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This post is an example of how the media plays a part in the incarceration of innocent physicians. Whether it is just for the sensationalism or if the government has a part in this, I don’t know. But the automatic incrimination of doctors through the power of the media needs to stop. In this post, I will compare the outrageous conduct of a CBS affiliate with a fair and honest presentation without the sensationalism of Fox News.

Dr. John Patrick CouchIn May 2015, authorities executed a raid of Physicians’ Pain Specialists of Alabama‘s (PPSA) two clinics in Mobile and C&R Pharmacy located next door, all operated by Dr. John Patrick Couch and Dr. Xiulu Ruan. It was part of “Operation Pilluted,” a massively-coordinated DEA raid of prescription painkiller clinics across the four southern states of Arkansas, Alabama, Mississippi and Louisiana.

Dr. Couch and Dr. Ruan were both arrested for distributing controlled substances outside of legitimate medical purposes and healthcare fraud. Dr. Couch pleaded not guilty. He was ordered to surrender his passport and is to have no contact with his co-defendant, Dr. Xiulu Ruan, as well as his employees, potential witnesses or patients.

Defendants can’t say anything on their behalf in these cases, but a press conference was held in Montgomery where Alabama Governor Robert Bentley said, “Alabama is one of the highest states per capita as far as the abuse of prescription drugs, and so I’m not surprised that we have some of these arrest that are taking place in our state,”

In a more recent news article on April 29, 2016 by J. B. Biunno entitled “Painkiller Doctors Accused of Killing Four Patients” the pictures of the two doctors were adulterated into this:

Drs. Couch and Ruan

Drs. Couch and Ruan

This was done by News 5 WKRG, an affiliate of CBS, the same broadcast company that used programs prior to my trial to turn public opinion against me. Also this negative reporting included the following statement:

The two painkiller doctors are under fire for operating a highly-lucrative painkiller clinic in Mobile.

This statement, in few words, tries to make the doctors look like they are drug pushers “in it for the money”. Again, purely negative reporting. Shame on you, Mr/Ms. Biunno, and shame on you CBS.

According to this article, Dr. John Patrick Couch and his associate were hit with 11 new charges in connection to what’s been called “excessive and dangerous” painkiller prescribing practices. Part of these charges were the deaths of four patients, two per each doctor, one in 2012, 2 in 2014, and one in 2015.  Each of these charges carries a sentence of 20 years to life in prison.

Now in pain management, to have only 4 deaths between 2 doctors in 3 years is darn good statistics. That shows good medical care, not bad.

WKRG, in an older release in June, 2015 headed “Shocking Evidence Against Pain Doctors’ Pill-Prescribing Practices” stated that 66,892 prescriptions were written by Couch and Ruan combined in 2014, deliberately “over-prescribing controlled substances to increase revenue.”

This type of reporting is inflammatory in multiple ways. What is shocking about the number of prescriptions?  This practice was for pain management. If the average patient got 3 controlled drug prescriptions per month—one long acting, one for breakthrough, and one other like for anxiety or Lyrica for example, or if the doctors covered themselves by writing prescriptions for less than one month at a time like I did, then the number of prescriptions covers less than 1000 patients per doctor appropriately. News media throwing numbers out like this with inflammatory headers are a disgrace. And then making the statement “deliberately ‘over-prescribing to increase revenue” is really out of place. How can they speak to intent or even state they were over-prescribing? They aren’t doctors with any knowledge of correct or incorrect treatment. But writing like this can mean the conviction of an innocent physician.

I know all about how CBS affiliates can work with the Feds to incriminate an innocent physician in the eyes of the public. In my case, 2 weeks before my trial was to take place, the CBS station in Roanoke played a documentary for 2 days in the evening. The gist of the documentary was that drug abuse in Southwest Virginia is caused by doctors.  Now Channel 7 has a court reporter that also showed up at my trial. So you know that they were aware of the upcoming trial when they showed that documentary. Not only that, the binders filmed in the prosecutor’s offices in the documentary showed that they were filming US Attorney’s work. So they also knew about my upcoming trial, and worked with CBS to get it before the public at the most advantageous time to convict me just based on public opinion of pain management physicians in general causing drug abuse.

Then the news article by WKRG goes on to publicize that one informant who previously worked for Couch and Ruan said the two doctors would regularly compete to see who could hand out the most prescriptions to patients.

Really? More opportunity here to create prejudice. And the informant was a previous employee. To me that reeks of disgruntlement. Or it could be that the previous employee had their arm twisted by the authorities to make incriminating statements or suffer charges themselves. They tried that with my employees as well, but mine (except for the doctor helping) didn’t cave to their threats.

Now a much more professional approach was done by Fox News in the release by Linda Jones, Executive Producer on May 20, 2015. She used the simple non-inflammatory header of: “Two Mobile pain doctors arrested on drug and fraud charges”, stated the same in the body, and that was basically it.

Another release by Fox news reporters Candace Murphy and Rudy Harper was informative and professional without being inflammatory or falsely incriminating. In it they point out that as a result of the charges, patients are concerned about the future of their medication.  They also connect this raid with the four state government agenda called “Operation Pilluted”. A picture of an operation

Drug Enforcement Administration Special Agents leave a housef Friday, Sept. 23, 2011, in Roswell, N.M., as part of an investigation that included the arrest of dozens of suspected drug traffickers Friday. (AP Photo/Roswell, Daily Record, Mark Wilson)

(not from this article) to the left shows agents in masks. Really? Is the DEA now just a bunch of hoodlums who have to protect their identity like criminals?  You can read more about this “Operation Pilluted” in a post by that name. Click on the name.

Ms. Murphy and Mr. Harper reported the Press release of US Attorney Kenyen Brown correctly identifying the real charges as (1) conspiracy to distribute controlled substances outside the usual course of professional practice and not for a legitimate medical purpose, and (2) conspiracy to commit healthcare fraud. They continue to correctly identify exactly what that indictment charged–that Dr. Couch and Dr. Ruan conspired with each other and others by knowingly and willfully distributing and dispensing Schedule II controlled substances outside the usual course of professional practice and not for a legitimate medical purpose.   The allegations of healthcare fraud identified in the Indictment were:

  1. The doctors routinely ordered extremely expensive secondary urine drug tests, which were billed to patients’ insurance providers under the false pretense that they were necessary tests.  However, the Indictment alleges these tests were ordered primarily because of the extremely high rate of reimbursement paid by insurance providers for these tests.  Furthermore, the Indictment alleges Dr. Couch and Dr. Ruan engaged a conspiracy to fraudulent up-code, which is where a patient service performed by a physician extender, such as a nurse, is fraudulently billed under the physician’s national provider identifier number.  Fraudulent up-coding results in a medical practice receiving more money than it was entitled to, because health insurance providers reimburse patient services at a higher rate when performed by a physician.

Now this allegation is again proof of correct medical procedure—urine drug screens. They were doing what they thought would cover their backside in a government conspiracy, not give the government additional charges. This just goes to show that in our profession, you’re damned if you do, and damned if you don’t. If they hadn’t done drug screens, they would have been charged. And here they’re still being charged for doing the drug screens.

And then the charges for billing under the physician’s provider number. According to Medicare/Medicaid, which is all the government could involve in a federal crime anyway (although they do now involve Blue Cross insurance in charges against physicians—how, I don’t know), if the doctor is present the physician extender can bill to the doctor’s number. That is completely legal. It will be interesting to see how they approach this in court—i.e. how they adulterate the laws.

And finally, the crux of all the attacks on doctors:

The Indictment contains forfeiture notices stating that the United States intends to seek the forfeiture of numerous bank accounts, exotic vehicles, and real property if the defendants are convicted of one or both of these conspiracy offenses.

This paragraph states the real reason this is happening to all the doctors in the country—government confiscation of their assets. People, we have to stop this. It is up to you declaring these and all doctors innocent. Stop this abuse of power for money.

Thank you, Fox News, for being more professional. You can interview me any time.

If you are interested in stopping this flagrant attack on good doctors, we must prevent the kind of sensational, inflammatory reporting being done by CBS affiliates. I suggest you write to CBS, inform them of your displeasure, and switch your viewing to Fox News.