CALAIS, Maine — Dr. John S. Tkach, an internal medicine specialist who was affiliated with the Calais Regional Medical Services’ Rural Health Clinic, has been reprimanded by the Maine Board of Licensure in Medicine and ordered to stop prescribing controlled substances for the treatment of chronic pain.
According to Dee Dee Travis, a spokeswoman for Calais Regional Hospital, Tkach no longer is seeing patients at the facility. He remains employed at the hospital interpreting medical tests, she said.
Tkach concedes in a consent agreement that the board had sufficient evidence to conclude that he failed to meet the standards of care for the diagnosis and treatment of nonmalignant chronic pain. Specific concerns with Tkach’s care, the board said, included failure to document rationale for prescribing controlled medications, failure to document violations, failure to consider alternative treatments, early refills, escalating doses of controlled medications, and lack of urine screens and pill counts.
As a condition of the consent agreement, Tkach is indefinitely prohibited from prescribing controlled substances for chronic pain unless he has a chronic pain patient in skilled nursing facilities or long-term care facilities, in hospice care or who has metastatic cancer.
Tkach also agreed to pay the board $2,705, which was the cost of its investigation.
Tkach has been licensed to practice medicine in Maine since November 1994. The investigation into his prescription practices was prompted by a complaint filed in July 2008 by The St. Croix Regional Family Health Center in Princeton.
I guess the drug addicts insatiable appetite for controlled substances made it bad for good people who suffer from chronic pain. What a shame.
You just don’t get it.
Improper monitoring and prescribing turns people with chronic pain INTO addicts.
No, an addiction is not a problem of improper monitoring and prescribing. If you follow the directions on the label of the bottle, chances are you’ll do well. Even then, the drug itself is probably a narcotic and very chemically addictive, hence why it is a perscribed drug.
Let’s not just throw personal responsibility out the window. Some people are addicts because they like being high. I can’t blame them 100% though.
Either way, people in general usually have addictive personalities. We get addicted to everything! Sex, drugs, video games, politics, religion, frozen peas. Even “OCD” could be considered an addiction – An addiction to a certain way of performing a task/function.
If we’re ever going to get the opiate problem in this state under control, we’re going to need to see a lot more stories like this one.
Hardly a solution. You could lock up every doctor in the state and opiates would still be readily available.
Actually, it’s a great solution. It would also eliminate clogged emergency rooms. People with real emergencies may actually be able to get treated in a timely manner.
It’s a darn good start
If you have a friend that’s a pharmacist ask them the scoop on what the problems are with over prescribing these medicines. It’s real. They are the middlemen between the doctors and the patients.
Another great doctor hurt by our local drug addicts
I think you have this backwards!!!
I’m sure they tied him up and forced him to write the prescriptions.
common practice is they take part of the script to show they are on it when they get tested at next docters visit then they sell the rest to the pill heads.I know this cause a guy was talking about his girl friends pill problem and who she was geting them from.Well not the guys name but that it was a guy who sells part of the script that he gets.
It’s only the beginning.
Exactly! One down, how many more to go?
You can’t keep prescribing and prescribing all the time, eventually it will catch up to you!!! I feel bad this happened to him, but he should have kept better records and learned to say NO when they would call and want more when they just got it the day before. He even had a couple who called and said the kid dropped them down the sink drain!!
Not that I don’t agree that meds get over prescribed, but how would you know what someone said to get more?
Ask any corrections officer in the jails or prisons of this or any other state. You hear quite a bit of this. Of course theses people aren’t Rush Limbaugh and some end up doing time for Dr. shopping. Dr. Tkach was a favorite among the drug crowd in Washington County.
A $10,000 fine to go along with being indefinitely prohibited from prescribing controlled substances for chronic pain might have made a bigger impact in the medical community!
Medical marijuana is an incredible natural medication to manage chronic pain. I suspect many could be spared opiate addition if the government would get out of medicine and if doctors would get fully informed on this subject.
We live in an upside down world where opiates are prescribed like candy and Americans get locked up for possessing a plant has in the last 10,000 years.
We are a country held hostage by the pharmaceutical companies who are legal drug dealers killing and destroying more lives that this miraculous natural plant.
So, smoke in your lungs is healthy?
No. Smoke is not good but vaporizing and tinctures are
Please become informed on this matter. There are vaporizers, edibles such as tinctures, hard candy, lolly pops, brownies, granola bars, olive oils, etc. But even so, there is absolutely no overwhelming evidence that smoked cannabis causes any damage to the lungs as cigarette smoking does. In fact there is mounting evidence that it shrinks tumors because of its anti-inflammatory properties.
Point taken…
Having a bunch of stoned pot heads running around stealing everyone’s twinkies is not the answer either.
Please stop stereotyping medical marijuana patients. Your comments show that you are uninformed about this subject. Doctors who prescribe medical marijuana and who over see patients recommend very small doses spread throughout the day for the best pain relief. If you smoke/ingest too much, it will not control the pain and will make you appear stoned.
Most people dealing with life-changing chronic pain want relief from their suffering without feeling stoned or impaired. Your vision of these patients is typical for those who have absolutely no idea what they are talking about. Also, many patients dealing with chronic pain and illness stay away from twinkies because they are harmful and do not give their bodies the strength that they need to fight the illness or deal with the pain.
So your answer is to let people suffer in pain so that they become debilitated and can no longer contribute to society and you think that using a natural plant to relieve suffering rather than toxic addictive pharmaceuticals is bad? So typical for those who have never suffered an illness or injury that forever changes your life.
“So your answer is to let people suffer in pain so that they become debilitated and can no longer contribute to society.”???
Contribute to society? Are you kidding? Some would say that with your proposed method of “treatment” has a greater effect of people being being useless for society.. Oh, unless you’re talking about Willie Nelson who writes songs about being stoned… And there’s Snoop Dog. Yeah, we’re progressing leaps and bounds nationally because of their “contributions”.
You are confusing those who are recreational smokers with those who are suffering and use it to relieve suffering.
You have watched too many “stoner” movies. Please get better informed. What does Snoop Dog and Willie Nelson have to do with people dealing with life-changing chronic pain, illness and injury? And furthermore, those two that you mentioned are talented musicians who have been more successful than you ever will be.
There are people from all walks of life who use this as medicine who have successful careers . Please don’t confuse those who abuse this medicine recreationally with those who are patients under a doctor’s care. There is a HUGE difference!
I hate to break it to you, but there are many, many “productive members of society” who regularly use marijuana. They just do it at home, at night, after their long day at work!
You have no idea what you’re talking about.
Marijuana is the least of this nation’s problem. Lots of people I know, work while on Marijuana, not because they want to but because if they didn’t, they couldn’t work from being in so much pain.
Marijuana is NOT chemically addictive. Most perscribed pain medications ARE chemically addictive. Why is a drug that is not chemically addictive illegal, when things like alcohol and tobacco that are chemically addictive are legal? Even without a perscrption! Isn’t that crazy?
Boy, you really know what you’re talking about, don’t you?
I’d rather have “a bunch of stoned pot heads” stealing my Twinkies than stealing material items from my house, my money or threatening me! I’ve never known any pot heads that rob banks and stores, either!
Why did it take almost 4 years from complaint to consequences?!
Because the guy had the initials M.D. after his name. If he lived in a trailer park with a tattoo on his neck he would be called a drug dealer and would have been dealt with rather quickly and harshly . He (Tkach) had resources the law consequently was afraid of him, Because he went to college he is called Doctor (not a thing against education, I spent a decade in the halls of academia) and is held to a different standard. The guy in the TP is called dope dealer. Oh yeah, the guy in the trailer park? He would’ve went to prison for 10 years. Because the doctor works in a hospital, he gets fined the equilivant of a days work perhaps and is allowed to work IN THE SAME PLACE. The guy in the trailer park would never be able to work again because he would be a convicted felon, hence in desperation he would have to make money doing what he knows to do. I am not saying that would be right, just illustrating a point. You know like state trropers that drive drunk and molest kids, prison guards that abuse animals, postal employees that steal from veterans, Turnpike managers that steal from the state, prison wardens that get to buy state ocean side state property at Marden’s prices ? They have a different set of laws than the rest of us.
….and there should be MANY more to follow!!!!
It is doctors like this that make it harder for severe chronic pain sufferers to get the medications they need.
He should have been fined $500,000 to reimburse medicaid for paying to treat the drug addicts he hleped create. WHAT A LOSER, I HOPE PEOPLE REFUSE TO BE TREATED BY HIM.
How about digging deeper and reporting whether doctors are somehow remunerated somehow for writing prescriptions on certain pharmaceutical companies? How about diverting the profits realized by the pharmaceutical companies that manufacture replacement drugs for those diverted into the illegal trade?
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With the shortage of medical providers in Washington Co., primary care physicians routinely face the difficult task of attempting to manage the needs of their patients without valuable input from medical specialists . It appears this physician was trying to manage the chronic pain needs of his patients who did not have a pain management specialist available to them. The lack of physicians in the area results in higher patient numbers than what may be the norm in other parts of the state. Physicians are already burdened with the enormous responsibility of treating their patients and providing a constantly increasing amount of documentation as required by insurers. Consider these factors and it becomes more clear how this physician became overwhelmed by wanting to meet the both the demands of his practice and the needs of his patients.
I see where you are comming from. Any physician has to know that there are a number of people who are going to come into their office and have the symptoms down pat. The symptoms that are going to gain them the pain meds that they seek.
What we lack, apparenty is the network of Doctors working together to document who the people are that are Dr. shopping. These people aren’t hard to identify. They are frequent flyers at the ER’s of virtually every hospital in the area. Some have worn their welcome out and travel as far as Boston using false ID’s and addresses. They are relentless in their pursuit of pain medications.
We as a society have come to the point that we don’t believe that we should feel anything. No pain, emotion, fear, anger, laughter, etc. We seem to have stepped away from the human frailties that are a part of us. We are taking the human out of being human. It is so sad.
With the shortage of medical providers in Washington Co., primary care physicians routinely face the difficult task of attempting to manage the needs of their patients without valuable input from medical specialists . It appears this physician was trying to manage the chronic pain needs of his patients who did not have a pain management specialist available to them. The lack of physicians in the area results in higher patient numbers than what may be the norm in other parts of the state. Physicians are already burdened with the enormous responsibility of treating their patients and providing a constantly increasing amount of documentation as required by insurers. Consider these factors and it becomes more clear how this physician became overwhelmed by wanting to meet the both the demands of his practice and the needs of his patients.
That assertion sir/madam is ridiculous.
Yes. And it is rare to find a realist/humanist in medical practice. This physician may or may not be such a practitioner.
Or he could just be a scumbag doctor? I doubt it, but I do think that he was overwhelmed and tried to get rid of people who suffered from chronic pain by perscribing more medication to them. That is, and at the same time isn’t, his fault.
Everything works great, on paper. Let’s not drag him through the mud OR put him on a pedestal.
That’s the fine? This is a win win for him. he can get the patients out real fast when they come to him looking for meds. takes one min to write a script and he gets to see a lot more patients.
With all the many options for pain control, I have never understood how & why the physicians here can/could, get away with presribing addictive drugs with such frequency. I have been in this state for 10 years now & where I came from such drugs as Oxys, for instance were only given to the terminal patients- because, it is so overwhelmingly addictive.. It is a sure bet that if you take that stuff you will become addicted. Also, drug seekers are not hard to spot, he should have known better….that being said, he is not the only MD out there doing this…
The Board of Licensure must have received a complaint. The Board does not randomly review practitioners. Was the complainant thinking he or she was doing good, or were there other motives.
This is th enew hot topic. It is feasible that this physician was acting in the best interests of the patient(s). Documentation? Anyone who has read charts can easily see bias and errors that go unreviewed and uncorrected, by any peer group. They exist as finite and permanent accounts, regardless of their validity. This can result in mistreatment that spans across time, and involve several medical practitioners who view the information and accept it as true.
If you look at the medical practitioners who have violations, (and you must be certain to check for medical doctors, as opposed to doctors of osteopathy, for example, as they do not follow the same rules, nor are they governed by the same department), you will see slaps on the wrist for more insidious bad practices, with pracitioners signing their “confessions,” and being allowed to continue practicing. This is far more grevious than the topic of this story.
It is completely unacceptable that all physician records do not undergo some measure of review — and now, with the forced electronic medical records, this should not be quite so difficult – not looking only for problems, but for exemplary physician practices.
There are many people in need of pain medication who are unable to get a prescription because this is the new scapegoat.
…and what is the responsibility of the medical practitioners who do not follow accepted medical procedure in the dispensing of controlled drugs in the absence of “peer’ review? Does the fact that “some” including doctors of osteopathy according to you do not have to follow the same “rules” obscure the fact that this medical doctor deserved reprimand?
This doctor is completely deserving a reprimand and to suggest ulterior motives of the Princeton Health Clinic to diminish this is unnecessary.
How many medical practitioners actually take the time to monitor non-pain relieving medication effect on an individual. Do you not think that this is as important? Few.
There was no suggestion of “ulterior motives on the part of the St. Croix clinic. But you are correct, there is nothing needed to diminish the easy target that has been offered up as a sacrifice.
Let’s see if we are reading the same article and you are indeed the poster who wrote “Was the complainant thinking he or she was doing good, or were there other motives.”
It appears Dr.Tkach has assumed responsibility through his statement to the board unless there is alternative motive to his concession.
Quote: “Tkach concedes in a consent agreement that the board had sufficient
evidence to conclude that he failed to meet the standards of care for the
diagnosis and treatment of nonmalignant chronic pain. Specific concerns with
Tkach’s care, the board said, included failure to document rationale for
prescribing controlled medications, failure to document violations, failure to
consider alternative treatments, early refills, escalating doses of controlled
medications, and lack of urine screens and pill counts.”
It’s just what it says — was the complaint made because it was thought to be right, or were there other motives. It is a question.
It appears you have not taken the time to look at the complaints listed on the Board of Licensure website, nor how they were disposed. If you read through the procedures and complaints, the prevalent response to a complaint is to sign a statement of admission. Until you step away from the hanging tree and learn about the process, evaluate what is real and what is not, there is no point in attempting discourse.
I was a patient of Dr. Tkach. I have no regrets about that, I know that he is a great doctor. And, no, I did not receive pain meds from him, in fact when I complained about the pain I was having, we discussed what the best treatment option would be. This man had a patient load that was unbelivable. There are always two sides to a story, and he is professional enough not to discuss this in public. I am sure he conceded and agreed to pay the fine because if he had fought it, it would have cost him a lot of money, and time, time that would have been better spent with patients. The majority of primary care doctors, Dr. Tkach being one of them, treat their patients based on symptoms and test results. Maybe the Board should have looked at a few more patient files, or even interviewed a few patients. I don’t know both sides of the story, but I do know that Calais has lost a doctor that truly cared for his patients.
the drug seekers must have been in line to see this guy. Probably would stay in tents overnight for more meds.
Dr. Tkach is a good physician, an excellent diagnostician (IMHO), and a very caring person. If he prescribed a medication, it is because he felt it was warranted based on physical exam, tests and resultant diagnosis. Removing him from the community at large is going to have NO impact on the drug problem in this area.
Gotta stop blaming the doctors for this. Unless the doc tells you to crush up your pills and snort them you can’t blame them for your addiction.
Right, because every single addict crushes up their pills and snorts them?!?
Your logic regarding addiction is seriously flawed.