Paul VolkmanPaul H. Volkman, MD, the physician for Tri-State Health Care and Pain Management Clinic in Ohio, was sentenced to four life terms in prison for his conviction in the drug overdose deaths of four patients, along with sentences ranging from 10 to 20 years on 13 other drug-trafficking related counts.

Every case I’ve written about is a travesty, but this is probably the worst. Doctors are no more responsible with what patients do then General Motors is responsible for what people do behind the wheel of a car they built. And only 4 deaths in a practice as big as Dr. Volkman’s is actually a credit to his medical care, not a discredit. Again, this is just a way for the government to attack good doctors for their assets.

Dr. Volkman worked at three pain management clinics in three towns in Ohio. Obviously there was a need and not many other doctors were knowledgeable enough or willing to do the job, considering the risk. But like me, Dr. Volkman obviously knew what he was doing.  He held an M.D. and Ph.D. in pharmacology from the University of Chicago. He had practiced as an emergency room physician as well as in family practice and pediatrics, and became a diplomat in the American Academy of Pain Management. Standard medical schools and residencies probably did not teach pain management when Dr. Volkman attended, as the case in my training in the 1990’s. But the degree in pharmacology and the testing by AAPM meant that he knew how to prescribe these medicines correctly. So here they had a knowledgeable physician taking care of most of the pain in the area. That was a blessing. But the government works with blinders on. They only see what they want to see.

According to the press articles about this case, the reasons the government attacked Dr. Volkman were:

  1. “His DEA Certificate was immediately suspended on February 10, 2006 on the government’s grounds that his continued registration would constitute an imminent danger to public health and safety because of the likelihood that the controlled substances would be diverted to persons who would abuse them.”

So all of the legitimate pain patients get thrown to the street by the swipe of some DEA pen, causing more anxiety, toxicity, and addiction potential. I wonder how many of these people died because of suicide or overmedicating from use of street drugs. (see paragraph at end of blog for statistics)  As I’ve said before, the government is a threat of imminent danger to public health and safety when they do this.

  1. “Dr. Volkman dispensed the most oxycodone from 2003 to 2005 than any other physician in the country.”

The government tracks how many pills a physician prescribes. Even the drug companies do this, to see what the competition is at a doctor’s office.  I was told by one of my drug reps that I prescribed the most oxycodone in my region as well—probably one of the reasons I was attacked. Dr. Volkman appears to be the only pain management specialist in a large area. So just by numbers he would be a big prescriber. Then, because of the negativism about OxyContin at the time, most doctors were prescribing Percocet or roxycodone, which took 6 or more pills/day to control pain. That equates to a lot of pills. So the number of pills he prescribes, as long as he is controlling the pain and giving appropriate treatment, should not be a factor.

  1. “Volkman was the physician at the center of a criminal scheme to distribute millions of controlled substances to hundreds of individuals in exchange for cash”

The government calls his pain management “criminal”. I call it compassionate. Here they try to make him look bad because his office did not take insurance.  First, if you don’t have malpractice insurance, you can’t get insurance companies to contract with you.  That was my problem as well after the first attack on my office. The cost of getting malpractice insurance, even though no one was injured, went through the roof. So it isn’t a reflection on his medical care that he worked without malpractice insurance. In fact, it is a reflection that he knew what he was doing, and he wasn’t worried about being sued. The government, however, uses this argument of a cash office to make the jury think something was being done against medical standards. In my opinion, every doctor in this country should stop taking insurance and start running cash-only offices. As it stands now, the doctors are working for the insurance companies and the hospitals, not for the patient.  Fight this trend by going to the independent physicians in your area.

  1. “The Drug Enforcement Administration considered Scioto County, where Volkman distributed the pills, one of the worst places for prescription painkiller abuse.”

So are things better there now, with pain patients not receiving their medication? I doubt it. In the last 10 years addiction has quadrupled across the country. Now, because people can’t find treatment for their pain, they are resorting to heroin.

  1. They accused Dr. Volkman, of running a “pill mill”.

This is simply stigmatizing to win their case. Shame on them. If they don’t have a case without resorting to castigation, they obviously don’t have a case.

  1. The indictment said patients came from hundreds of miles away and were charged $125 to $200 in cash for visits to see a doctor.

When you are the only doctor willing to take the risk, people have to travel from far away. In general when you run a business where people travel to see you, it is a mark of doing a good job. Why not here? And $125-$200 per visit is not an exorbitant price. The pain management clinics in my area, like the one the government used as an expert witness against me—Dr. Marc Swanson—now cost the patient up to $400 per visit. But they don’t seem to be attacked for charging too much. Only the doctors that the government wants to put out of business. They tried to make me look bad with my $50 per month or $90 for 3 months charges. I don’t know how they kept a straight face when they said I was “in it for the money”.

  1. Prosecutors said Volkman rarely, if ever, counseled patients on alternative treatments for pain, such as physical therapy, surgery or addiction counseling.

This is a weak argument. Generally by the time a patient goes to see a pain management specialist, he has already run the gamut of alternative conventional treatments. Those specialists have generally given up, and refer the patient to pain management. And since conventional medicine doesn’t cure the cause of pain, but only make it worse, pharmaceuticals is all the person has. Generally the hospital-owned clinics use steroid injections (which only harm by the way), until the insurance won’t pay anymore. Then they discharge the patient with “there’s nothing more we can do” when the truth is, “We’ve made all the money we can off of you.”

As evidence of Dr. Volkman’s personal assurance that he had done no wrong in his care, he maintained his innocence, denied the allegations and said he always acted in good faith. He even demanded the judge release him immediately.

One blasphemous article reported this while reporting on Dr. Volkman:

“More than 1,300 people died from accidental drug overdoses in 2009 in Ohio, according to the most recent data from the Ohio Department of Health. The number of fatal overdoses has more than quadrupled from 1999, when the state recorded 327 accidental deaths, according to the department.”

It is my charge that removing doctors  like Dr. Volkman from practice is the cause of these accidental drug overdoses. People in pain will take whatever they can get. And they don’t know equivalent strengths of medications, so they accidentally overdose. This is especially easy with methadone, which is cheap and available on the street.

To show that this government agenda of attacking well-meaning and professional doctors is a failure are the following statistics following the removal of Dr. Volkman from practice:

  • In 2007, unintentional drug poisoning became the leading cause of injury death in Ohio, surpassing motor vehicle crashes for the first time on record. This trend continued has continued through 2012.
  • From 2000 to 2012, Ohio’s death rate due to unintentional drug poisonings increased 366 percent, and the increase in deaths has been driven largely by prescription drug overdoses.
  • In Ohio, there were 411 fatal unintentional drug overdoses in 2000 growing to 1,914 annual deaths in 2012.
  • On average approximately five people die each day in Ohio due to drug overdose.

Had Dr. Volkman been allowed to treat pain appropriately, these statistics would not be as high.

 

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