Bad News for The HEADoc

 It troubles the HEADoc to make today's entry. . .

but he must as a matter of principle. A reporter from the local paper was courteous enough to contact The HEADoc before printing information about a Consent Order from the NC Medical Board to run this weekend. Gossip usually doesn't bother The HEADoc for he knows that the truth always wins with enough time. There are always two sides to every story with the truth usually caught up somewhere in the middle. A consent order from a board is equivalent to an indictment in the traditional criminal court but should not be equated with a criminal act. It simply states that it has been determined that there is sufficient evidence for a case to be heard in the appropriate legal forum for the purpose of settling the complaint. The accused could be dealt with any number of ways. It could be determined that nothing further is required to remedy the situation or problem. Sometimes a doctor's license is restricted or suspended for a set amount of time. In the most serious cases a doctor will have his license to practice medicine taken away. The process serves to promote self regulation of the behavior of all members in a profession basically by public humiliation of the one accused of violating or deviating from what has been deemed the norm for that profession. Having information available on a website is one thing but editorializing it in a public newspaper is another. This is why the HEADoc must speak for himself. He has nothing to hide but just wishes to be treated fairly and understood from his own point of view. He will allow his reputation to speak for itself and those who truly know The HEADoc will stand by him because they know his heart and his devotion and intent to strive to do the right thing at all times. Those who don't really know The HEADoc can make up their own minds, if they even care about the matter at hand. The haters can think what they want.

One of the HEADoc's traits that has tended to cause him difficulties in the past has been a tendency to over extend himself for the sake of others. He chose the medical profession and psychiatry in particular because he didn't like seeing people hurt and suffer. The HEADoc is not ashamed to say that he believes himself to be gifted in the area of connecting with those suffering emotionally. He did not learn that in medical school. Even if he weren't trained as a physician, that would still remain. Being a physician has in a sense provided the necessary authority that those in need would have trust. The HEADoc believes in helping patients grow spiritually. Self destructive behaviors and addictions are the greatest hindrance to this occurring. No person can change such behaviors until they decide for themselves they are ready to let the denial go, seek and accept appropriate help, and make the necessary commitment to work toward their goals.

So what does any of this have to do with the Medical Board one might ask? The Board became involved because a pharmacist didn't think The HEADoc should treat chronic pain patients with methadone and made a complaint. The HEADoc knows of multiple cases of chronic pain where the use of methadone has given a much higher quality of life to that patient. The Board itself has encouraged physicians not to undertreat chronic pain due to fear of being disciplined by them. On the other hand, North Carolina is 5th in the nation in overdose deaths from methadone. This problem was major before The HEADoc even knew what methadone was. That's where the Board comes in. The facts are that 80% of the deaths are from wreckless or naive polysubstance abusers who weren't prescribed the drug from any doctor. When tested on autopsy such a person would have at least 3 other drugs of abuse in their system. Who is truly responsible here? Is it the government who continues to cut funding for mental health and substance abuse treatment? Is it society or is it that people should be more accountable for their own behavior? The HEADoc takes accountability that he did not document his treatment in the manner the Board thought that he should. At times addicts have been skilled enough to pass themselves off as legitimate pain patients, which the HEADoc regrets. Is not the more important question why are people so desperate that they would go to any length to obtain narcotics and other mind altering substances? Is The HEADoc responsible for this?

For a period of time The HEADoc found himself amidst a town that was recently voted to be in the top 5 best places to live of the nation. This is perplexing in that illegal drug use seems to be completely out of control and very little done about it in this great town. Is society that blind, that this problem can be that easily overlooked? Maybe The HEADoc is the one who is delusional. So what has the HEADoc done in the name of self accountability? Since everything will be exposed publicly this weekend he may as well speak for himself in regards to this. The HEADoc has got the heck out of Dodge, with Dodge being the town mentioned above that was voted one of the 5 best in the country to live. The HEADoc witnessed mostly despair economically and emotionally for many people. Being the only provider accepting Medicaid or Uninsured may have led to a skewed view but what The HEADoc saw was real. While reporting to the Board since 2005, The HEADoc set up policies in his practice that included a written agreement with patients prescribed narcotic medications for their medical condition. Violation of the agreement would lead to termination of treatment and referral to the appropriate substance abuse treatment facility or pain clinic, none of which really exist in a functional capacity. Well over 150 patients were screened and dismissed from the practice through policy enforcement in the years 2006 through 2008. The HEADoc attended a 13 hour course at Portland State University on appropriate prescribing of controlled medications to please the Board. On his own he did 20+ hours of self study and attended several lectures involving the management of chronic pain. He recently completed training for office based opioid dependency treatment with Bupenorphrine. In the new office all patients with suspected addiction problems receive routine drug screening. The HEADoc knows that discharging those who violate their agreement with referrals to places they won't even go to or won't accept them anyway is a futile gesture but it puts him in compliance with the Board. Those patients will return to that pool of patients doctors have been conditioned to avoid until another doctor accepts the risk of trying to treat one of their many problems.

So let the unofficial record state that no matter what you read in the papers about The HEADoc, he is not a quack. He is not a drug dealer or murderer. He abides by the law of the land. He has made every effort to work with the Medical Board in the past and present. He has tried to make a positive difference and he has done so with many patients. He is learning to recognize his limits and acknowledge that some problems are too big for any one person to tackle and attempting to do so can be self defeating in the long run. The HEADoc knows that the Board is the ultimate authority and will be well aware of that at his hearing on August 20th. He may be ordered to stop treating chronic pain or his license could be restricted or suspended. Whatever happens to The HEADoc will have little bearing on the real problems that have led to this situation. The HEADoc knows that the world is not a perfect place and he feels good about the patients he has helped in the past. Not treating chronic pain patients will actually be a relief for The HEADoc but he worries about many who won't have access to such treatment. From a political standpoint the Board may feel that it has done its job and publicizing this case will certainly put fear into other doctors of what to avoid doing in their practice of medicine.

  War on Pain Doctors http://www.doctordeluca.com

Comments

[a sympathizer]

I am sorry you were put through this nightmare, HEADdoc. More and more docs are ceasing to Rx opioids despite desperate need due to the witchhunt going on in the DEA, and it is the patients that suffer. Methadone is often unique in it's ability to control certain types of chronic pain. It is blamed, however, for ANY death in which methadone is in the decedent's system, even if it had nothing to do with the death at all, and even if multiple other drugs were being used, which inflates the stats artificially.

Hang in there and know that many support you.

[HEADoc]

Comment greatly appreciated!

[PsychRN]

Ken, I often feel as though I am fighting a losing battle in the field of mental health. Ther are so few individuals who really care about the individuals we serve. And when someone dares to stand against the tide, they are most often singled out as the enemy.

My thoughts are with you in this battle. Stand firm in your convictions.

PsychRN

[genie]

Because of your position, a 6 year old child's welfare has been compromised. Because of a letter written by you to be submitted to Family Court stating that her mother was deemed by you to be fit for visatation with said child. Mother has hx of Federal probation for "dr. shopping" and receiving drugs through fraud and deceit. You continued to treat her with narcotic prescriptions for "supposed" chronic pain and other suspicious complaints.
The records of this person are available online.
Obviously, you were manipulated as were several other physicians by this person.