Washington state pain patients seek help after doctor’s suspension
The calls are coming, angry and anxious, from pain patients across Washington worried they can’t find care.
Three weeks after state officials suspended the medical license of Dr. Frank Li, medical director of Seattle Pain Centers, citing allegations of billing fraud and possibly contributing to patient deaths, other providers say they’ve been swamped with a new — and desperate — demand.
“We’ve had hundreds of patients who have been referred to us already,” said Dr. David Tauben, the chief of pain medicine at the University of Washington.
It’s the same story at Swedish Medical Center, where Dr. Steven Stanos is the medical director for Pain Services. At the Washington Center for Pain Management, which has clinics here and in Oregon, staff has been fielding at least 200 calls a day.
“We’re absorbing quite a few of them,” said Jae Lee, chief executive of the operation.
But finding enough places to accept more than 8,000 Seattle Pain Centers patients prescribed opiates this year — and an estimated 25,000 who have received care overall — is a challenge.
“It puts us in a precarious situation when you have a huge prescriber of patients and they suddenly close up,” Stanos said. “A lot of these patients were very high-risk to start with.”
Li has not been charged with a crime. He has requested a hearing regarding the charges brought by the Medical Commission, but no date has been set. Julie Graham, a spokeswoman for the Washington State Department of Health, said the hearing is likely to be held in the fall.
Particularly vulnerable are an estimated 400 patients who receive pain medications through implanted pumps. If they run out of drugs, they could suffer severe withdrawal or die, doctors said.
Seattle Pain Centers previously operated eight clinics across Washington. As of this month, only one, in Renton, is open, state officials said.
Other providers of pain care were taken by surprise when the Washington Medical Commission suspended Li’s license July 14 and took action against more than 40 other providers who worked for his clinics since 2013. The state Health Care Authority, which oversees Medicaid, also revoked his ability to bill for services.
“We weren’t warned this was going to happen,” Stanos said. “Looking back, that would have been helpful. We could have done a better job to plan.”
It’s especially difficult now, in the middle of summer, when vacations mean staffing levels are lower and trauma incidents — boating and car accidents, among others — are high.
“I can’t think of a worse time than Seattle in August,” Tauben said, adding later: “We are indicating that we are not staffed for this … We are beyond our resource capacity to take this on.”
‘Kicked to the curb’
State records showed problems with Li’s practice dating to 2013. But health department officials say they acted quickly to coordinate efforts to offset the impact of the clinic closures.
“We are working with HCA to identify resources, gaps and potential short- and longer-term solutions for patients and health care provider,” said Graham, of the health department.
More than 60 providers across Washington called in last week for a telephone conference organized by the health department. The session was closed to reporters.
“We reviewed the whole problem,” Stanos said. “We all had the goal of not keeping people out in the cold.”
That’s hopeful news for people like Joseph Tade, 54, of Olympia. He was hurt at age 20 in an industrial accident — a transmission fell out of a machine and he caught it, he said. It left him with degenerative disc disease — and chronic back pain. He’s been a patient of Seattle Pain Centers for four years and found out July 27 his clinic was closed.
“I’ve never been kicked to the curb without a referral,” said Tade, explaining he takes opiates and other drugs to function. “I’ve got enough for two months to get by. I can’t be off of medication. I’m one of the people who actually need it.”
State health officials have set up a patient hotline and urged those who are without care to reach out to the primary-care providers who originally referred them to Li’s centers.
UW Medicine and Swedish pain-management officials say they’ll take responsibility for the patients already in their system. Whether they will accept new patients is a question.
“The solution is not running to the University of Washington to get your pain care,” Tauben said.
But other primary-care doctors may be reluctant to take on chronic-pain patients who are covered by strict state pain-management rules that took effect in 2012. It’s especially difficult to tackle patients who may be on high doses of painkillers, he said.
“Many of them have not been trained and many of them have been terrified that they don’t know how to manage patients above the guidelines,” Tauben said.
New guidelines from the Centers for Disease Control and Prevention say doctors should avoid doses higher than 90 milligrams of morphine-equivalent drugs per day — or have a strong justification for their use. State rules require an expert consultation at doses of 120 milligrams of morphine equivalent or higher.
Complicating matters, many doctors don’t like to accept Medicaid patients because reimbursement for care is low.
“You can’t get a doctor. It’s real hard to get a doctor,” said Pam Rockwood, 67, of Woodinville, who said she was treated at Seattle Pain Centers after her back was injured in three car accidents between 2003 and 2006.
Rockwood said she has reached out to a former primary-care provider at UW Medicine and hopes to be seen before her two-month pill supply runs out.
“I’m not a drug addict. I’m responsible with my medications,” she said. “You could have seizures. You could die.”
Filed under: General Problems
Well said Bob Shubring
The deficiency in the US legal system, is that a person asserting sovereign immunity, is believed immune until proven otherwise.
Therefore, an ambitious lawyer or other official of a state, can inflict grievous damage upon the citizens of the state, and not be sued for the harm he causes…because if he is sued, he asserts sovereign immunity and is believed.
That is why these need to be viewed as genocide cases and charged appropriately.
Ideally, one of these ambitious lawyers may lose consciousness, wake up some hours later in a foreign country, and find himself jailed on Genocide charges, for actions he perpetrated in the US, while believing he was immune from prosecution. Were that to happen once or twice, this racket would grind to a halt.
Rendition affects domestic terrorists, too.
As Vice President of the Central Pain Syndrome Foundation I have seen some of our CPS patients who reside in Washington wanting to give up on life from being kicked to the curb and going through major withdrawals. Not because they are addicted but because it is unethical to not titrate patients off of all different sorts of meds that are not pain pills. Such an irresponsible, disorganized way to handle this situation. Preparation would/could have prevented this un-needless suffering by the patients and doctors who are struggling to find a way to help those that were cut off with no transitioning plan before hand. Doing so much more harm to those who are already suffering 24/7/365.