Pain clinic doctor being investigated
Pubdate: 20 May 2004
State alleges anomalies in prescribing narcotics
By Lee Mueller
EASTERN KENTUCKY BUREAU
A doctor who complained to Kentucky medical regulators 21/2 years ago that an Eastern Kentucky health clinic was a "store-front narcotic prescription outlet" is now under regulators' scrutiny himself.
Dr. Richard O. Gritzmacher of Castle Rock, Colo., who worked briefly at the Tri-State Health Care pain clinic in South Shore, faces an Aug. 10 hearing and possible disciplinary action by the Kentucky Board of Medical Licensure, according to a complaint filed April 27.
Efforts to reach Gritzmacher were not successful. An official for the licensure board shrugged off questions about whether the doctor's complaint had backfired on him.
"He complained about the prescribing going on at the clinic, but, of course, in looking at it, we looked at him, too," said C. Lloyd Vest II, the board's general counsel.
Gritzmacher, whose primary practice is in Colorado, at times works in Kentucky on a locum tenens, or short-term contract, basis, the board complaint says.
"Dr. Gritzmacher unknowingly walked into a 'Store Front Narcotic Outlet,'" a board consultant was quoted as saying in the complaint. "In spite of this, he still failed to perform to minimal standards of practice by prescribing multiple controlled substances to patients without performing a patient history, exam, assessment or treatment plan that would meet minimal standards of care."
The consultant said in his report that he believed Gritzmacher's claims about the clinic had merit, but both Tri-State owner Denise Huffman and her daughter, office managerAlice Jewett, denied the allegations.
Gritzmacher's "letter was just totally bogus," Jewett said. "There was nothing in that letter that was true, at all."
Jewett said the clinic had just opened in 2001 and that Gritzmacher was the first of three doctors the clinic employed while it was in South Shore. Huffman decided last July to move the facility across the Ohio River to Portsmouth because they found a better building in a nicer location, she said.
Both Huffman and Jewett said they have had no problems with Ohio regulators.
Both women also said they were shocked by Gritzmacher's complaint and blamed him for any improper prescribing.
Huffman responded to the complaint by providing 16 of Gritzmacher's patient files to the licensure board's investigators, claiming he had inappropriately prescribed controlled substances while working for her, the complaint said.
"He made this bogus statement, he kind of insinuated that we made him see these people and made him write, you know, certain medications, and that just wasn't the case," Jewett said. "And I wanted the medical board to know that.
"That was his decision," she said. "We didn't knock him in the head and make him treat patients."
Huffman agreed. "I hired him to do a job: treat patients," she said. "If he violated any rules, he wasn't hired to do that."
Jewett twice said she felt the Kentucky licensure board was on a "witch hunt" generated by prescription-drug cases involving Dr. David Procter of South Shore.
Jewett once worked for Procter, whose medical clinic became a boot camp for teaching temporary doctors to operate pill mills, investigators said. Procter and at least four physicians who had worked for him were sentenced to prison last year after being convicted or pleading guilty to state or federal prescription-drug charges.
In a Nov. 10, 2001, letter to the medical board, Gritzmacher said that after working an hour at the South Shore clinic, it became clear to him that it was not the urgent-care facility he had been promised it was.
"During the five days I practiced in the facility, seeing 30 to 35 patients each day, I estimate only five or six were seen for an acute illness; the rest were seen only for refills of Lorcet, Xanax and Soma."
Gritzmacher said he felt obligated to fulfill his five-day contract but also felt obligated to notify the board about the clinic "so that other responsible physicians will not, like me, unknowingly become involved in its operation."
Huffman responded that Tri-State always took care to describe itself as a pain-treatment clinic and that if the placement agency that sent Gritzmacher to South Shore "misled him, that's their problem, not ours."
That agency was not identified in the complaint.
Jewett pointed out that no charges were filed by the Kentucky board against any other doctors employed by the clinic.
The licensure board's consultant wrote that little background was obtained from each patient, and none provided medical records from previous treatments and tests. "They all got refills of what they were supposedly taking without any double checking prior to prescribing controlled substances," the consultant reported.
All 16 patients were making their first visits to the clinic, the consultant's report said. All 16 were given 28 to 120 Lorcets, a painkiller, and 14 to 60 Xanax, a tranquilizer, while most were also given 60 to 90 Somas, a muscle relaxant.
None of the charts reflected a proper patient history, examination, assessment, or treatment plan, the consultant said.
All of the patients paid cash, the report said. Patients at the clinic said last year an office visit cost between $120 and $250.
Reach Lee Mueller at (606)789-4800 or [email protected]