Examiner: no action recommended against Helena physician for pain pill prescriptions
http://www.kxlh.com/story/29326510/examiner-no-action-recommended-against-helena-physician-for-pain-pill-prescriptions
HELENA – Nearly two years after the Montana Board of Medical Examiners first brought the action, a state hearing examiner says the board “did not meet its burden of proof” that longtime Helena doctor Mark Ibsen over-prescribed pain medication to nine patients.
Ibsen, owner of Urgent Care Plus and a former emergency department doctor at St. Peter’s Hospital, failed to meet standards of care in his record keeping, according to the hearing examiner with Montana Department of Labor & Industry, David Scrimm.
He proposed that the board put Ibsen’s license on probation for 180 days, and take various measures to improve his record keeping.
But on the more serious matter of failing to meet standards of care for the patients, the examiner found insufficient evidence.
The order, issued late Friday, is just a one step in a process that began for Ibsen as a board action in July 2013, concerning allegations by a former employee that Ibsen over-prescribed medication to nine patients. A board screening panel narrowed the allegations to the care of five patients.
The investigation then expanded to include 21 additional patients who sought his care after the board and the U.S. Drug Enforcement Administration raided and shut down the office of Dr. Chris Christensen in Florence in April 2014. But Scrimm found no evidence of unprofessional conduct by Ibsen with those patients either.
Along the way, agent of the U.S Drug Enforcement Administration visiting his office suggested he could face criminal charges.
According to the proposed order, in July 2014, a DEA agent told Ibsen, “You are not only risking you’re license by prescribing to these folks, you are risking your freedom.”
When Ibsen asked how, then, he should ensure he was doing things right, the agent replied, “I can’t tell you. We’re not doctors.”
Scrim wrote that he went through 5,000 pages of documents, including more than 800 pages of just one patient’s medical record.
The 49-page proposed order describes in detail the efforts by Ibsen to examine the situation of each patient and prevent abuses such as doctor shopping. It notes that some of the patients reduced or eliminated their use of opioids under Ibsen’s care.
The proposed order also takes several jabs at the board’s case, calling out its attempts to paint Ibsen as mentally unstable and casting doubt on the reliability of some witnesses.
One local pharmacist, the proposed order notes, “took it upon himself” to ensure Ibsen was weaning patients as he claimed, and enlisted other pharmacists in his effort; the examiner said such judgments were beyond the scope of that pharmacist’s training.
Michael Fanning, a lawyer for the board, said it Monday morning it was too early to say whether the board would file many exceptions. Ibsen declined comment, pending consultation with his attorney.
Once fully briefed, the case will then go to the board’s adjudication panel, which will review the entire record — which Fanning called a “monumental task.”
The panel’s final order could come in a few months — at which time either side could appeal it to District Court.
Ibsen meanwhile has held weekly group pain therapy sessions, where patients discuss their issues including the runaround some say they get when seeking medications. The sessions include plenty of Ibsen’s opinions on the way pain patients are treated, along with some discussion of the cultural context of pain.
Some of his patients have said they were turned away from other doctors and came to Ibsen because he alone prescribed the medications they said they need to simply live a functional life.
Ibsen has described pain — and the anticipation of pain — as “terroristic,” crippling people with the fear of pain. At one such session in May, he discussed the different way pain patients are treated compared to, for example, cancer patients.
“The families of people in pain are busy criticizing the pain patient,” he said. “Until you have pain, you don’t understand pain. Until you get pain, you don’t get pain. You don’t get it.”
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