“Candy Man” gets his license back
David sends us a link to the Daily Caller which reported the news last week that Dr. David Houlihan, the Tomah, Wisconsin VA hospital’s chief of staff may get his job back after losing his state medical license for over prescribing dangerous drugs to veterans, so much so that the hospital was known as “Candy Land” and the good doctor himself as known as the “Candy Man”. The State Medical Board yanked his credentials two years ago, but a judge restored those creds ahead of an investigation, according to local news;
Administrative Law Judge Jennifer Nashold overturned the Wisconsin Medical Examining Board’s emergency suspension, saying in a ruling made Friday and released Monday that the evidence against Houlihan didn’t justify the immediate sanction while the medical board continues its investigation into whether he violated state law.
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The center reported on Jason Simcakoski, a 35-year-old Marine Corps veteran who died from a drug overdose while at the hospital in 2014.
The medical board, in issuing its emergency suspension March 16, said Houlihan did not act as “a minimally competent” doctor when he prescribed an unnamed patient Suboxone, commonly used to treat opioid dependence, for chronic pain and anxiety, on top of nine drugs he was already taking.
The patient matched Simcakoski’s circumstances.
The board also said Houlihan acted outside the scope of his psychiatry practice when he treated patients with chronic pain, often prescribing opioids in “dosages greatly exceeding the recommended daily amount” for up to 12 years, creating “an unacceptable risk” of harm to patients and the public.
He’s been on paid leave since 2014, and in the interim started his own practice.
While the VA goes through the motions of investigating the doctor and his methods, acting Director Victoria Brahm of the hospital has forbade the media from the premises;
“The media will not be allowed on the campus while the DAB is meeting as we do not want to disrupt the environment for our residents, Veterans coming in for healthcare services or staff,” read the memo, signed by acting Director Victoria Brahm. “Therefore if you see members of the media on campus not being escorted by Matthew Gowan, Tomah VAMC public affairs officer, please contact the VA Police Department.”
As the weeklong hearing of the Disciplinary Appeals Board — a grievance process outlined in federal code — got underway, Brahm softened her tone.
“The hearing is already generating much attention and for the reasons I’ve mentioned above, it has been decided that the media will not be authorized access to the hearing,” the new message stated. “If you see unescorted members of the media on campus please contact Matthew Gowan … so that he can assist them.”
So, I’m convinced that the process will be fair, impartial and in the interests of veterans.
Category: Veterans' Affairs Department
Fair, impartial and in the interest of veterans…. yes, and if you believe that, I have some real estate on Titan I’d like to sell you.
This is unfortunate. I hope the truth comes out and the situation is handled reasonably. I also hope that it doesn’t hamstring providers and result in inadequate pain management measures for those that really need it.
Already happening. I know of at least one individual who’s fighting that battle right now.
In case you missed it, there appears to be significant pressure in many medical communities to reduce or eliminate opiate prescriptions. You can bet a good deal of the pressure is coming direct from DC on that score. The CDC has recently declared an “addiction epidemic” in America, and I’m certain they’ve done some behind-the-scenes arm-twisting with the AMA to get their members “to fall in line”.
No I haven’t missed it….It’s been hitting my inbox recently among the journal articles. I’m old enough that I’ve seen this before and seen patients suffer because of it. A knee jerk reaction from high levels that ties the hands of the practitioners at the patient level is not what is needed.
Agreed. Opiates may well be over-prescribed by some doctors. But when they’re needed to manage chronic pain, from what little I’ve seen precious little works anywhere near as well.
Many GPs are very reluctant to prescribe narcotics for more than a short duration, maybe a month or two. Increasingly, they are referring patients who need long-term pain control to pain management specialists.
True, and understandable – for someone without a documented chronic condition persisting over literally decades that requires them for pain management.
But when someone has been prescribed the same medications at the same dosage for 2+ decades for a chronic condition causing significant pain, I’d think that even a GP should be willing to continue prescribing those same medications – opiate or not.
The reluctance by many GP to prescribe pain management drugs also results in those MDs that do having an abnormal number of pain management patients, which in turn gets them flagged for investigations… (at least that was the case in the 90s when I managed an MD office)
This “Doctor” is in way over his head. Training in psychiatry? Needs to co-ordinate with an MD for prescriptions ( common practice ).
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No media? No press? They are telegraphing their intentions. Back to “business as usual”.
“Move along Comrade, nothing to see.”
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The more I read about the VA, the more it looks like a congressional / union vote buying scheme.
You are confused.
Psychiatrists are MDs. A well-trained psychiatrist knows more about medication management than just about any other specialty. Whether or not he was well-trained or practiced within the scope of his training is at question.
Considering my own history, I doubt they are *so* highly knowledgeable. ( That info is TMI territory ).
3 possibilities :
VA is starting/continuing a “Liverpool Care Pathway” program.
OR
This doc is a mail order grad.
OR
This doc is a drug addict, using while “working”.
There are no mail order MD grads in America….period
I suggest you actually gain some expertise in the commonalities every physician experiences before you start running amok about things that don’t even exist. There are exceptional doctors, good doctors, mediocre doctors, and occasionally bad doctors.
The bad doctors are no measure of central tendency of doctors practicing across the U.S.
We have three things going on here regarding Dr. Hotlips. The first is a VA patient died of an overdose while at the VA. The event occurred in 2014, but more specific dates are not given. That triggered a VA IG investigation which found no wrongdoing and offered that the decedent may have been using drugs other than those prescribed. The second thing is that Dr. Hotlips was fired from the VA in November (presumably 2015, but that isn’t specified.) The third is that his license to practice was suspended on an emergency basis by the Washington State Medical Examining Board on 16 March (presumably, 2016, but that isn’t specified either.) Why was his license suspended? Because he did not act as a minimally competent doctor would under the circumstances presented and he practiced outside of the scope of his practice in treating patients for chronic pain, often exceeding dosage limits.
Unlike the VA which, I guess, Hotlips could do without, he needed his license so he appealed the suspension. Enter the administrative law judge and her conclusion that the basis for the emergency suspension was lacking, so she reinstated his license. Said the ALJ, “Emergency suspension of a professional license is an extreme measure, as it deprives a person of the ability to earn a living in his or her profession without a conclusive finding of wrongdoing after full due process.” Yeah, that’s true, although it only deprives the individual his livelihood in his chosen field for a time. It is an extreme measure aimed at protecting patients for malpracticing doctors. The Medical Examiners had already established their rationale for suspending Hotlips’ license and a fuller investigation is pending. So, I just don’t get it. When a police officer is suspended, he doesn’t have a be-all, end-all hearing either. In some cases, his weapon is taken. That’s the nature of emergency action for the protection of others. I’m guessing that the ALJ and those she cares about will not be seeing Hotlips. Hell, they’re not crazy!
It’s been awhile, but if I remember correctly, there is something referred to as the “Rule of Seven.” If you take seven or more medications together, the chances of you having an adverse reaction increase astronomically, and you will also find that you are being given medications to treat the symptoms caused by a medication that you are already on. You might think ‘SEVEN medications??’ but particularly among geriatric patients, it’s not uncommon for a patient to arrive with a paper sack full of bottles when they come to see their doctor.
And having said that, I’ll say this: there are times when taking that many meds is unavoidable, particularly with chronic, serious illnesses that require long-term treatment.
What PN said, but in addition, there are many of these strong chemical compounds that have severe reactions when they are used together. There are apparently a lot of doctors who ignore the black box warnings (DO NOT USE WITH: Rx whatever), and many of these ‘black box’ compounds react adversely when used with opiates.
The result is flooding an organic system with chemical compounds it simply can’t handle, and the results are sometimes catastrophic.
This is a huge issue in the North East for the civilian population as well…opioids are the de facto pain killer of choice and some folks who get them for their pain can’t stop taking them later…I’m glad the few times they’ve prescribed them to me I felt so loopy I tossed them down the toilet and suffered through on alleve instead.
There is much discussion at some of the smaller local hospitals about pain management and not prescribing opioids as often as previously in an attempt to reign in the abuse. That often means some poor bastards in extreme pain aren’t getting the aid they need to manage that pain effectively. That’s the unintended consequence behind initiatives of this nature.
It sounds like the doctor has some problems in his future, or not…I’m thinking with a nickname like “Candy Man” it’s not going to go all that well, but stranger things have happened than a Candy Man getting a walk.
Medical malpractice resulting in death is one of the leading causes of death in the United States. It’s pretty shocking how protected these people are from consequences of killing other Americans.
It just isn’t that simple. One of my doctors has been sued for malpractice TWICE. I know the backstory on both cases, and the doctor wasn’t at fault, and that was proven in court both times — but if you do the name search, the results indicate he’s been sued twice for malpractice, and that’s all. So what would someone think? A malpractice suit is a near deathblow for a doctor, whether he’s good, bad, or indifferent.
Torches and pitchforks, yet the darkness persists.
The near death blow, as you call it, is not that at all. It’s part of the medical business. Being sued for malpractice, singularly or as one of many named in a lawsuit, will happen to most doctors during their careers, without any long term effects, other than to distrust patients, according to a 2015 Medscape Malpractice Report. And most lawsuits are settled, meaning hours on the stand with reportable testimony do not occur. I have no doubt that many cases are brought for idiotic reasons. I know this because of the silly warning stickers I see on things telling me that this or that is potentially dangerous and, when it comes to many chemicals, that the state of California knows what the rest of the country apparently does not.
http://www.kevinmd.com/blog/2011/05/malpractice-hurts-doctors-future-patients.html
A lawsuit is not always the best way to go about things, but ‘money’ seems to be the go-to default in this day and age.
I was not aware the media could be banned from an entire campus; especially a Government one. I understand certain areas due to privacy concerns and HIPPA issues, but the entire campus to include parking lots?
Sure, 3E9, an agency of government can impose all sorts of restrictions as to who may access a facility, even a . And although most of us think that the press enjoys rights of access greater than yours or mine, it doesn’t, but is more frequently accommodated. The media can get their info the old fashioned way, by interviewing anonymous sources and filing state or fed info act requests to get to those things that gov’t will allow to be seen. There are some very good reasons to bar or restrict the press but don’t ask me what they are. Outside of security concerns, the only one that makes sense to me is the gov’t types don’t want folks snooping around and asking good questions.
You would think with the way the VA is getting hammered in the press for the last few years they would avoid even the perception of restricting the media to general areas. But then again I guess that would take some common sense and thought.
Just over 15 years ago I fell 12 feet to pavement from a ladder, landed flat on my back. Unable to get up, first thing I did was to realize I could still move my toes. This gave me hope that I was not paralyzed. Waiting three days in the hospital for the doctor of choice to repair a crushed vertebrae, my periodic tremendous pain was not even close to being eliminated by LOTS of morphine. In fact, my breathing slowed down so much that they put me in CCU as my blood pressure was dropping to serious low levels. Long story short…..pain pills of low dosage do not relieve me of the hurt. But I know for certain an increase in dosage would only be temporary and my body would adjust accordingly and still hurt..creating a want to increase my dosage. My pain is something I have learned to live with, mostly by staying very busy and keeping the mind occupied. Regrettably those in far more severe pain than I have little hope other than to beg for increases in dosage as the body adjusts to the current level of medication. Same for sleep medication, been there, done that. Finally admitted to myself that I just have to deal with it. Up until this recent crackdown on over use of opiods, the V A was trying to be helpful in reducing a patient’s long term pain, but even something as low dosage as Tramadol is closely controlled these days. Bottom line is I DO feel sorry for those living with EXTREME pain, and even more sorry that situations result from overdose, but have no answer for a solution.
You may want to research alternate therapies. Start with a book entitled “The Miracle of MSM.” This is a book written about the research being done with a compound that helps with chronic, intractable pain. Good luck.
Thanks P N, I’ll look into it. I”m just blessed to be in pain and not in a wheel chair. Staying physically active beyond my years is the best sleep medication of all. Plus it keeps one younger at heart.
I normally don’t recommend something like this because, let’s face it, it smacks of snake oil. However: there are a couple of reasons I broke my own rule: 1. I use MSM and it works for me; 2. You can buy it OTC at any big box store or pharmacy, cheap; and 3. it’s not some weird thing out of the jungles of who-knows-where, but a form of sulfur, a mineral found all over the world. The book will explain how and why it works, and then you can adjust for your situation.
I haven’t had anywhere near the level of pain you suffer from, and I know how it wears you out and drags you down. You’ve been very strong, but if there is any relief to be had out there, you deserve it.
Hey It’s the NEVER ENDING STORY Lol…??????????
Anecdotally, have had three surgeries in the last few years in which each time the doc has told me “for pain at these levels we used to prescribe more effective drugs, but in the current atmosphere with all the government scrutiny, Tylenol is the best I can do.” If they monitored their own spending as effectively as they seem to watch over my docs, the government would run a surplus…
Word on that