BIDDEFORD, Maine — A physician affiliated with Southern Maine Medical Center has been reprimanded by state licensing officials in the wake of a patient’s apparent overdose death.
Stephen H. Doane, a Biddeford internist and geriatrician, was ordered by the Maine Board of Licensure in Medicine to stop prescribing controlled drugs for chronic pain.
The board initiated a complaint against Doane after Biddeford police expressed concerns last year about his prescribing of controlled drugs, according to a May 18 consent agreement.
The patient, who is not named in the agreement, died of an apparent drug overdose on Jan. 18, 2011. Doane saw her on Jan. 7 and Jan. 10 of that year, and acknowledged several missteps that led him to prescribe a “significant amount of narcotics,” the agreement states.
He prescribed the patient Oxycodone, Xanax and Ambien, among other drugs.
At her first visit, Doane had not seen the patient’s most recent medical records, which indicated that another physician would no longer prescribe her narcotics, the agreement states. Her medical records also referenced a November 2010 hospitalization for an overdose that left the patient on a breathing machine, as well as a history of suicide attempts.
The patient was initially scheduled for a December 2010 appointment with Doane, and failed to show up. Doane received a telephone message that she had been in the hospital for three weeks, but he failed to recall the message during that first appointment with her in January 2011, according to the agreement.
Doane also acknowledged failing to check a prescription drug monitoring database prior to prescribing her the controlled substances.
Doane doubled the dose and frequency of the patient’s narcotics four days after prescribing her 15 days worth of drugs. He took full responsibility for prescribing that amount, according to the agreement.
Doane discussed the patient’s medical history with her, but she did not mention past substance abuse, the agreement states.
By signing the consent agreement, Doane conceded that the board had enough evidence to conclude that he failed to adhere to standards for using controlled medications to treat pain.
He was ordered to stop prescribing controlled medications for chronic pain, unless he has a chronic pain patient in skilled nursing or long-term care facilities, in hospice care, or who has metastatic cancer.
Doane, who was first issued a Maine medical license in 1985, is an employee of PrimeCare Physicians, a subsidiary of Southern Maine Medical Center, said Sue Hadiaris, vice president of planning and development for SMMC. Doane will continue to see patients as he abides by the requirements of the consent agreement, she said.
Doane agreed to reimburse the board $1,185 for the cost of the investigation.
Do they reprimand the street pusher or do they jail them. You can’t make an example of doctors who perscribe narcotics because they would all be in jail.
The street pusher would be held for manslaughter..
Exactly, but you can make an example out of doctors and this is a clear case where a strong message could be a deterrent. The medical community is a major contributor to the flood of drugs and addiction issues in our area, and the country, and this general attitude that a pill will fix whatever ails you without personal responsibility on the part of anyone – patient or physician is criminal. He should be charged.
There is significant motivation for them to do business in this manner. Pharmaceuticals are a multibillion dollar industry and the corporations have immense political power.
Far too many doctors passing out prescriptions for pain meds like they were candy. I have heard of one in Winterport, another in Lincoln….they are all around us. I have to beg my doctor for an aspirin. I would love to see them start to even things out a little, and get the narcotic pushers off the streets. They cant sell what isnt prescribed.
Then they steal it or get it other ways….you would be surprised at the lengths the “pusherman” will go! I wonder if they ever stopped to think, “how would I feel if someone was pushing this stuff on my kid (or brother, sister, etc). We have to help combat with education and communication…..JUST SAY NO!
Add this one to your list from last month:
“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.”
Sounds more and more like we have an epidemic of bad doctors in this state that get “reprimanded” for their illegal practices.
Drug use should be considered a medical issue. We don’t throw people in jail for twinkies or McDonald’s “food”, despite the fact that each year more people die in one state from diabetes and heart disease than the total number of drug fatalities for the entire country.
No person should ever be imprisoned merely because they chose to consume something.
The main point was not irresponsible consumption but irresponsibility in the providing of the drugs – big difference.
I am aware of the point of the article, I simply take every opportunity I can to spread the truth and perhaps a more enlightened approach to the idea of regulating human consumption.
If this State is ever going to address its prescription opiate problem, it is going to have to be willing to take down a bunch of people with prescription privileges. This story is a good sign. Keep it up. Let’s remember that Oxy’s are controlled drugs. Without lousy prescribers, it would be awfully hard to get hooked on them.
We also need some legislation to regulate the Drug Dealers (drug reps) that work for Pharmaceutical companies. Why aren’t they required to be licensed and trained and regulated? Really?
I dunno… not to sure I like the idea of doctors worrying about Narc cops more then their pain patients. Medications, whether for pain, cancer, or whatever are best left as a decision between doctor and patient. Having said that, I think that doctors shouldn’t be trying to see 50 patients a day either so there can be a conversation longer than, “Oh, you are in pain? Here take these.”
So now we require doctors to act as investigators of potential drug violations before prescribing meds?
Two sentences stand out in the consent agreement relative to this issue:
1. “Doane also acknowledged failing to check a prescription drug monitoring database prior to prescribing her the controlled substances.”
2.. . . . “Doane discussed the patient’s medical history with her, but she did not mention past substance abuse, the agreement states.”
So, if the patient lies, beware.
If you don’t act as a cop, beware.
Docs can’t get all the info they need in 10 minute appoinments. They rely heavily on patient honesty in providing background. Patients lie. The Board want to use docs as the gatekeepers without pay for that role.
Uh, the docs ARE the gatekeepers. That is their role. These are “controlled” substances, controlled by the medical profession, a trusted role with certifications, licenses and RESPONSIBILITIES they are required by the nature of their role as physicians to observe.
“geriatrician”. I think the key here is that word. The physician was assisting in what the patient desired.
We need a Death with Dignity Act…
If medicine continues to allow insurance companies to dictate the amount of time spent with patients and how one is treated…………………this behavior and neglect will continue. Insurance companies have NO business dictating the guildelines for medical/dental health. You as the comsumer would be better off to seek your care in entities that are NOT part of your “health plan” and pay a little bit more for someone that cares about YOU not what your insurance company dictates……just saying………….
Thank you for your comment! I am in the healthcare field, and have tried to educate patients that the ins. companies do not have your best interests at heart. They are for profit– theirs. Find care givers you feel comfortable with and trust; not necessarily those an ins company pushes you toward.
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“Pill Mill”
This case gives new meaning to ‘Doan’s Pills’. His privileges were not suspended completely.
It does appear there were a few opportunities to better know this patient’s history with addiction which is not to say she wasn’t experiencing significant pain and in need of relief. A lot of internists, who are strapped for time past the allotted 15 minutes, and are in short supply in Maine, refuse to prescribe controlled pain medications, opting to refer those patients to pain specialists, instead.
That makes sense.
i went to emmc walk in care for a bad chest cold…he gave me vicodin. I said “i dont want that stuff” he said “oh thats ok stick em the back of your fridge, theyre good for 2 years, in case you sprain an ankle or something”…ya no wonder everyone is hooked on that crap.