a nucleus of about 4-5 people at medical boards determine who they ‘discipline’. It is typically an AAG from the DOJ, the Executive director, the Medical Director, the investigator for the case, and a Board member. The rest of the board members are a rubber stamp. They also revoke licenses of those they ‘don’t like’ for any reason. Licensees are defenseless, because medical boards control the entire process. As far as ‘legal representation’ for physicians, there is no ‘effective’ representation available. Legal representation at the medical board consists of a lawyer “plea bargaining” on behalf of a licensee with the medical board. This concentration of power at medical boards allows them to full-on assault physician licensees, but at the same time allows medical boards to protect their friends, partners, associates, etc. from medical board disciplinary action for horrendous medical outcomes or criminal actions.

HCQIA has made it very easy for entities such as medical boards or hospitals to get rid of competitors or individuals they dislike for any reason. In the 1980s, a federal case was filed in Portland Federal District Court that involved a ‘physician competitor’ being attacked by the Astoria Hospital Executive Board in Astoria, OR and the Oregon Medical Board (OMB). There was a member on the Executive hospital board and a member of the OMB that were from the Astoria Clinic whom Dr. Timothy Patrick had snubbed regarding employment. The case went all the way to the SCOTUS. PATRICK v. BURGET, 486 U.S. 94 (1988) https: //caselaw.findlaw.com/us-supreme-court/486/94.html. Dr. Patrick won his case at the District Court and Supreme Court. This is the last time a physician was able to protect themselves from a medical board. While this case wound its way through the Federal courts, HCQIA was put together by Wyden. He had full knowledge of how this would ultimately affect the practice of medicine in the United States.

Physician licensees have no constitutional or due process rights. Medical boards control the entire process; they act as the investigator, jury, judge and executioner – a completely closed loop so that only their story of the situation is given to the media, general public, NPDB and the FSMB Data Bank. Medical boards control every aspect of the sham hearing process, which in reality is a sham trial to revoke the licensee’s license, i.e. their property. Licensees have no access to ‘effective’ counsel because medical boards like the OMB have control over lawyers who are involved with representing licensees. The control mechanism is the lawyer’s access to investigators, administrators, lawyers, etc. at the medical board as they plea bargain on behalf of their client. If a licensee is scheduled for a hearing, they have already lost. Medical boards never lose a sham hearing, and why would they when they make the rules and run the show without any oversight. The Administrative Law Judge (ALJ) at the sham hearing is just for pretenses. The ALJ typically comes down on the side of the medical board, but just in case they don’t, most medical boards can simply overrule the ALJ’s decision.

Medical boards claim they have at least sovereign immunity, if not absolute immunity, as a result of Wyden’s HCQIA. The state courts and lower federal courts had looked upon the immunity issue similarly up until the North Carolina State Board of Dental Examiners v FTC 135 S. Ct. 1101 (2015) decision which defined the requirements needed for board members to obtain sovereign immunity from lawsuit.

Physicians are being heavily disciplined, don’t think otherwise. There are physicians who do bad things – no doubt. Unfortunately, the system many times chooses to ‘discipline’ licensees who have harmed no one. Every year, the equivalent of almost 20% of each year’s graduating class has their license revoked and/or their careers irreversibly crapped on. That data comes straight from the FSMB’s website. Do you believe that the medical schools and residency programs are doing that poor of a job selecting candidates? I doubt that. It’s more likely medical boards and the FSMB harvesting their own for monetary gain.

There are 350 to 400 plus physician suicides every year, most being tied to current or past medical board cases that have robbed physicians of their dignity and income. I personally know two physicians who have committed suicide.

Medical boards are under the direction of the FSMB.

The FSMB is a tax exempt 501(c)6. The FSMB states it’s lobbying for medical boards, but in the past, they have been open to corporate influence. They have legal and legislative programs to push their medical board agenda. This makes it very easy for them to take in ‘donated’ money and spin their lobbying in a beneficial way for a ‘donor’.

We know of at least one instance of the FSMB taking millions of dollars from a drug manufacturer. It involved Purdue Pharmaceuticals and Oxycontin. Senators Grassley and Bauchus of the Senate Finance Committee opened an investigation because of public concern about opiate prescribing and deaths. The entirety of the investigation was later sealed from the public by Senate Finance Committee members Grassley and Wyden. After the investigation, the medical boards began attacking chronic pain physicians for prescribing too many opiates. Pain patients have suffered severely

Once a physician’s private property medical license is revoked, they will never work in any capacity in medicine again. The physician can’t get licensed in any other state. The FSMB notifies every state board about the licensee’s revocation, in particular those states that the licensee is additionally licensed in. I know a licensee who simply had his license restricted for opiate prescribing. He has no idea who made the complaint or what the complaint was. His license was restricted 9 years ago. It was only supposed to be restricted for 5 years. His twin boys who were 5 years old at the time are now 14. They suffer from PTSD and anxiety. Their parents divorced as a result of financial and emotional stress. Their father can only find minimum wage work, has no car and lives in a rusty RV as a homeless man. The State of Oregon wouldn’t even let him drive a school bus because of the OMB license restriction. He eventually got a medical license in Utah, but no one will hire him, he can’t get hospital privileges, no one will sell him medical malpractice insurance and insurance companies will not contract with him to see their patients. Every ‘medical’ entity has the ability to go to the National Practitioner Data Bank (NPDB) and FSMB Data Bank and find out anything related to the physician licensee that these data banks have available. So, ‘Shuck and Jive’ Wyden’s and your take on physician discipline is nowhere near reality. Question, why is physician ‘discipline’ suddenly an ‘issue’?

I know many physician licensees from Oregon and across the United States that would be happy to relate their medical board stories to you. Medical boards and the FSMB especially love to attack and revoke Integrative Medicine physicians (MDs or DOs who incorporate both allopathic and naturopathic medicine). The FSMB hates Integrative Medicine physicians and I have their internal document that specifically states that they are directing medical boards to attack and remove these physicians from medical practice. The reason: The public makes more visits and spends more money out of pocket for Integrative Medicine physicians than allopathic primary care physicians. As usual, it’s about money. The medical boards have had a hard on for Integrative Medicine physicians since this document. See (SPECIAL REPORT BY FSMB ON INTEGRATIVE MEDICINE DOCTORS).

If you’d like to know more about me, the OMB, the FSMB, other licensees, my published chapter “Functioning as a Physician in a Regulatory Environment [Controlled by Medical Boards and the Medical Industrial Complex] (January 2016) and numerous documents, go to drdovervsomb.weebly.com

Respectfully,

Eric Dover, MD

 

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Former DEA agent: assets can determine whose office practice they raid

Posted on March 8, 2023 by Pharmaciststeve

start watching video around 00:30 https://www.tiktok.com/@bilkedtothebrink/video/7170431661136465194?_r=1&_t=8aUCzL4beaQ Here is a “help wanted ad” from the DEA https://www.pharmaciststeve.com/forfeiture-financial-specialist-supporting-the-dea/

BIRMINGHAM, Ala. (WHNT) – A federal judge sentenced a Tennessee physician and his wife on Monday for unlawfully distributing opioids and defrauding insurers through their now-shuttered Alabama clinics.

Mark Murphy, 65, and his wife, Jennifer, 65, both from Lewisburg, Tenn. were convicted of conspiracy to distribute controlled substances and conspiracy to commit health care fraud, along with various substantive counts related to the same, and conspiring to defraud the United States and receiving kickbacks.

The Murphys were sentenced to twenty years each in prison

The Murphys owned and operated North Alabama Pain Services (NAPS). The couple closed both the Decatur and Madison offices in early 2017.

(Photo courtesy AL.com)

The U.S. Department of Justice (DOJ) said over a five-year period before the clinics closed Murphy wrote prescriptions for more than ten million opioid pills, including millions of oxycodone 30 mg tablets. The Murphys also ordered tens of millions of dollars of unnecessary items and services that were paid for by taxpayer-funded and private insurance programs.

The DOJ said Murphys received kickbacks for those orders and prescriptions. In all, Medicare, TRICARE, and Blue Cross Blue Shield of Alabama were billed more than $280 million as a result of the fraud and kickback schemes and paid more than $50 million.

After Mark Murphy closed the Alabama clinics he continued to work from his Tennessee practice in Lewisburg which was raided by FBI agents in 2018 and was indicted in 2020 along with his wife and four other people.

“Dr. Murphy and his wife preyed on countless vulnerable patients and stole tens of millions of dollars from Medicare and other taxpayer-funded health insurance programs,” said U.S. Attorney Escalona in a statement. “Our office will continue to prosecute drug dealers and health care fraudsters to the full extent of the law.”

“The abuse of prescription drugs, especially opioids, is a serious problem in our communities,” said DEA Assistant Special Agent in Charge Towanda Thorne-James. “All too often, this abuse leads to addiction, shattered lives, and even death. For the health and safety of our citizens, DEA and our law enforcement partners will continue to target those who illegally distribute these potentially dangerous drugs. We hope that the sentences, in this case, serve as a reminder to anyone who might illegally divert pharmaceuticals that they will be held accountable for the harm they cause.”

“Mark and Jennifer Murphy learned today that unlawfully distributing controlled substances, committing health care fraud, and receiving kickbacks comes with hefty legal consequences,” said James E. Dorsey, Special Agent in Charge, IRS Criminal Investigation, Atlanta Field Office. “Their conviction today serves as a lesson to others who think no one is paying attention.”

Mark Murphy and Jennifer Murphy were each ordered to pay more than $50 million in restitution. Jennifer Murphy was also convicted of tax-related charges for underreporting clinic income.

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Shortage of albuterol is about to get worse, especially in hospitals

Posted on March 3, 2023 by Pharmaciststeve

About 10-15 yrs ago, many of the generic pharmas were merging to create some economy of scale,  because the PBM’s were reimbursing pharmacies less and less for the medications they were dispensing and the generic pharmas were competing to be the lowest price on a particular generic. So that more pharmacies would buy their products, to be able to make a extra $0.50 to $1.00 per Rx filled.

Apparently Akorn Operating Company LLC, couldn’t be price competitive in the market place and apparently Akorn couldn’t sell enough units to pay their overhead operational costs and has went bankrupt and closed their operations.  We have had some serious shortage of various meds over the last number of years…  this situation is just getting worse,  how many people

Shortage of albuterol is about to get worse, especially in hospitals

https://www.abc12.com/news/health/shortage-of-albuterol-is-about-to-get-worse-especially-in-hospitals/article_a03f500d-2ac3-5d41-9295-954a57ce5da1.html

An ongoing shortage of a medicine commonly used to treat people with breathing problems is expected to get worse after a major supplier to U.S. hospitals shut down last week.

Liquid albuterol has been in short supply since last summer, according to the American Society of Health-System Pharmacists. It has been on the U.S. Food and Drug Administration’s shortages list since October.

The news of the plant shutdown worries some doctors who work with patients with breathing problems such as asthma.

“This is definitely concerning, especially as we are coming out of the respiratory season where we had a big demand with RSV, COVID-19 and flu, and are now heading into spring allergy season when a lot of kids and adults experience asthma symptoms,” said Dr. Juanita Mora, a national volunteer medical spokesperson for the American Lung Association and an allergist/immunologist based in Chicago. “This is a life-saving drug and being able to breathe is vital for everyone.”

The manufacturer that recently shut down, Akorn Operating Company LLC, had filed for Chapter 11 bankruptcy in May 2020.

It was the only company to make certain albuterol products used for continuous nebulizer treatment. It’s a staple in children’s hospitals, but had been out of stock since last fall. Without that particular form of the product, hospitals have had to scramble to find alternatives.

“Members are either forced to compound it themselves to make the product or go to an outside third party source who is compounding the product,” said Paula Gurz, senior director of pharmacy contracting with Premier Inc., a major group purchasing company for hospitals.

With the Akorn shutdown, Gurz said products from the one remaining major domestic source of liquid albuterol, Nephron Pharmacuticals, have been on back order. Nephron just started shipping albuterol last Friday, Gurz said, but to get back on track, “it’s going to be an uphill climb.”

Hospitals work around shortages

Hospitals around the country said they’re watching the supply chain — and their current stock — closely. There’s concern they might have to delay discharging patients because they don’t have enough medicine, or that they may see more ER visits for people with breathing problems who don’t have access to medicine.

Dr. Eryn Piper, a clinical pharmacist at Children’s Hospital of New Orleans, said her hospital has been largely unaffected so far, but for months she has heard about retail pharmacies and other health systems that have had issues with albuterol shortages.

“The big problem we’ve been hearing about is inhalation solutions, not really the inhalers, it’s more like the solutions that go into the nebulizer machines for inhalation that the patients breath in,” said Piper.

Without the larger Akorn product, staff at Lurie Children’s Hospital in Chicago had to squeeze out the albuterol contents from smaller packages.

It’s “time-consuming and labor-intensive as it takes opening 40 containers to equal 20 mL (each patient on continuous albuterol requires 3-5 syringes per day),” said hospital spokesperson Julianne Bardele in an email.

When Nephron was unable to meet demand due to manufacturing issues, Bardele said Lurie had to make another temporary switch to a different concentration and use an alternative liquid bronchodilator, levalbuterol.

Most hospital pharmacies are aware of supply issues for many medicines, particularly pediatric medicines, said T.J. Grimm, the director of retail and ambulatory services at University Hospitals Cleveland Medical Center, and they try to keep a higher stock — especially of the less expensive medicines like albuterol.

“Just so we can cover situations like this,” Grimm said.

Grimm said his system has albuterol supply for a couple of months still, but he’s frustrated and concerned about the supply chain.

“When you have supply chains that are just-in-time, it can create some issues with when something goes off,” Grimm added. “There’s the short-term crisis we all have to get through and then there’s a longer term. We need to think about these things a little more strategically, especially with our kids.”

Dr. Jerrod Milton, the chief clinical officer at Children’s Hospital Colorado, said they’ve been paying close attention to the albuterol shortages for many months. The hospital has experienced shortages in the past, and has continued to implement protocols to conserve doses.

“Challenges are what we deal with when it comes to pediatric medicine. We consider most of the kids that we take care of as somewhat therapeutic orphans,” Milton said. “It’s just another one of the myriad of shortages that we have to deal with, I guess.”

Supply chain concerns

Jessica Daley, the group vice president of strategic sourcing for Premier, said that she doesn’t anticipate that the albuterol shortage will be an ongoing problem for years, but when the market has only a handful of suppliers, “it makes for a very tight market, a very concerning market right now.”

Daley said there are things hospitals can do to help, such as protocol changes, making products on site and finding different suppliers.

The Children’s Hospital Association stepped in to help when it heard from members having difficulty finding enough supply. The association worked with STAQ Pharma, a facility that provides compounded pediatric medication, to start production on batches of albuterol for children’s hospitals in the sizes they needed.

“We’ve been creative and trying to work proactively. So when we think there’s going to be a problem, we’re trying to plan ahead,” said Terri Lyle Wilson, director of supply chain services for the Children’s Hospital Association.

STAQ should be at full production by May, so hospitals will have a steady, stable supply ahead of the next season in which respiratory viruses are in wide circulation, the association says.

Daley at Premier said that in an ideal world, there would be more suppliers of these products, particularly with generic drugs, so that when there is a problem with one, the market could handle it. When there is a concentration of manufacturing with a small number of suppliers, it is very hard to recover, she said.

“We really advocate for diversity and supply to prevent types these types of issues,” Daley said. “Meaning at least three globally, geographically diverse suppliers that are supplying the market with sufficient products.”

Guidance for patients

For patients, Piper at Children’s Hospital of New Orleans said they are encouraging patients with breathing problems to take precautions and avoid asthma triggers if possible. She said if a patient’s usual pharmacy runs out, it’s also good to check with a doctor to see if there is another medication that’s available.

Inhalers don’t seem to be impacted by the shortage so far, but Daley said if people panic about the lack of albuterol for hospitals, that could change.

“Albuterol is one of those things that if there’s a patient who needs it, you want to have it all the time. So there’s always that potential for the market to respond and react in a way that that will then create downstream shortages of other sizes or presentations of a product,” Daley said.

To avoid that problem, Milton at Children’s Hospital Colorado said it’s simple: “Talk to a provider and see if there are alternatives,” Milton said. “And please don’t hoard.”

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Cardinal Health, McKesson prevail in Georgia families’ opioid trial

Posted on March 3, 2023 by Pharmaciststeve

Cardinal Health, McKesson prevail in Georgia families’ opioid trial

https://www.reuters.com/legal/cardinal-health-mckesson-prevail-georgia-families-opioid-trial-2023-03-01/

March 1 (Reuters) – Drug distributors Cardinal Health Inc (CAH.N), McKesson Corp (MCK.N) and JM Smith Corp on Wednesday prevailed at trial in Georgia in a case brought by families of opioid addicts accusing the companies of acting as drug dealers.

A jury in Glynn County Superior Court handed down the verdict after two days of deliberations, according to Courtroom View Network, which carried live video of the trial. It was the first trial of opioid claims brought by individual plaintiffs, rather than government entities.

“We are pleased with the jury’s decision, which confirms that a law meant to apply to street dealers of illegal drugs cannot be used in a misguided attack” on distributors of federally licensed drugs, Cardinal said in a statement.

McKesson called the verdict “the right outcome based on the law and evidence.”

A lawyer for the plaintiffs did not immediately respond to a request for comment.

The 21 plaintiffs include children whose parents died of overdoses, a woman whose grandson was born with opioid addiction symptoms and died at one month old, and a woman who was raped as a teenager but received no help from her opioid-addicted mother.

Plaintiffs said the distributors fueled illegal opioid use by filling illegitimate pharmacy orders and failing to report suspicious opioid purchases to law enforcement, as required by the federal Controlled Substances Act.

Litigation by more than 3,300 state, local and tribal governments against opioid manufacturers, distributors and pharmacies has resulted in more than $50 billion in settlements.

Unlike those lawsuits, which accused companies of creating a public nuisance by failing to stem the flow of illegal opioids, the Georgia plaintiffs brought their claims under the state’s Drug Dealer Liability Act, which allows people injured by illegal drug use to sue dealers.

More than half a million people died from overdoses in the United States in the period from 1999 to 2020, according to the U.S. Centers for Disease Control and Prevention. The agency has said opioid overdoses surged further during the COVID-19 pandemic, increasing 38% in 2020 over the previous year and another 15% in 2021.

Filed under: General Problems | 3 Comments »

Government agent’s fake testimony

Posted on March 3, 2023 by Pharmaciststeve


what is the definition of police entrapment

Police entrapment refers to a situation in which law enforcement officers use coercive or deceptive tactics to induce a person to commit a crime that they would not have otherwise committed. This may involve encouraging or enticing someone to engage in illegal activity, and then arresting them for that activity.

Entrapment is considered a defense in criminal law, and it can be used to argue that the defendant was not responsible for their actions because they were induced by the police. However, it is important to note that not all police behavior that leads to a person’s arrest constitutes entrapment. The key factor is whether the police used tactics that overcame the defendant’s free will and caused them to commit a crime that they would not have otherwise committed.

The above text is what I got back from asking CHATGPT… what is the definition of police entrapment

My understanding of the CSA, it is illegal to try obtain a controlled substance without a legit medical issue. Since pain is subjective, so there is really no way to determine if a pt has pain nor the intensity of the pt’s pain. Apparently this “investigator” chose to investigate Dr Pompy’s practice because of some “fishing ” and data mining in some medical databases.. to find that Dr. Pompey has some “out-lying” numbers. I guess this Blue Cross has never heard of a BELL CURVE.  No random segment of our population is going to produce a FLAT LINE, homo sapiens are not homogeneous. Isn’t it amazing the lengths law enforcement will go to to entrap a prescriber.  Send in a person with fake driver’s license, fake home address, fake insurance card, and fake referral from another practitioner.

https://doctorsofcourage.org/government-agents-fake-testimony/

When doctors are attacked in the United States, one of the techniques used by the government is to send in an agent as a patient. They complain of pain, get treated appropriately for their complaint, and then later testify that the treatment was medically unnecessary because they really don’t have pain and the doctor broke the law.  Here is the testimony of one such CS (confidential source) in the trial of Lesly Pompy, MD.

The government witness is James Stewart Howell.  The direct examination is by US Attorney Andrew J. Lievense.  Questions (Q) are by Mr. Lievense and answers (A) are by Mr. Howell

Q. And what role did you have in this case?
A. I was an employee of Blue Cross doing undercover visits.

Q. And what type of patient were you posing as when you went to see Dr. Pompy?
A. I was posing as an undercover patient seeking drugs or pills or medication.
Q. And did Dr. Pompy prescribe those pills to you?
A. Yes.
Q. what did he prescribe to you?
A. Norco.

Q. Now, in your role with Blue Cross Blue Shield, how do you identify people to investigate?
A. We have a variety of ways that we get our Case. One of them is we have an antifraud hotline. We get cases from law enforcement. We get cases from other areas within the company. We get cases from former employees of providers, doctors’ offices, things like that.

Q. And does Blue Cross Blue Shield have people who are engaged in — in data mining?  What does that mean?
A. Data mining is when you search for particular things within data that you have possession of. We receive cases that are created by data mining.
Q. And so you would see the results of their work?
A. Yes.
Q. And based on your review of the results of that work, do the people that are referred to you, are they just randomly drawn out of the databases?
A. No.

Q. Based on the results of work that you received from them, are the people referred to you kind of outliers in some way?
A. Yes.
Q. In what ways might a health care provider be an outlier?
A. They could be an outlier based on the fact they compare them against peers of similar practice size, et cetera. If somebody’s outside of the peer comparisons, they would be considered an outlier.

Q. What types of methods do you employ as a health care fraud investigator for Blue Cross?
A. We use undercover techniques, record review techniques, audits, and there’s other ways.

Q. Why does Blue Cross or why do you as an investigator for Blue Cross use undercover work as one of your techniques?
A. The reason I like to use them is that it gives you an inside view of actually what’s going on at a particular place such as the time spent or like what transpires, the number of employees, exactly how the practice works.

Q. Now, do you use your normal driver’s license that’s issued by the Secretary of State that you’ve had since you turned 16 years old? A. No.
Q. Are you able to get an undercover driver’s license?
A. Yes.
Q. Now would you need an insurance card that matched your undercover driver’s license?
A. Yes.
Q. And why do you use an undercover driver’s license and undercover Blue Cross Blue Shield insurance card instead of your personal ones?
A. You don’t want to give your own personal information out.

Q. How did you come to learn about Dr. Lesly Pompy?
A. He came to my attention from another investigator within the area where I work.
Q. And do you know how your colleague learned of Dr. Pompy?
A. Yes.
Q. And how did essentially you and Blue Cross learn about Dr. Pompy? Did Dr. Pompy getting on your radar came from law enforcement?
A. Yes.

Q. All right. And I’d like to direct your attention to January 5th, 2016. Do you recall what happened that day with respect to your investigation of Dr. Pompy?
A. So on January 5th, 2016 I did go to Dr. Pompy’s office to inquire about becoming a new patient there in an undercover capacity.
Q. And can you describe what you did when you entered the office?
A. I spoke with the person on the desk.
Q. And did the person there ask you whether you had any insurance?
A. Yes.
Q. And did they provide you a new patient questionnaire and paperwork?
A. Yes.
Q. In addition, did the person there at the reception area say anything else that you needed to fill out or have with you besides the new patient questionnaire?
A. Yes. Told me I needed a referral from a doctor for pain management. The explanation I remember was to fill out the new patient paperwork and return it when it was completed fully and bring that referral from another doctor back when I had it all filled out.

Q. Do you recall when the next time you went to Dr. Pompy’s office was?
A. That was on January 26th of 2016.
Q. I’d like to show you a clip from Government’s Exhibit 91. We’re going to be showing you a series of videos from the undercover investigation. Were you the person who made those video recordings?
A. Yes.
Q. And where is the camera?
A. It’s in my hand recording, handheld or it can be set down, but it’s portable. It’s hidden in the top of a coffee mug.
Q. Is this a special coffee mug that has this equipped?
A. It’s a camera mug, yes.

He discussed the protocol used to accept a new patient.

Q. And did you also turn in the new patient questionnaire?
A. Yes.
Q. And what does it say underneath “New Patient Information Packet”?
A. “Please be advised that during your initial evaluation for pain management narcotic medications will not be prescribed. Testing and evaluations will be performed to determine the best treatment for your condition.”

Q. When you filled it out, what was your goal, what was your purpose?
A. My goal was to get in as a new patient.
Q. Was your goal to present as a new patient who was completely healthy?
A. No. My goal is to get in as a pain patient and be seen as a normal patient that was being seen there.
Q. So did you know you had to present as someone who had some level of discomfort?
A. Yes.

Q. What address did you put down as your address?
A. It’s Dearborn, Michigan.
Q. And if you know, approximately how far away is that from Monroe, Michigan?
A. I’m going to estimate 25 miles.

THE Judge: Why did you say Dearborn instead of Monroe?
THE WITNESS: Just to give an address that wasn’t too close to Monroe or was in Monroe because I was trying to appear to be a drug-seeking patient not from the area.

And under “Referring Physician,” did you write in Dr. Robertson, which is consistent with the referral?
A. Yes.
Q. And what did you write for Dr. Robertson’s city in which he lived in?
A. I listed Eastpointe because that’s where his practice is.
Q. And is that a farther distance from Monroe?
A. Yes.

Q. What’s the title of this page of the document?
A. Title of the page is “Review of Symptoms-Circle All that Apply to your current condition.”
Q. And the fourth one down is — you circled “Musculoskeletal,” is that correct?
A. It is, yes.
Q. And next to — of that list of musculoskeletal symptoms, which one did you circle?
A. I circled “stiffness.”
Q. Why did you circle “stiffness”?
A. I was indicating stiffness, not really pain.
Q. All right. And it looks like underneath “Musculoskeletal” there’s “Neurological.” What did you circle next to “Neurological”?
A. Back, back problems.
Q. And below that under “Psychiatric,” did you circle one of the symptoms under “Psychiatric”?
A. “Personality changes.” I don’t remember the purpose of circling that.
Q. And if you go further down, right at the bottom, did you circle “Addiction”?
A. Yes. I wrote “Booze weekends.” I was giving indications of not only drug seeking but alcohol abuse or use.
Q. the next page under “Review of Symptoms.” Did you write anything on this page?
A. I did. Under “List Past-Current Medical Diagnosis” I wrote “Back and Nerves.” I was indicating stiff back, so I was directing it towards back.

Q. All right. And what did you write on this page in terms of your wishes
A. I indicated “help with back” in two different spots.
Q. So on these two pages you did report some symptoms consistent with discomfort, is that right? A. Yes.
Q. And you also — and you also mentioned the alcohol abuse, is that right?
A. I did, yes.
Q. And under Question 4 it says, “Use the Following Scales to Indicate How Severe Your Pain is.” Did you circle anything?
A. No.
Q. What did you write?
A. I wrote “stiffness mostly.”
Q. And under number 5, “Which Statement Best Describes Your Pain?,” what did you check?
A. I checked “Always Present, Always Same Intensity,” and wrote “stiffness” next to it.
Q. And on page 16 what were you asked to circle?
A. On that form I was asked to “Indicate on the Diagram Where Your Pain Occurs by Shading the Painful Areas,” and which I circled low back.
Q. And under Question 8 is the question “What Makes Your Pain Feel Worse?” And what did you check?
A. I checked “Other: driving.”
Q. And driving, did you report that you had a particular occupation in your undercover capacity?
A. Yes. I indicated that I was a driver.
Q. And under Question Number 9, when it says, “What makes your pain feel better?” what did you check there?
A. I checked “alcoholic drinks” and “medicines.”
Q. Now, the questionnaire asks you to “List All Pain Medication You’re Currently Taking.” What did you write?
A. I wrote “Norco 7.5, Soma 350 and Ativan .5.”
Q. And do you understand Norco to be a — an opioid, a narcotic?
A. Yes.
Q. Do you know what Soma is?
A. Yes. It’s a muscle relaxer.
Q. And do you know what Ativan is?
A. It’s a benzodiazepine.
Q. And had anybody, any physician been prescribing those three medications for you? A. No, not those three together, no.
Q. And you are aware of something called MAPS, right?
A. I am.
Q. And so when you listed those, were you aware whether Dr. Pompy or anyone else could check to see whether that was accurate?
A. Yes.

Lievense: I’d like to go back to page 26
Q. What did paragraph 6 of this document advise you?
A. Paragraph 6 says that “I agree to disclose all pain medications that I receive. I agree to receive my pain medications from one doctor only. I agree not to misrepresent my pain medication intake or my physical status to any of my health care providers.”
Q. And what is the first sentence of paragraph 10.
A. It says, “I will not share, sell or trade my medication for money, goods or services.”
Q. And the next one says what?
A. It says, “I agree not to doctor shop, street shop, conceal or divert prescribed medications for additional drugs.”
Q. And what about the next sentence?
A. “Any illegal diversion or questionable use of opioids will result in weaning and discontinuance of narcotics with the potential for clinic discharge.”
Q. As part of this agreement, did you also sign saying you agreed to take your medications as directed by Dr. Pompy?
A. Yes.
Q. Given that these paragraphs were part of the narcotics contract that you were provided, were these things that you were looking to see whether Dr. Pompy enforced them?
A. Yes.
Q. And if you didn’t comply with these requirements, what did you expect him to do?
A. I expected to be either questioned, called out or discharged.
Q. After turning in the questionnaire, did you then leave the office? And as you were leaving, did you talk to other people who were in the hallway?
A. Yes.
Q. Did you learn anything during those conversations that impacted your investigation?

MR. CHAPMAN: Your Honor, I’m going to object to the relevance of these statements. They’re from patients out in the hallway. There’s no indication Dr. Pompy knew these things were said.
THE JUDGE: Right, but I think he can testify as to how they affected his next steps in the investigation,
THE WITNESS: What I learned in the hallway from talking to some people was that it would take multiple visits to get medications and also that you may be required to submit to some testing.

 

So a 26+ page patient questionnaire is amazing! And all of the procedures are appropriate. So how does the government get away with sending fake patients in like this, who complain of pain, lying about their history but saying enough to get the appropriate medication, and then use these fakers to get a doctor convicted?  It’s purely because of the prejudice in the juror’s minds against opioids that the government has planted in our minds since 1999.

Does anyone know what happened to the Benedict Arnold physician—J Alan Robertson, MD—that helped the government by writing a referral to Dr. Pompy? Googling him states that his office is permanently closed. But other offices say he is practicing addiction medicine and working as a chiropractor.  Let me know what he is doing. Patients need to boycott him.

The only way to end this is to end government immunity and learn the REAL cause of addiction–and it isn’t the drugs!. Did you know that the government can lie to you and nothing happens?  But if you lie, you commit a crime. Lying to achieve a conviction in court should be a punishable offense. Prosecutorial misconduct is rampant now, simply because they can. There is no morality or virtue anymore in the legal profession.  “Do whatever it takes to get a conviction” is the rule. People don’t understand this until it happens to them. Do something before it happens to you. Join the communication campaign and let’s get some laws changed.

 

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