Attached an important and troubling article from today's Miami Herald pointing out that "Florida Republican leaders have begun crafting anti-illegal-immigrant legislation modeled after an Arizona law that has incited widespread protests and fueled national and international debate over U.S. immigration policies.
Under the proposed bill, police would have broad power under state law to ask suspects for proof of legal residency."
I am strongly opposing such legislation and urge my specialty society to raise concerns regarding this bill as it pertains to the way family physicians practice medicine.
I often (even today) encounter patients, mostly uninsured, who are reluctant to go to the hospital because of their residency status fearing a backlash, or possible investigation by the immigration authorities.
Today I referred a Haitian patient to Publix to benefit from a FREE Metformin program. She asked me if she would have to provide a form of identification because she has no papers. I reassured her that she should not worry.
What will happen IF we have such a discriminatory law on the books? More undocumented immigrants will avoid doctors but will be taken by ambulance to emergency rooms for preventable illnesses instead. Who will pay? The taxpayer!
Just the debate of such a law in the legislature will trigger additional pressure on our State which already has to deal with a massive and continuous oil spill, high unemployment and a jittery tourism industry. Do we need anything else to shut down!!
Looking forward to your comments.
Yours
Bernd
Posted on Sat, Jun. 26, 2010
Florida GOP risks Hispanic anger with Arizona-like crackdown
Cristina Silva
Miami Herald/St. Pete Times
TALLAHASSEE — Florida Republican leaders have begun crafting anti-illegal-immigrant legislation modeled after an Arizona law that has incited widespread protests and fueled national and international debate over U.S. immigration policies.
Under the proposed bill, police would have broad power under state law to ask suspects for proof of legal residency, said Rep. William Snyder, a Republican from Stuart who plans to introduce the legislation in November.
"We have significant components from the Arizona bill that I plan to incorporate,'' he said. "We have the beginnings of it.''
The effort, which would be filed for consideration during the March legislative session, is already drawing broad support within the GOP.
Majority leaders in the Florida Senate and House said a new approach is needed to address the federal government's failure to temper illegal immigration.
It has the backing of both leading Republican gubernatorial candidates -- businessman Rick Scott and Attorney General Bill McCollum, whose office is helping to draft the bill.
Snyder, a former police officer, said the proposed legislation is needed to protect undocumented immigrants, who are vulnerable to abusive employers and violent criminals.
"This is a human right issue,'' he said. "They don't enjoy the same rights and privileges that you and I do. The solution is to enforce the laws that currently exist and to discourage people from coming here to `find a better life' when in fact they just come here and are victimized.''
Immigrant advocates and Hispanic lawmakers alike called the measure an unconstitutional assault on minority communities.
"The reaction is, 'What? This is ridiculous,' '' said Neelofer Syed, a Tampa immigration lawyer from Pakistan. "It is supposed to be that you are legal until you are proven guilty. This law is like, `We think you are guilty unless you establish that you are innocent.' ''
Rep. J.C. Planas, a Republican from Miami, called it an election-year stunt.
"I don't understand how anyone can think the Arizona law is good for Florida,'' said Planas, chairman of the Florida Hispanic Legislative Caucus. "It is a huge waste of police resources to start doing these things.''
Senate and House leaders said immigration reform is ripe for passage.
"What we want to do is encourage legal immigration and discourage illegal immigration,'' said incoming Senate President Mike Haridopolos, who cautioned that any changes will be shaped by how the Arizona law is put into practice after it takes effect next month.
Republican leaders in Pennsylvania, Rhode Island, Minnesota, South Carolina and Michigan have made similar vows to mirror Arizona's immigration law, amid growing criticism that the federal government has not adequately protected the nation's borders.
Civil rights groups such as the American Civil Liberties Union have filed legal challenges to the legislation, and President Barack Obama's administration is expected to follow suit.
Critics questioned why Florida lawmakers would consider replicating Arizona's untested immigration strategy while legal challenges are still pending.
"Rep. Snyder's proposal solves nothing, exploits public concern over immigration and just creates new problems,'' said Howard Simon, executive director of ACLU Florida.
The tension has become a rallying point for candidates on both sides of the political spectrum.
Democratic gubernatorial candidate Alex Sink has highlighted her Republican opponents' support of the law in stump speeches.
"She was opposed to the law in Arizona,'' said campaign spokeswoman Kyra Jennings. "She believes it unfairly discriminated against American citizens. She would veto that type of legislation.''
Championing tougher immigration laws is a risky election strategy, said George Gonzalez, a University of Miami political science professor.
"It is a way to channel people's anger and frustration about the labor market onto a group and to take advantage of it, too,'' he said.
But it could also anger Hispanic voters, an important constituency in Florida's increasingly diverse political landscape, Gonzalez said.
Florida's estimated illegal immigrant population ranks third in the nation. Arizona places seventh. But while Florida's undocumented population has dropped by 10 percent during the past decade, Arizona's climbed by 42 percent.
"None of this is foolproof,'' Gonzalez said. "It could blow up in the Republicans' faces either way.''
Snyder said he doesn't want his law to stir up the same accusations of racism that hounded Arizona's decision.
His law would be refined, he said, because it would only allow law enforcement officials to inquire about immigration status during a potential arrest or traffic violation. In Arizona, officers are required to request legal documentation during any lawful stop if ``reasonable suspicion'' exists.
Coming up with the precise language will be difficult, conceded Snyder, who recently defended his views on Fox News. ``Reasonable suspicion makes people nervous,'' he said.
But he vowed his final draft would apply equally to all illegal immigrants, regardless of skin color or ethnicity.
"I've never in my 32 years been accused of using the `N' word or being racially motivated,'' he said. "No one who knows me would say I have a racist bone in my body.''
Saturday, June 26, 2010
Shorter Work Days For Doctors
Attached a link to an important NEJM article http://content.nejm.org/cgi/content/full/NEJMsb1005800 entitled "The New Recommendations on Duty Hours from the ACGME Task Force."The goal of the ACGME's new approach to duty hours is to foster a humanistic environment for graduate medical education that supports learning and the provision of excellent and safe patient care.
At the heart of the ACGME's proposed changes is the recognition that the least-experienced residents need to be treated differently than more experienced ones. The plan recommends that first-year residents be limited to 16-hour shifts, and those in the second year and above work continuously for no more than 24 hours. They can stay an additional four hours to facilitate patient handoffs to another doctor. Currently residents are allowed to work up to 30-hour shifts.
The guidelines also include detailed expectations about direct supervision of younger residents by more experienced ones, in the hopes that a supervising doctor would catch any error before it affects a patient, according to Dr. Nasca.In addition, the ACGME will step up its monitoring and enforcement of the requirements, conducting on-site visits of each institution annually beginning in July 2011. The site visits are likely to cost each institution about $12,000 to $15,000, according to Dr. Nasca.
Those programs that don't comply with the rules could ultimately lose accreditation and be forced to disband.
I strongly support the proposed changes and call upon my colleagues to do the same.
Our patients deserve the same assurance about the quality of service as millions of airline passenger do already: strictly enforced duty hours for pilots, checklists before take-off and landing, elimination of human errors and the relentless pursuit of excellence.
We must change the way we do business! Our patients deserve it!!
Yours
Bernd
At the heart of the ACGME's proposed changes is the recognition that the least-experienced residents need to be treated differently than more experienced ones. The plan recommends that first-year residents be limited to 16-hour shifts, and those in the second year and above work continuously for no more than 24 hours. They can stay an additional four hours to facilitate patient handoffs to another doctor. Currently residents are allowed to work up to 30-hour shifts.
The guidelines also include detailed expectations about direct supervision of younger residents by more experienced ones, in the hopes that a supervising doctor would catch any error before it affects a patient, according to Dr. Nasca.In addition, the ACGME will step up its monitoring and enforcement of the requirements, conducting on-site visits of each institution annually beginning in July 2011. The site visits are likely to cost each institution about $12,000 to $15,000, according to Dr. Nasca.
Those programs that don't comply with the rules could ultimately lose accreditation and be forced to disband.
I strongly support the proposed changes and call upon my colleagues to do the same.
Our patients deserve the same assurance about the quality of service as millions of airline passenger do already: strictly enforced duty hours for pilots, checklists before take-off and landing, elimination of human errors and the relentless pursuit of excellence.
We must change the way we do business! Our patients deserve it!!
Yours
Bernd
Friday, June 18, 2010
Opioid Dependence
Attached a very interesting article supporting the fact that office based treatment of opioid dependence can decrease illegal activity and incarceration.
Yours
Bernd
Family Practice News
Volume 40, Issue 10, Page 31 (1 June 2010)
Opioid-Dependent Patients Respond to Therapy
DIANA MAHONEY
Article Outline
Major Finding: Office-based buprenorphine/naloxone treatment was associated with a statistically significant decrease in participants reporting illegal activity, from 19% to 2%, and in interacting with the legal system, from 16% to 1%.
Data Source: A secondary analysis of data from a randomized clinical trial of 166 opioid-addicted individuals treated with buprenorphine/naloxone in a primary care clinic.
Disclosures: Dr. Fiellin reported no relevant financial conflicts of interest.
MINNEAPOLIS — Opioid-dependent patients with a history of incarceration do well with office-based buprenorphine/naloxone therapy and have fewer interactions over time with the legal and criminal justice systems, according to a data analysis of a previous randomized, controlled trial.
“Our findings should offer some reassurance for community health care providers about initiating buprenorphine/naloxone treatment in the office setting,” Dr. David Fiellin reported. Office-based buprenorphine/naloxone treatment also can be an avenue for addressing other negative health consequences of chronic addiction, including referral for hepatitis C treatment, when indicated, as well as vocational and mental health programs.
Dr. Fiellin, along with lead investigator Dr. Emily Wang and colleagues at Yale University, New Haven, Conn., performed a secondary data analysis of a previous trial of three levels of psychosocial counseling and medication dispensing in conjunction with buprenorphine/naloxone maintenance treatment in a primary care clinic (N. Engl. J. Med. 2006;355:365-74).
The investigators compared demographics, clinical characteristics, and treatment outcomes for 166 adults receiving primary care–based buprenorphine/naloxone treatment, stratifying by history of incarceration as determined by the legal domain of the Addiction Severity Index.
Of the 166 patients, 52 had previously been incarcerated, Dr. Fiellin reported. Former inmates were more likely than other patients to be older, male, an ethnic minority, and unemployed. Also, they were more likely to have long histories of opioid dependence, have received methadone treatment, and have hepatitis C infection. The mean dose of buprenorphine/naloxone (Suboxone) was 17.9 mg and 18.0 mg for the previously incarcerated and never incarcerated patients, respectively, he said.
Among the previously incarcerated patients, the mean consecutive weeks of opioid abstinence was 6.2 based on opioid-negative urine samples. For other patients, it was 5.9 weeks. Mean treatment duration was 17.9 weeks and 17.6 weeks. The percentage of previously incarcerated patients completing treatment was 38%; for other patients, it was 46%.
Among patients who remained in treatment, a subsequent longitudinal analysis of self-reported illegal activity and interactions with the legal and criminal justice systems, conducted at 4-week intervals, showed “office-based buprenorphine/naloxone treatment was associated with a statistically significant decrease in participants reporting illegal activity, from 19% to 2%, and in interactions with the legal system, from 16% to 1%,” Dr. Fiellin said.
About “25% of all of those dependent on heroin pass through the criminal justice system each year,” Dr. Fiellin said. Correctional facilities provide an obvious opportunity to engage opioid-dependent individuals with treatment. “Unfortunately, less than 0.5% of all opioid-dependent individuals receive treatment while incarcerated, and as such they are more likely to connect with services in office-based programs upon release,” he said.
From the Annual Meeting of the Society of General Internal Medicine
Yours
Bernd
Family Practice News
Volume 40, Issue 10, Page 31 (1 June 2010)
Opioid-Dependent Patients Respond to Therapy
DIANA MAHONEY
Article Outline
Major Finding: Office-based buprenorphine/naloxone treatment was associated with a statistically significant decrease in participants reporting illegal activity, from 19% to 2%, and in interacting with the legal system, from 16% to 1%.
Data Source: A secondary analysis of data from a randomized clinical trial of 166 opioid-addicted individuals treated with buprenorphine/naloxone in a primary care clinic.
Disclosures: Dr. Fiellin reported no relevant financial conflicts of interest.
MINNEAPOLIS — Opioid-dependent patients with a history of incarceration do well with office-based buprenorphine/naloxone therapy and have fewer interactions over time with the legal and criminal justice systems, according to a data analysis of a previous randomized, controlled trial.
“Our findings should offer some reassurance for community health care providers about initiating buprenorphine/naloxone treatment in the office setting,” Dr. David Fiellin reported. Office-based buprenorphine/naloxone treatment also can be an avenue for addressing other negative health consequences of chronic addiction, including referral for hepatitis C treatment, when indicated, as well as vocational and mental health programs.
Dr. Fiellin, along with lead investigator Dr. Emily Wang and colleagues at Yale University, New Haven, Conn., performed a secondary data analysis of a previous trial of three levels of psychosocial counseling and medication dispensing in conjunction with buprenorphine/naloxone maintenance treatment in a primary care clinic (N. Engl. J. Med. 2006;355:365-74).
The investigators compared demographics, clinical characteristics, and treatment outcomes for 166 adults receiving primary care–based buprenorphine/naloxone treatment, stratifying by history of incarceration as determined by the legal domain of the Addiction Severity Index.
Of the 166 patients, 52 had previously been incarcerated, Dr. Fiellin reported. Former inmates were more likely than other patients to be older, male, an ethnic minority, and unemployed. Also, they were more likely to have long histories of opioid dependence, have received methadone treatment, and have hepatitis C infection. The mean dose of buprenorphine/naloxone (Suboxone) was 17.9 mg and 18.0 mg for the previously incarcerated and never incarcerated patients, respectively, he said.
Among the previously incarcerated patients, the mean consecutive weeks of opioid abstinence was 6.2 based on opioid-negative urine samples. For other patients, it was 5.9 weeks. Mean treatment duration was 17.9 weeks and 17.6 weeks. The percentage of previously incarcerated patients completing treatment was 38%; for other patients, it was 46%.
Among patients who remained in treatment, a subsequent longitudinal analysis of self-reported illegal activity and interactions with the legal and criminal justice systems, conducted at 4-week intervals, showed “office-based buprenorphine/naloxone treatment was associated with a statistically significant decrease in participants reporting illegal activity, from 19% to 2%, and in interactions with the legal system, from 16% to 1%,” Dr. Fiellin said.
About “25% of all of those dependent on heroin pass through the criminal justice system each year,” Dr. Fiellin said. Correctional facilities provide an obvious opportunity to engage opioid-dependent individuals with treatment. “Unfortunately, less than 0.5% of all opioid-dependent individuals receive treatment while incarcerated, and as such they are more likely to connect with services in office-based programs upon release,” he said.
From the Annual Meeting of the Society of General Internal Medicine
Saturday, January 23, 2010
Should We Stop Healthcare Reform Now?
Should We Stop Healthcare Reform Now?
After the election in Massachusetts many predict the collapse of the health care reform efforts. President Obama seems to seek a scaled back version, which is acceptable for Republicans who are blocking ANY reform efforts. But why do we need health care reform NOW? Lets look at the facts: If nothing will happen healthcare spending will continue to outpace the growth in the rest of the domestic product by at least 2.5% annually. Despite the overall slowdown in national health spending growth in 2008, increases in this spending continue to outpace the growth in the resources needed to pay for it! At that rate health spending will absorb 40% of GDP by 2050! The suggested reform proposal will provide 30 Million uninsured Americans adequate coverage requiring about $800 Billion to $1 Trillion in federal subsidies over the next decade. This represents only 3% of the $35 Trillion projected by actuaries to be spent on U.S. health care in the coming decade in the ABSENCE of reform. The relatively small $ 1 Trillion investment in preventing the surge of neglected chronic disease will save Trillions of healthcare dollars normally spent for the emergency room care needed to serve the growing numbers of uninsured! We need to invest money in order to save money!!!
Furthermore, health care insurance companies know very well that the initial rise in health care stocks, on expectations that the Massachusetts’s vote might derail health care reform, may symbolize a pyrrhic victory only! Even though, the reform package included mandated coverage for everyone, regardless of health status, it also offered to heavily subsidize the health care for 30 million Americans who are currently uninsured. This potential financial windfall may not materialize. Insurance companies are very well aware that selling insurance package to employers has slowed because of rising premiums, which reflect rising health care expenditures. The insurance companies must have an interest to bend the cost curve and to expand insurance coverage to offer competitive products. Insurers may gamble with their financial future by supporting the Naysayer because without an overhaul of the insurance industry and the health care market they may face an even bleaker future, which will force draconian government intervention to cut costs.
Therefore, we must support rational reform efforts and President Obama should stop pandering to the opponents of any meaningful reform efforts. We have to act now to avoid a future financial crisis!
Bernd Wollschlaeger,MD,FAAFP,FASAM
After the election in Massachusetts many predict the collapse of the health care reform efforts. President Obama seems to seek a scaled back version, which is acceptable for Republicans who are blocking ANY reform efforts. But why do we need health care reform NOW? Lets look at the facts: If nothing will happen healthcare spending will continue to outpace the growth in the rest of the domestic product by at least 2.5% annually. Despite the overall slowdown in national health spending growth in 2008, increases in this spending continue to outpace the growth in the resources needed to pay for it! At that rate health spending will absorb 40% of GDP by 2050! The suggested reform proposal will provide 30 Million uninsured Americans adequate coverage requiring about $800 Billion to $1 Trillion in federal subsidies over the next decade. This represents only 3% of the $35 Trillion projected by actuaries to be spent on U.S. health care in the coming decade in the ABSENCE of reform. The relatively small $ 1 Trillion investment in preventing the surge of neglected chronic disease will save Trillions of healthcare dollars normally spent for the emergency room care needed to serve the growing numbers of uninsured! We need to invest money in order to save money!!!
Furthermore, health care insurance companies know very well that the initial rise in health care stocks, on expectations that the Massachusetts’s vote might derail health care reform, may symbolize a pyrrhic victory only! Even though, the reform package included mandated coverage for everyone, regardless of health status, it also offered to heavily subsidize the health care for 30 million Americans who are currently uninsured. This potential financial windfall may not materialize. Insurance companies are very well aware that selling insurance package to employers has slowed because of rising premiums, which reflect rising health care expenditures. The insurance companies must have an interest to bend the cost curve and to expand insurance coverage to offer competitive products. Insurers may gamble with their financial future by supporting the Naysayer because without an overhaul of the insurance industry and the health care market they may face an even bleaker future, which will force draconian government intervention to cut costs.
Therefore, we must support rational reform efforts and President Obama should stop pandering to the opponents of any meaningful reform efforts. We have to act now to avoid a future financial crisis!
Bernd Wollschlaeger,MD,FAAFP,FASAM
Wednesday, December 30, 2009
Pain Clinics
Attached a great article from today's Miami Herald highlighting the issue of pain clinics and Buprenorphine use. The author points out that
"A Miami Herald review of 353 Suboxone-approved doctors in Miami-Dade, Broward and Palm Beach counties found at least 53 of them have been disciplined by state health officials or have been charged with a crime -- about one of every seven doctors."
This is a grave issue of concern!
Yours
Bernd
PS: Have a Happy New Year.
Posted on Tue, Dec. 29, 2009
South Florida pain-clinic doctors also treat drug addicts
BY SCOTT HIAASEN
shiaasen@MiamiHerald.com
CARL JUSTE / MIAMI HERALD STAFF
One of many pain clinics that have sprung up all over South Florida. In the past two years, the region has emerged as the pill-mill capitol of the United States.
State regulators stripped Dr. Michael I. Rose's power to write prescriptions two months ago, after health officials found that the pain-clinic doctor had prescribed enough painkillers to put one patient ``at risk of death from overdose.''
The health department findings are all the more alarming given the North Miami physician's other specialty: drug-addiction treatment.
Rose is one of at least 41 South Florida doctors who straddle the fence between two seemingly opposite disciplines: They treat drug addicts while at the same time giving pain patients addictive drugs that have been blamed for a spike in overdose deaths statewide. Rose declined to comment for this article.
Some of the same clinics offering addiction treatment are often targeted by out-of-state drug couriers seeking painkillers for an illicit black market stretching from South Florida to Appalachia and the northeastern United States.
Many of these doctors who serve as both pain and addiction specialists have been disciplined by state health officials for improper prescribing of drugs -- and some have been convicted of crimes, a Miami Herald review found.
Yet these doctors retain approval from the federal government to prescribe a narcotic called buprenorphine -- a drug used to help wean people addicted to opiates such as oxycodone.
Addiction experts say this mixing of two delicate medical fields has potentially dangerous consequences: Instead of receiving the therapy they need, addicts seeking to get off drugs may simply end up alongside users and drug peddlers who frequently skip from clinic to clinic seeking narcotics to be sold illegally.
`ADDED RISK'
``If you have an environment where you have drug access and availability, then you have an added risk,'' said Dr. Ihsan Salloum, an addiction psychiatrist with the University of Miami's Miller School of Medicine.
``Offering services of this kind is a slap in the face,'' said Dr. Bernd Wollschlaeger, an addiction specialist and past president of the Dade County Medical Association. He suspects many pain clinics are seeking not to help addicts but to boost profits by selling drugs used to curb dependency -- in addition to selling large amounts of potent painkillers.
``It's just a fig leaf to conceal their true nature,'' Wollschlaeger said. ``These pain clinics are pure and simple pill mills. Their goals are pushing huge volumes of prescription pills.''
Clinics offering both pain medications and addiction treatment can also present difficulties for police investigating pill trafficking. Under federal law, doctors approved to provide addiction drugs are afforded special protection from narcotics investigators. Agents need a court order from a federal judge before pursuing undercover investigations of these doctors.
Over the past two years, South Florida has emerged as the pill-mill capital of the United States, the chief supplier of black-market painkillers that spawned an epidemic of overdose deaths in Kentucky, Ohio, West Virginia, Tennessee and other states.
The pills have flowed by the millions through storefront pain clinics that open up almost daily from Miami to Palm Beach County. Broward County alone has at least 115 pain clinics, and is home to 33 of the 50 doctors who dispense the most oxycodone in the country, according to U.S. Drug Enforcement Administration data.
Dozens of clinics entice patients with blaring advertisements in alternative newspapers, offering coupons and discounts and not-too-subtle appeals to out-of-state clients.
In the same ads, many clinics also promote treatment for drug addicts with Suboxone, whose primary ingredient, buprenorphine, is designed to help blunt the affects of heroin, oxycodone or other opiates.
Suboxone and similar drugs are considered highly effective for treating dependency and addiction. It's also proven safer than methadone, once commonly used to treat heroin addicts.
To encourage more addicts to seek treatment, federal regulators in 2002 began allowing doctors to dispense Suboxone from their offices -- unlike methadone, which must be administered in hospital or clinic settings.
But a doctor does not need to be a board-certified addiction specialist to distribute Suboxone. A doctor can receive approval simply by completing an eight-hour online course. About 17,000 doctors nationwide are approved to administer Suboxone, including almost 1,200 in Florida.
TREATMENT METHODS
Addiction experts and federal health officials warn that Suboxone should be given to patients along with counseling and other treatment methods -- methods rarely employed at many pain clinics, where pills are often the only remedy, critics say.
``Use of the medication in and of itself is not a substitute for full addiction treatment,'' said Dr. Louis Baxter, president of the American Society of Addiction Medicine. ``Some of these people that are advertising their services may not be certified, and may not be experienced to do what they say they can do.''
But some doctors say it can be difficult to get many addicts to attend counseling or psychological therapy, which is often more costly than Suboxone treatment.
``The No. 1 reason for someone coming in to do detox is that they can't afford their addiction,'' said Dr. James Milne, who offers both pain management and addiction treatment as part of his general family practice in Fort Lauderdale.
Milne said he believes the need for addiction treatment has increased with the explosion of pain clinics in South Florida. As many as half of his new patients come to him first seeking painkillers -- and many end up as addiction patients, he said.
``Some of these people convert there on the spot. They burst into tears and beg for help,'' he said.
At the Fort Lauderdale Pain Relief Center, the staff emphasizes its detoxification program to its pain patients who may feel they are becoming dependent on pills, said clinic attorney Sandy Topkin.
``They want people to get off these medications more than they want them on them,'' Topkin said.
Though buprenorphine is less dangerous than methadone, a patient could overdose or die if it is mixed with other drugs, Baxter said. The drug is sometimes sold illegally on the street as well, although it doesn't produce the highs of other drugs.
``You want to have it prescribed in legitimate settings, and these pain clinics are not legitimate settings. There is a high probability that they are using this medication inappropriately,'' Wollschlaeger said.
Records show many of the doctors working for South Florida pain clinics have no special certification in either addiction or pain management. And many of the doctors offering both services have troubling professional records.
53 DISCIPLINED
A Miami Herald review of 353 Suboxone-approved doctors in Miami-Dade, Broward and Palm Beach counties found at least 53 of them have been disciplined by state health officials or have been charged with a crime -- about one of every seven doctors.
Among those allowed to dispense drug-treatment narcotics are doctors disciplined for recklessly prescribing addictive drugs, including:
• Dr. Rachael Gittens of Wilton Manors. She was suspended for 90 days and fined $10,000 earlier this year after investigators found 33 blank prescriptions given to patients without including their names or addresses. At the time, Gittens was working at a pain clinic identified by Kentucky investigators as a prime source of illegal pills in that state.
• Dr. Robert Lentz of Lake Worth. He was fined $30,000 and placed on two years' probation earlier this month for prescribing ``very high dosages'' of painkillers to a patient without documenting the medical need. The health department found that Lentz increased the dosage of oxycodone when the patient should have been sent to addiction counseling, records show.
• Dr. Ricardo Sabates of Delray Beach. State health officials suspended his medical license in October for over-prescribing painkillers and anti-anxiety drugs to 10 patients, records show.
Federal officials say the law allows any doctor to prescribe Suboxone, regardless of any disciplinary history, as long as the physician has completed an eight-hour training course, and the doctor has a valid medical license and approval from the DEA to prescribe medications.
``If the physician has a license to practice medicine, we don't have the right to prevent them from prescribing Suboxone,'' said Nick Reuter, a senior policy analyst with the Substance Abuse and Mental Health Services Administration, a branch of the U.S. Department of Health and Human Services that oversees the Suboxone certification program.
The American Society of Addiction Medicine has pushed for greater scrutiny for doctors prescribing medications to drug addicts, and for doctors offering narcotics for pain management, Baxter said. For example, he said, some states like New Jersey require doctors to be board certified in pain management before they can dispense painkillers. Florida has no such requirement.
``There are some renegade physicians that are doing the medication harm by doing unregulated and unorthodox pain and addiction treatment,'' Baxter said.
"A Miami Herald review of 353 Suboxone-approved doctors in Miami-Dade, Broward and Palm Beach counties found at least 53 of them have been disciplined by state health officials or have been charged with a crime -- about one of every seven doctors."
This is a grave issue of concern!
Yours
Bernd
PS: Have a Happy New Year.
Posted on Tue, Dec. 29, 2009
South Florida pain-clinic doctors also treat drug addicts
BY SCOTT HIAASEN
shiaasen@MiamiHerald.com
CARL JUSTE / MIAMI HERALD STAFF
One of many pain clinics that have sprung up all over South Florida. In the past two years, the region has emerged as the pill-mill capitol of the United States.
State regulators stripped Dr. Michael I. Rose's power to write prescriptions two months ago, after health officials found that the pain-clinic doctor had prescribed enough painkillers to put one patient ``at risk of death from overdose.''
The health department findings are all the more alarming given the North Miami physician's other specialty: drug-addiction treatment.
Rose is one of at least 41 South Florida doctors who straddle the fence between two seemingly opposite disciplines: They treat drug addicts while at the same time giving pain patients addictive drugs that have been blamed for a spike in overdose deaths statewide. Rose declined to comment for this article.
Some of the same clinics offering addiction treatment are often targeted by out-of-state drug couriers seeking painkillers for an illicit black market stretching from South Florida to Appalachia and the northeastern United States.
Many of these doctors who serve as both pain and addiction specialists have been disciplined by state health officials for improper prescribing of drugs -- and some have been convicted of crimes, a Miami Herald review found.
Yet these doctors retain approval from the federal government to prescribe a narcotic called buprenorphine -- a drug used to help wean people addicted to opiates such as oxycodone.
Addiction experts say this mixing of two delicate medical fields has potentially dangerous consequences: Instead of receiving the therapy they need, addicts seeking to get off drugs may simply end up alongside users and drug peddlers who frequently skip from clinic to clinic seeking narcotics to be sold illegally.
`ADDED RISK'
``If you have an environment where you have drug access and availability, then you have an added risk,'' said Dr. Ihsan Salloum, an addiction psychiatrist with the University of Miami's Miller School of Medicine.
``Offering services of this kind is a slap in the face,'' said Dr. Bernd Wollschlaeger, an addiction specialist and past president of the Dade County Medical Association. He suspects many pain clinics are seeking not to help addicts but to boost profits by selling drugs used to curb dependency -- in addition to selling large amounts of potent painkillers.
``It's just a fig leaf to conceal their true nature,'' Wollschlaeger said. ``These pain clinics are pure and simple pill mills. Their goals are pushing huge volumes of prescription pills.''
Clinics offering both pain medications and addiction treatment can also present difficulties for police investigating pill trafficking. Under federal law, doctors approved to provide addiction drugs are afforded special protection from narcotics investigators. Agents need a court order from a federal judge before pursuing undercover investigations of these doctors.
Over the past two years, South Florida has emerged as the pill-mill capital of the United States, the chief supplier of black-market painkillers that spawned an epidemic of overdose deaths in Kentucky, Ohio, West Virginia, Tennessee and other states.
The pills have flowed by the millions through storefront pain clinics that open up almost daily from Miami to Palm Beach County. Broward County alone has at least 115 pain clinics, and is home to 33 of the 50 doctors who dispense the most oxycodone in the country, according to U.S. Drug Enforcement Administration data.
Dozens of clinics entice patients with blaring advertisements in alternative newspapers, offering coupons and discounts and not-too-subtle appeals to out-of-state clients.
In the same ads, many clinics also promote treatment for drug addicts with Suboxone, whose primary ingredient, buprenorphine, is designed to help blunt the affects of heroin, oxycodone or other opiates.
Suboxone and similar drugs are considered highly effective for treating dependency and addiction. It's also proven safer than methadone, once commonly used to treat heroin addicts.
To encourage more addicts to seek treatment, federal regulators in 2002 began allowing doctors to dispense Suboxone from their offices -- unlike methadone, which must be administered in hospital or clinic settings.
But a doctor does not need to be a board-certified addiction specialist to distribute Suboxone. A doctor can receive approval simply by completing an eight-hour online course. About 17,000 doctors nationwide are approved to administer Suboxone, including almost 1,200 in Florida.
TREATMENT METHODS
Addiction experts and federal health officials warn that Suboxone should be given to patients along with counseling and other treatment methods -- methods rarely employed at many pain clinics, where pills are often the only remedy, critics say.
``Use of the medication in and of itself is not a substitute for full addiction treatment,'' said Dr. Louis Baxter, president of the American Society of Addiction Medicine. ``Some of these people that are advertising their services may not be certified, and may not be experienced to do what they say they can do.''
But some doctors say it can be difficult to get many addicts to attend counseling or psychological therapy, which is often more costly than Suboxone treatment.
``The No. 1 reason for someone coming in to do detox is that they can't afford their addiction,'' said Dr. James Milne, who offers both pain management and addiction treatment as part of his general family practice in Fort Lauderdale.
Milne said he believes the need for addiction treatment has increased with the explosion of pain clinics in South Florida. As many as half of his new patients come to him first seeking painkillers -- and many end up as addiction patients, he said.
``Some of these people convert there on the spot. They burst into tears and beg for help,'' he said.
At the Fort Lauderdale Pain Relief Center, the staff emphasizes its detoxification program to its pain patients who may feel they are becoming dependent on pills, said clinic attorney Sandy Topkin.
``They want people to get off these medications more than they want them on them,'' Topkin said.
Though buprenorphine is less dangerous than methadone, a patient could overdose or die if it is mixed with other drugs, Baxter said. The drug is sometimes sold illegally on the street as well, although it doesn't produce the highs of other drugs.
``You want to have it prescribed in legitimate settings, and these pain clinics are not legitimate settings. There is a high probability that they are using this medication inappropriately,'' Wollschlaeger said.
Records show many of the doctors working for South Florida pain clinics have no special certification in either addiction or pain management. And many of the doctors offering both services have troubling professional records.
53 DISCIPLINED
A Miami Herald review of 353 Suboxone-approved doctors in Miami-Dade, Broward and Palm Beach counties found at least 53 of them have been disciplined by state health officials or have been charged with a crime -- about one of every seven doctors.
Among those allowed to dispense drug-treatment narcotics are doctors disciplined for recklessly prescribing addictive drugs, including:
• Dr. Rachael Gittens of Wilton Manors. She was suspended for 90 days and fined $10,000 earlier this year after investigators found 33 blank prescriptions given to patients without including their names or addresses. At the time, Gittens was working at a pain clinic identified by Kentucky investigators as a prime source of illegal pills in that state.
• Dr. Robert Lentz of Lake Worth. He was fined $30,000 and placed on two years' probation earlier this month for prescribing ``very high dosages'' of painkillers to a patient without documenting the medical need. The health department found that Lentz increased the dosage of oxycodone when the patient should have been sent to addiction counseling, records show.
• Dr. Ricardo Sabates of Delray Beach. State health officials suspended his medical license in October for over-prescribing painkillers and anti-anxiety drugs to 10 patients, records show.
Federal officials say the law allows any doctor to prescribe Suboxone, regardless of any disciplinary history, as long as the physician has completed an eight-hour training course, and the doctor has a valid medical license and approval from the DEA to prescribe medications.
``If the physician has a license to practice medicine, we don't have the right to prevent them from prescribing Suboxone,'' said Nick Reuter, a senior policy analyst with the Substance Abuse and Mental Health Services Administration, a branch of the U.S. Department of Health and Human Services that oversees the Suboxone certification program.
The American Society of Addiction Medicine has pushed for greater scrutiny for doctors prescribing medications to drug addicts, and for doctors offering narcotics for pain management, Baxter said. For example, he said, some states like New Jersey require doctors to be board certified in pain management before they can dispense painkillers. Florida has no such requirement.
``There are some renegade physicians that are doing the medication harm by doing unregulated and unorthodox pain and addiction treatment,'' Baxter said.
Saturday, November 21, 2009
Pain Clinics: Immediate Action Required
Attached two recent articles from the Miami Herald and Sun Sentinel highlighting the continuous and growing problem with pain clinics in South Florida.
I also witnessed a new phenomenon: one pain clinic in my area was finally shut down but reopened several days later calling itself "MedClinic" offering ALL medical services INCLUDING pain management. That means they will restart the SAME activities with the SAME management!! Its really frustrating! We have to focus on promoting tough measures as outlined in the grand jury recommendations. Therefore, I ask FSAM to issue a press release supporting the following recommendations and to contact the legislators asking them for their support.
The grand jury recommended to the Legislature 18 new reforms to curb the pain-clinic problem, including closing several loopholes the new state law failed to address. They include:
• Preventing pain clinics from distributing drugs on site until the state database is up and running next year.
• Limiting prescriptions from pain clinics to no more than a three-day supply.
Looking forward to your comments.
Yours
Bernd
Bernd Wollschlager,MD,FAAFP,FASAM
Member of the PRESCRIPTION DRUG MONITORING PROGRAM IMPLEMENTATION AND OVERSIGHT TASK FORCE
Posted on Fri, Nov. 20, 2009
Broward grand jury recommends pain clinic reforms
BY SCOTT HIAASEN
shiaasen@MiamiHerald.com
A Broward County grand jury issued a damning report Thursday bemoaning the explosion of illegal painkillers sold through Broward pain clinics -- and warning that reforms passed by the Legislature may not be enough.
Echoing a Miami Herald investigation earlier this year, the report details how lax state laws spawned a cottage industry of storefront pain clinics across South Florida, which have become the primary source of illegal painkillers in the eastern United States.
In just the past two years, the number of pain clinics in Broward County grew from four to 115, the grand jury found. In one six-month span, Broward pain-clinic doctors dispensed more than 9 million tablets of oxycodone, one of the most powerful and dangerous painkillers on the market -- far more than any other part of the country.
Addicts and drug peddlers routinely hop from clinic to clinic using bogus medical records to pass off fake injuries and obtain prescriptions -- a practice known as ``doctor shopping,'' the grand jury found. The proliferation of clinics attracts carloads of illegal drug buyers from other states, notably Kentucky, Ohio, West Virginia and Tennessee.
While some pain clinics offer legitimate medical services, most are ``rogue clinics putting out pills for cash,'' the report found.
``By the time law enforcement initiates and completes a successful investigation leading to the arrest of a doctor, user or dealer, several new clinics have opened,'' the report said.
WEAKNESSES
In response to the growing problem, state lawmakers approved a new law this spring placing pain clinics under greater scrutiny, and creating a database of prescription drugs sold, so prescribing doctors can better detect ``doctor shopping'' patients.
But the grand jury highlighted weaknesses in the law -- most notably, that the database program has no dedicated source of funding. State officials plan to seek grants to pay for the $4 million program.
The grand jury also criticized a section of the law that allows doctors to record prescriptions in the database within 15 days of their distribution. The grand jurors said drug traffickers could have come and gone by the time their prescriptions are recorded.
CLOSING LOOPHOLES
The grand jury recommended to the Legislature 18 new reforms to curb the pain-clinic problem, including closing several loopholes the new state law failed to address. They include:
• Preventing pain clinics from distributing drugs on site until the state database is up and running next year.
Many clinics advertise that they both prescribe and sell pills on site to attract clients -- another practice the grand jury would ban.
• Limiting prescriptions from pain clinics to no more than a three-day supply.
Clients at pain clinics typically receive a 30-day supply of drugs -- 150 to 240 tablets of oxycodone, often coupled with the painkiller roxycodone and anti-anxiety drugs such as Xanax -- after only one doctor's visit.
CRIMINAL RECORDS
• Barring people with criminal records from owning pain clinics. The Miami Herald investigation found several examples of clinic owners with criminal records, including the owner of a Boca Raton pain clinic who once pleaded guilty to possession of steroids with intent to sell.
• Limiting the number of pain-relief patients to 100 per clinic, and placing limits on the number of out-of-state patients a clinic may have.
Narcotics investigators have said that some pain clinics have as many as 65 patients per day. One Coral Springs doctor indicted on trafficking charges last year had nearly 500 patients from Kentucky.
======================================================================================================================
sun-sentinel.com/news/broward/flgrand-jury-pill-mill-20091119,0,1892598.story
South Florida Sun-Sentinel.com
Grand jury recommends pill mill cleanup
In two years, number in Broward jumped from four to 115, panel finds
By Scott Hiaasen, The Miami Herald
November 19, 2009
A Broward County grand jury issued a damning report Thursday bemoaning the explosion of illegal painkillers sold through Broward pain clinics — and warning that reforms passed by the Legislature may not be enough.
Echoing a Miami Herald investigation earlier this year, the report details how lax state laws spawned a cottage industry of storefront pain clinics across South Florida, which have become the primary source of illegal painkillers in the eastern United States.
In just the past two years, the number of pain clinics in Broward County grew from four to 115, the grand jury found. In one six-month span, Broward pain-clinic doctors dispensed more than 9 million tablets of oxycodone, one of the most powerful and dangerous painkillers on the market — far more than any other part of the country.
Addicts and drug peddlers routinely hop from clinic to clinic using bogus medical records to pass off fake injuries and obtain prescriptions — a practice known as "doctor shopping," the grand jury found. The proliferation of clinics attracts carloads of illegal drug buyers from other states, notably Kentucky, Ohio, West Virginia and Tennessee.
While some pain clinics offer legitimate medical services, most are "rogue clinics putting out pills for cash," according to the report.
"By the time law enforcement initiates and completes a successful investigation leading to the arrest of a doctor, user or dealer, several new clinics have opened," the report said.
In response to the growing problem, state lawmakers approved a new law this spring placing pain clinics under greater state scrutiny, and creating a database of prescription drugs sold, so prescribing doctors can better detect "doctor shopping" patients.
But the grand jury highlighted weaknesses in the law — most notably, that the database program has no dedicated source of funding. State officials plan to seek grants to pay for the $4 million program.
The grand jury also criticized a section of the law that allows doctors to record prescriptions in the database within 15 days of their distribution. The grand jurors said drug traffickers could have come and gone by the time their prescriptions are recorded.
The grand jury recommended to the Legislature 18 new reforms to curb the pain-clinic problem, including closing several loopholes the new state law failed to address. They include:
Preventing pain clinics from distributing drugs on site until the state database is up and running next year. Many clinics advertise that they both prescribe and sell pills on site to attract clients — another practice the grand jury would ban.
Limiting prescriptions from pain clinics to no more than a three-day supply. Clients at pain clinics typically receive a 30-day supply of drugs — 150 to 240 tablets of oxycodone, often coupled with the painkiller roxycodone and anti-anxiety drugs such as Xanax — after only one doctor's visit.
Barring people with criminal records from owning pain clinics. The Miami Herald investigation found several examples of clinic owners with criminal records, including the owner of a Boca Raton pain clinic who once pleaded guilty to possession of steroids with intent to sell.
Limiting the number of pain-relief patients to 100 per clinic, and placing limits on the number of out-of-state patients a clinic may have. Narcotics investigators have said that some pain clinics have as many as 65 patients per day. One Coral Springs doctor indicted on trafficking charges last year had nearly 500 patients from Kentucky.
I also witnessed a new phenomenon: one pain clinic in my area was finally shut down but reopened several days later calling itself "MedClinic" offering ALL medical services INCLUDING pain management. That means they will restart the SAME activities with the SAME management!! Its really frustrating! We have to focus on promoting tough measures as outlined in the grand jury recommendations. Therefore, I ask FSAM to issue a press release supporting the following recommendations and to contact the legislators asking them for their support.
The grand jury recommended to the Legislature 18 new reforms to curb the pain-clinic problem, including closing several loopholes the new state law failed to address. They include:
• Preventing pain clinics from distributing drugs on site until the state database is up and running next year.
• Limiting prescriptions from pain clinics to no more than a three-day supply.
Looking forward to your comments.
Yours
Bernd
Bernd Wollschlager,MD,FAAFP,FASAM
Member of the PRESCRIPTION DRUG MONITORING PROGRAM IMPLEMENTATION AND OVERSIGHT TASK FORCE
Posted on Fri, Nov. 20, 2009
Broward grand jury recommends pain clinic reforms
BY SCOTT HIAASEN
shiaasen@MiamiHerald.com
A Broward County grand jury issued a damning report Thursday bemoaning the explosion of illegal painkillers sold through Broward pain clinics -- and warning that reforms passed by the Legislature may not be enough.
Echoing a Miami Herald investigation earlier this year, the report details how lax state laws spawned a cottage industry of storefront pain clinics across South Florida, which have become the primary source of illegal painkillers in the eastern United States.
In just the past two years, the number of pain clinics in Broward County grew from four to 115, the grand jury found. In one six-month span, Broward pain-clinic doctors dispensed more than 9 million tablets of oxycodone, one of the most powerful and dangerous painkillers on the market -- far more than any other part of the country.
Addicts and drug peddlers routinely hop from clinic to clinic using bogus medical records to pass off fake injuries and obtain prescriptions -- a practice known as ``doctor shopping,'' the grand jury found. The proliferation of clinics attracts carloads of illegal drug buyers from other states, notably Kentucky, Ohio, West Virginia and Tennessee.
While some pain clinics offer legitimate medical services, most are ``rogue clinics putting out pills for cash,'' the report found.
``By the time law enforcement initiates and completes a successful investigation leading to the arrest of a doctor, user or dealer, several new clinics have opened,'' the report said.
WEAKNESSES
In response to the growing problem, state lawmakers approved a new law this spring placing pain clinics under greater scrutiny, and creating a database of prescription drugs sold, so prescribing doctors can better detect ``doctor shopping'' patients.
But the grand jury highlighted weaknesses in the law -- most notably, that the database program has no dedicated source of funding. State officials plan to seek grants to pay for the $4 million program.
The grand jury also criticized a section of the law that allows doctors to record prescriptions in the database within 15 days of their distribution. The grand jurors said drug traffickers could have come and gone by the time their prescriptions are recorded.
CLOSING LOOPHOLES
The grand jury recommended to the Legislature 18 new reforms to curb the pain-clinic problem, including closing several loopholes the new state law failed to address. They include:
• Preventing pain clinics from distributing drugs on site until the state database is up and running next year.
Many clinics advertise that they both prescribe and sell pills on site to attract clients -- another practice the grand jury would ban.
• Limiting prescriptions from pain clinics to no more than a three-day supply.
Clients at pain clinics typically receive a 30-day supply of drugs -- 150 to 240 tablets of oxycodone, often coupled with the painkiller roxycodone and anti-anxiety drugs such as Xanax -- after only one doctor's visit.
CRIMINAL RECORDS
• Barring people with criminal records from owning pain clinics. The Miami Herald investigation found several examples of clinic owners with criminal records, including the owner of a Boca Raton pain clinic who once pleaded guilty to possession of steroids with intent to sell.
• Limiting the number of pain-relief patients to 100 per clinic, and placing limits on the number of out-of-state patients a clinic may have.
Narcotics investigators have said that some pain clinics have as many as 65 patients per day. One Coral Springs doctor indicted on trafficking charges last year had nearly 500 patients from Kentucky.
======================================================================================================================
sun-sentinel.com/news/broward/flgrand-jury-pill-mill-20091119,0,1892598.story
South Florida Sun-Sentinel.com
Grand jury recommends pill mill cleanup
In two years, number in Broward jumped from four to 115, panel finds
By Scott Hiaasen, The Miami Herald
November 19, 2009
A Broward County grand jury issued a damning report Thursday bemoaning the explosion of illegal painkillers sold through Broward pain clinics — and warning that reforms passed by the Legislature may not be enough.
Echoing a Miami Herald investigation earlier this year, the report details how lax state laws spawned a cottage industry of storefront pain clinics across South Florida, which have become the primary source of illegal painkillers in the eastern United States.
In just the past two years, the number of pain clinics in Broward County grew from four to 115, the grand jury found. In one six-month span, Broward pain-clinic doctors dispensed more than 9 million tablets of oxycodone, one of the most powerful and dangerous painkillers on the market — far more than any other part of the country.
Addicts and drug peddlers routinely hop from clinic to clinic using bogus medical records to pass off fake injuries and obtain prescriptions — a practice known as "doctor shopping," the grand jury found. The proliferation of clinics attracts carloads of illegal drug buyers from other states, notably Kentucky, Ohio, West Virginia and Tennessee.
While some pain clinics offer legitimate medical services, most are "rogue clinics putting out pills for cash," according to the report.
"By the time law enforcement initiates and completes a successful investigation leading to the arrest of a doctor, user or dealer, several new clinics have opened," the report said.
In response to the growing problem, state lawmakers approved a new law this spring placing pain clinics under greater state scrutiny, and creating a database of prescription drugs sold, so prescribing doctors can better detect "doctor shopping" patients.
But the grand jury highlighted weaknesses in the law — most notably, that the database program has no dedicated source of funding. State officials plan to seek grants to pay for the $4 million program.
The grand jury also criticized a section of the law that allows doctors to record prescriptions in the database within 15 days of their distribution. The grand jurors said drug traffickers could have come and gone by the time their prescriptions are recorded.
The grand jury recommended to the Legislature 18 new reforms to curb the pain-clinic problem, including closing several loopholes the new state law failed to address. They include:
Preventing pain clinics from distributing drugs on site until the state database is up and running next year. Many clinics advertise that they both prescribe and sell pills on site to attract clients — another practice the grand jury would ban.
Limiting prescriptions from pain clinics to no more than a three-day supply. Clients at pain clinics typically receive a 30-day supply of drugs — 150 to 240 tablets of oxycodone, often coupled with the painkiller roxycodone and anti-anxiety drugs such as Xanax — after only one doctor's visit.
Barring people with criminal records from owning pain clinics. The Miami Herald investigation found several examples of clinic owners with criminal records, including the owner of a Boca Raton pain clinic who once pleaded guilty to possession of steroids with intent to sell.
Limiting the number of pain-relief patients to 100 per clinic, and placing limits on the number of out-of-state patients a clinic may have. Narcotics investigators have said that some pain clinics have as many as 65 patients per day. One Coral Springs doctor indicted on trafficking charges last year had nearly 500 patients from Kentucky.
Thursday, November 12, 2009
Governor Crist Appointment
Governor Crist appoints Past FSAM President to the Prescription Drug Monitoring Program Implementation and Oversight Taskforce.
http://www.flgov.com/release/11150
GOVERNOR CRIST APPOINTS NINE TO THE PRESCRIPTION DRUG MONITORING PROGRAM IMPLEMENTATION AND OVERSIGHT TASK FORCE
November 12, 2009
Contact:
GOVERNOR'S PRESS OFFICE
(850) 488-5394
TALLAHASSEE – Governor Charlie Crist today announced the following appointments:
Prescription Drug Monitoring Program Implementation and Oversight Task Force
· Andre Benson, 62, of Tampa, physician, Operation PAR Inc., appointed for a term beginning November 12, 2009, and ending July 1, 2012.
· Lora “Lorrie” Brown, 44, of St. Petersburg, pain physician, Coastal Orthopedics, appointed for a term beginning November 12, 2009, and ending July 1, 2012.
· Kristen Cortes, 45, of Panama City, Florida Department of Law Enforcement agent, appointed for a term beginning November 12, 2009, and ending July 1, 2012.
· David Craig, 41, of Tampa, clinical pharmacist specialist, H. Lee Moffitt Cancer Center and Research Institute, appointed for a term beginning November 12, 2009, and ending July 1, 2012.
· Joel Kaufman, 57, of Ft. Lauderdale, vice president, United Way of Broward County, appointed for a term beginning November 12, 2009, and ending July 1, 2012.
· Nilesh Patel, 45, of Bradenton, interventional pain management physician, appointed for a term beginning November 12, 2009, and ending July 1, 2012.
· Donnie Reynolds, 41, of Weston, chief operating officer, Automated Healthcare Solutions, appointed for a term beginning November 12, 2009, and ending July 1, 2012.
· Paula “Pepper” Wakeland-Hewitt, 60, of Sarasota, pharmacy manager, Davidson Drugs, appointed for a term beginning November 12, 2009, and ending July 1, 2012.
· Bernd Wollschlaeger, 51, of Miramar, self-employed primary care physician, appointed for a term beginning November 12, 2009, and ending July 1, 2012.
http://www.flgov.com/release/11150
GOVERNOR CRIST APPOINTS NINE TO THE PRESCRIPTION DRUG MONITORING PROGRAM IMPLEMENTATION AND OVERSIGHT TASK FORCE
November 12, 2009
Contact:
GOVERNOR'S PRESS OFFICE
(850) 488-5394
TALLAHASSEE – Governor Charlie Crist today announced the following appointments:
Prescription Drug Monitoring Program Implementation and Oversight Task Force
· Andre Benson, 62, of Tampa, physician, Operation PAR Inc., appointed for a term beginning November 12, 2009, and ending July 1, 2012.
· Lora “Lorrie” Brown, 44, of St. Petersburg, pain physician, Coastal Orthopedics, appointed for a term beginning November 12, 2009, and ending July 1, 2012.
· Kristen Cortes, 45, of Panama City, Florida Department of Law Enforcement agent, appointed for a term beginning November 12, 2009, and ending July 1, 2012.
· David Craig, 41, of Tampa, clinical pharmacist specialist, H. Lee Moffitt Cancer Center and Research Institute, appointed for a term beginning November 12, 2009, and ending July 1, 2012.
· Joel Kaufman, 57, of Ft. Lauderdale, vice president, United Way of Broward County, appointed for a term beginning November 12, 2009, and ending July 1, 2012.
· Nilesh Patel, 45, of Bradenton, interventional pain management physician, appointed for a term beginning November 12, 2009, and ending July 1, 2012.
· Donnie Reynolds, 41, of Weston, chief operating officer, Automated Healthcare Solutions, appointed for a term beginning November 12, 2009, and ending July 1, 2012.
· Paula “Pepper” Wakeland-Hewitt, 60, of Sarasota, pharmacy manager, Davidson Drugs, appointed for a term beginning November 12, 2009, and ending July 1, 2012.
· Bernd Wollschlaeger, 51, of Miramar, self-employed primary care physician, appointed for a term beginning November 12, 2009, and ending July 1, 2012.
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