FORMER PAIN CLINIC DOCTOR
CHARGED IN DRUG CONSPIRACY
by Kenneth A. Gailliard
The Sun News
11/10/2004
Federal authorities have identified and charged another doctor with illegally distributing
narcotics at the former Comprehensive Care and Pain Management Center of Myrtle
Beach.
An arraignment is set for today in Florence for Gregory W. Walter of Albany, Ga., who
was indicted on charges of conspiracy to unlawfully distribute and dispense controlled
substances and money laundering.
Seven doctors from the clinic, including its owner, Dr. Michael Woodward, already have
been convicted and sentenced in federal court on charges related to money laundering
and drug distribution.
Three of those doctors, Michael Jackson, Deborah Bordeaux and Ricardo Alerre, have
yet to begin serving their sentences. Jackson's sentence is about 24 years, Bordeaux's
about 19 years and Alerre's about eight years. Each was convicted of conspiracy to
unlawfully distribute and dispense controlled substances and conspiracy to launder
money.
A federal judge recently ruled that the three, who were sentenced in February, would not
have to report to prison before January, said Assistant U.S. Attorney Bill Day.
Walter was indicted in October and was at the pain center before some of the other
doctors, Day said. Walters wasn't named in the initial indictment because he had moved
on from the clinic to a facility out of state before federal authorities charged the others,
Day said.
"We were trying to address the problem that was in Myrtle Beach at that time,"
Day said.
Other doctors who also worked at the clinic have not been charged, but it was unclear
Tuesday whether any of them would be charged, he said.
Federal agents investigated the pain center, which operated between 1997 and 2001, after
receiving multiple complaints from police, pharmacists and doctors that suspicious
amounts of narcotics were being prescribed from the pain center.
Friends,
Below, Dr. Walter eloquently catalogues the series of human rights abuses he
and his wife encountered in their search for pain treatment.
Frank
Joel,
So I guess that means, chronic pain patients who lost their
insurance when their disability ran out are not part of your practice. So
when they were without medical care unable to find a provider they are
simply drug seekers. Do you condone them living a government caused nomadic
existence from one ER or GP to another trying to find a sympathetic
provider? Do you just tell these patients to take a hike?
Having a wife
with chronic pain syndrome due to failed back surgery I have witnessed this
first hand. I reviewed my wife's post operative follow up notes where here
orthopedist writes some very derogatory notes. Basically that "I removed the
herniated disc therefore she can not be in pain and must be a drug seeker or
malingerer". Do you have any idea what this does to a chronic pain patients
ability to find care? My wife bounced back to her GP then ultimately a pain
specialist but it wasn't a straight line. She was never able to return to
work. Subsequently her husband divorced her and she lost her medical
insurance. She did okay for a while but ultimately moved to another city
where there there was a job offer and some semblence of support network. She
again entered a nomadic existence from ER to clinic in an attempt to find a
chronic pain provider. Perhaps your clinic was one of the many that threw
her out because of "gaps in her treatment".
Jennifer finally had a breakdown and entered a psyciatric hospital. She was lucky. Unlike Rush Limbaugh
who had doctors convince him that he had a drug addiction problem, Jen's
doctors recognized her chronic pain problem and they got her enrolled in a
chronic pain clinic at a local teaching University. It wasn't a free clinic
but based on her minimal income she could pay very little. The absolute
inflexability of the program would be insulting and humiliating to any adult
expecting compassionate care but that was only a minor hassle.
The real
insult was that every month she was forced to be psychologically dissected
by a first year psych resident (a different one each visit, and never once
a physical exam). Only then would the attending approve a refill of her #90
Lortab 5 mg.
When I met Jennifer she was living a very marginal existence
working two jobs to make ends meet. She at one time was weeks from
graduating nursing school, had a lucritive modeling contract and her husband
was a millionaire. When I married Jennifer, my Blue Cross Blue shield
insurance picked up her medical expenses but not her pre-existing illness.
So it cost me about $500-700 a month when I finally enrolled her in a proper
pain clinic where she saw a competent pain specialist on a regular basis.
This went on for 2 years. My only complaint was when he switched her to
Oxy-Contin, my out of pocket cost was about $1,100 a month.
Joel, how many of
your perfectly documented patients have $1,100 cash every month to pay for
their treatment? Would you consider that a "red flag"? My job situation
caused me to move to another city. I was in Rock Hill South Carolina. There
was one pain clinic in all of South Carolina in Myrtle Beach 3-1/2 hours
away. Comprehensive Care maybe you have heard of it? Would you consider that
a red flag if she drove that far? How about her sketchy history? That's a
definate sure sign! How about those comments by the sanctimonious Orthopedist,
who's attitude that no one who ever had surgery by him ever had pain again?
I am sure you would have thrown her out. Maybe after subjecting her to a
strip search to see if she had a hidden microphone.
We chose the closest
pain clinic in North Carolina 2 hours away. We were lucky. Between me being
a physician and a friend of a friend, we were able to get her enrolled in the
clinic in two months. Her previous Pain Specialist was willing to send her
prescriptions but only for another 2 months. (sounds a little like Richard
Paey doesn't it?)
Things were okay until the pain clinic cancelled her
appointment and rescheduled her for 5 weeks later. Naturally at some point
she ran out of medication. Her previous pain specialist would only give her
a refill if she made the 8 hour trip back to his office. She became one of
the nomadic pain patients roaming ERs for a measly 6 or 8 tylenol #3.
Well, she
came to my ER as a patient when I was working logged in under her maiden
name. I refused to give her any meds. I later came back with her during a
later shft when a different doctor was working. We sat and waited 5 hours. I
tried catching a nap in the car because I had to return in 12 hours.
Apparently the triage nurse must have flagged her as a drug seeker who had
been there before and refused drugs. When we finally were seen, despite the
fact that she was starting to show signs of withdrawal, my collegue, a fellow
physician, refused to give her anything. Not even phenergan for the
vomiting! He said that he would only refill her meds if he could reach her
Pain Specialist. Well it was 2am so guess what. We went home with Jennifer
in pretty rough shape so I said F**K it! and wrote her a refill. I wrote for
her to get #120 lortab 5mg, enough to get her through until her appointment.
The pharmacy called to verify the prescription and was told it was a forgery
and called the cops! I had to step in and verify the prescription as not
being a forgery. The next day I was fired and reported to the SC state
medical board. The story goes on but I think you have gotten my point.
I am
so glad that you have a perfect system of reviewing all of the perfect
patients who live in a perfect world and have perfect charts. However that
means that the other 80% of the true chronic pain patients, you must be
throwing out the door.
Also, if you are up to a challenge, I promise you that
I can generate a perfect paper trail to your doorstep and after you reviewed
it you would give a patient with no pain a prescription.
Gregory Walter MD
Dr. Walters' Letter to
Montel Williams December 16 2003
Dear Mr. Williams;
I am writing this letter to you to encourage you to do a show highlighting the plight of chronic pain sufferers and their physicians. I know by now you have probably heard quite a few letters about the situation. So, rather than telling the same story again I thought that I might add some of my personal story.
I am a physician. I graduated from NY Medical College in 1981, spent 4 years as an Army Physician, and then trained 3 years to be an Emergency Specialist. Throughout my career as an Emergency Specialist I have often had chronic pain patients come to the Emergency Department in pain. Our usual course is to alleviate their present pain, to try to determine if their has been some new deterioration in their condition and if not to return them to the care of their current physician. As an Emergency Specialist I have spent my career being vigilant not to prescribe narcotics unnecessarily. So the current dictum is that we don't refill narcotic prescriptions in the Emergency Department. As a result of this approach no narcotics end up in the hands of persons who might abuse then, resell them or otherwise divert them to other drug addicts. Unfortunately, the truly needy fall victim to this approach. I never knew how much of a problem this was until 1996 when I
Fell in love with and married my present wife Jennifer.
Jennifer had entered nursing school in about 1992. She was a dedicated nursing student was in the upper 1/3 of her class. Then unfortunately several months before graduation she injured her back lifting a patient.
After weeks of pain and inability to return to nursing she saw an Orthopedic Surgeon who recommended back surgery. So in 1994 when they called her name during the graduation ceremony at her nursing class instead of being one of the happiest days of her life Jennifer was in a hospital bed recovering from surgery.
Weeks went by her back healed however the pain never went away. She returned to her Orthopedist, still in pain. Instead of treating her respect and believing her when she said that she was still in pain her treated with suspicion and disdain. �I have fixed your back so if you are having pain it is in your head� was his response. Ultimately she was on her own. In pain. No medication, no relief, unable to work, unable to find a physician who would treat her pain. Shortly thereafter her husband filed for divorce. It was more than he could bear either.
When I married Jennifer I thought that me being a physician that I could ensure that she got the care she needed. She was covered by my medical policy however her previously existing medical condition was not.
I found her a sympathetic family physician who helped her get the medical care that she needed and I was fortunate to be able too afford the cost of her care (about $500-$800per month). Things went well for about 6 months then my job situation was such that we needed to move to Charlotte N.C. Through colleagues I was able to find an excellent chronic pain clinic. The earliest we could be seen was in 3 months. So Jennifer was destined to run out of medication. Her physician in Atlanta was not allowed to refill her prescriptions without seeing her. If he had then he could be prosecuted by the DEA for improper prescribing of a controlled substance. That act alone would be cause for him to lose his license, a felony conviction with a mandatory 10-year prison sentence and forfeiture of assets. This is the results of the DEA's present policy on prescription drugs. Jennifer went from clinic to Emergency Department trying to find a sympathetic physician who would refill her medication. In so doing she was labeled a drug seeker by several doctors and nurses and treated with contempt and suspicion. Another result of our present drug Policy. I am a physician and am licensed to prescribe controlled medication however I am specifically
forbidden from refilling my wife's prescription. Jennifer went through some tough weeks. First she went through withdrawal from narcotics then ultimately a return to her previous state of chronic pain. Why do we have a national policy that creates such a crisis for pain sufferers? This is supposed to be the �decade of pain relief� according to Congress. So why aren't doctors getting the message?
In 1999 I took a job in a Chronic Pain Center. I was able to see that my wife's troubles were far from uncommon. Every patient I had told me a similar story. The really sad thing is that these were the lucky ones, the survivors. For every chronic pain patient that is able to find a pain clinic I bet there is � dozen that can't. If they can find a clinic they probably can't afford the medication, or the office fee, or the transportation. When I worked in the Comprehensive Pain Clinic in Myrtle Beach South Carolina we were the only pain clinic in the state. Many of our patients would have to drive several hours to see their doctor every month. They would also have to wait many hours to be seen, as the clinic was always short staffed.
In 2001 the pain clinic was raided by the Drug Enforcement Agency who claimed that the clinic was the largest �pill mill� in the history of the state. The DEA claimed that some of the drugs ended up being sold to drug addicts and that the doctors at the pain clinic were contributing to the drug problem in America!
I find it odd to be accused by the DEA of contributing to the drug problem in America. Here I have worked
my entire career to make sure that my patients who need them have access to pain medication and those patients who don't need them are not given them. Where was the DEA for all of those 20 years? Never once has the DEA offered to help me keep drugs from patients they knew were drug dealers. Never once have they asked me to help them. What sort of national drug policy is that? Are you aware that doctors and pharmacist are supposed to somehow miraculously know whom the drug addicts are and whom the legitimate patients are however law forbids us to tell each other! Yes, it is true. A patient has a right to the privacy of their medical record. So for instance if I was to write a prescription for a medication to a patient I am forbidden to tell anybody. If I suspect that a patient is a drug addict I am forbidden to tell anybody. If a patient's urine drug screen is positive for drugs of abuse I am forbidden to tell anybody.
Well, the DEA has been a failure when it comes to controlling illegal drugs in this country. I believe that there is per capita the same amount of narcotics and certainly more cocaine than before the Harrison act of 1914 was passed. If the laws of supply and demand hold true I believe the street price of narcotics have been fairly stable or gone down the last twenty years suggesting no decrease in supply. We have spent billions of dollars, overthrown foreign governments, and imprisoned 2.7% of the US population and not a dent! Not only have they failed miserably but also the crime that Drug Prohibition has fostered has killed far more people than drugs have. Now the DEA has decided that if they can't keep the Heroin and Cocaine off the streets that they will at least try to keep the prescription drugs off the street. This would be okay in itself however the DEA tends to believe that every MD who writes a prescription is contributing to the drug problem. They themselves do not know how to tell a legitimate pain patient from a drug seeking narcotic addict. Their War on Pain Doctors is the results. In 1999 it was difficult for a chronic pain patient to find a doctor willing to treat them today in 2003 it is almost impossible. The DEA's War on Pain Doctors has the entire medical community terrified that they will be next. That Drug Enforcement Agents in full SWAT gear will kick down their door and haul them to prison. So the Doctors stop prescribing pain medications and the patients suffer! Some commit suicide. This is so wrong.
I can't close this letter without making a plea for the doctors who are wrongfully imprisoned under this current situation. At least 100 physicians to date. Several of these doctors I know personally. Compassionate physicians who simply believed that if you can't cure a patient's disease that you should at a minimum treat their pain. This is so very wrong.
Gregory Walter MD
539 N. Westover Blvd., Apt 335
Albany, Georgia 31707
Phone: 229 291-3037
[email protected]
