Q&A with Dr. Scott Bickman, Part 2: DEA let painkillers go underground and undetected
Dr. Scott Bickman saw first-hand how the U.S. Drug Enforcement Administration (DEA) handled complaints about a painkiller mill running in clinics in Santa Ana and Anaheim Hills. And he asks a good question: why did it take so long for the agency to shut the clinics down?
The first part of my interview with him ran Friday. The second part is below. It has been edited for space and clarity.
Q: Dr. Harrell Robinson actually paid you for the use of your DEA registration, right? The DEA says he paid you $2,000 a month.
A: Here's where it all gets sticky. He said in 2007, "Would you be the medical director at Chaparral?" I didn't trust him to begin with and so there was no way I would get involved in that way with him. So I said no.
Q: You said earlier that you didn't have any reason to be suspicious of Robinson. Why are you saying now that you didn't trust him?
A: I learned a lot about him after I worked for him for a little while in 2007. The dynamics of his business sense coupled with his sometimes shady business associates began to raise question about his Christian do-righter image.
Q: So why did you agree to let him pay you $2,000 a month?
A: That wasn't selling my license, which is what you called it. It wasn't selling my license. He was about to lose accreditation with JCAHO. So I said I have a friend who does accreditation, and I can you to get accredited. That required him to have certain supplies and certain paperwork in place. He said, "I need to use your license to order to the necessary supplies." That's what that money was for, end of story.
Q: What was he saying that he needed to have?
A: Why do you think the medical board didn't do an investigation into this? They took his license away on nine of 10 counts. They haven't done anything to my license. They said he paid me money to be medical director. They specifically do not say that I sold him my license. If the medical board thought I had done something wrong, why wouldn't they have done something about it?
Q: But the DEA clearly thought something was wrong. They call it out specifically.
A: You were assuming that what the DEA said was true. If you look through all of the transcripts, that part about him paying me didn't come up again. It's in the initial order to show cause, but it never came up again. She was never is able to say that I absolutely knew that he was misusing my license. She was only able to say that I should have known or that I should have thought to ask Robinson what was going on.
Q: But don't you have to admit that it seems odd that you would voluntarily give someone your DEA registration information when, as you have said, you didn't trust him, and then never follow-up to see what sort of drugs he was ordering with it?
A: But when I started working there I had to provide him my credentials. So he already had them. And then his wife became involved, and so she had access to them, too. While I was at the office, I was friends with the secretary who was in the front. We became pretty friendly actually. She used my DEA registration to order drugs from three different companies, but none of those companies ever verified with me that it was OK with me. I had never prescribed anything for anyone in my entire lifetime, and now I was all of a sudden supposedly ordering all these drugs. Something should have tipped them off that this was unusual. And everybody always wants to leave 2007 out of, but you have to look at what was happening in 2007. You accurately report that in the latter part of 2007 Robinson was reaching his limits and Harvard told him that. Harvard also says that it was notifying the DEA about that. Robinson was a known felon and was a known person who had been convicted of insurance fraud. If Harvard was notifying the DEA, why weren't they flying out to California and having him prove the documentation for all the drugs he had been ordering? The Harvard compliance officer should have done that. The DEA should have done that. But, instead, they just sat and waited. And so I ended up being taken advantage of. There's a responsibility factor here. They knew all of this and did nothing to stop him.
Q: And while he was doing all this, he also was helping sell drugs through the Madre Maria Ines Teresa Health Center. It was there that he worked with Magdalena Annan. Have you ever been there?
A: I don't even know about that clinic. I had never met Maggie. I don't even know what she looks like. I never even knew who she was.
Q: Again, it seems odd that you worked as closely as you did with Robinson but you didn't know about anything that was happening at any of his clinics.
A: I didn't want to know anything because I didn't want to be involved with him. I absolutely refused to be medical director for him in front of four or five people. He was about to lose his accreditation, so I couldn't even work there if I wanted to. I was on probation with the medical board, and one of the stipulations was that I could not work in an unaccredited facility. Why would I sell that guy my license for $2,000 when I'm already on probation? That's not a logical thing for me to do. And I didn't do that. In order for him to open the account at Harvard, he needed my DEA number. Have you ever looked up online what the requirements are for moving a license from one address to another?
Q: No.
A: There are three things that have to happen. It's not hard at all. I can go into the system and find my ex-wife's account and change her address and there will be no problem. Nobody would ever say a word and she would be the one responsible for anything bad that happened. Nobody would ever come to her and check that it matches the license. If I change the password of my Google account, I get a notification, but with the DEA anyone can log on and change my account. They let Robinson's wife go ahead and change the address so that it looked like my address was at Chaparral. But I never wanted that to happen and never knew it had happened or had any reason to know.
Q: What's your theory on why the DEA did not do anything to stop Robinson earlier?
A: I don't know. They were investigating the Harvard Group for the same thing in Florida, and maybe they were working with someone to line everything up there, too. I don't know if they made a deal with somebody or what. All I know is that they suspended the Harvard Group's license and shut down all of these clinics in Florida.
Q: Robinson was earning $10,000 a month from Annan. He paid you a smaller fee, $2,000 a month. Did you know he was making that much money?
A: I had no idea. For that $2,000, I said I have a friend who is a CNRA who helps clinics earn accreditation. For $2,000 over eight months, I made $16,000. That's not a lot of money. I'm thinking he needed to order anesthesia-related supplies to get accredited. So I said fine. You can use my DEA in the limited scope of supplies and anesthesia-related drugs.
Q: Why even entertain the idea of letting anyone else use your DEA registration number?
A: Because I thought everything was going to be fine. The Harvard Group sent me an affidavit that asked me if I was doing internet pharmacy. I said no. It asked me three other questions, and I answered all of them. It never once asked me if I was OK with Robinson ordering a lot of painkillers. I never talked to the guy from Harvard who the DEA put on the stand to talk about me. He's lying through his teeth. I sent them a letter saying that if Robinson ordered anything using my number I should be notified. Did they notify me? No. Nobody had told me that my DEA was being used fraudulently.
Q: If I were a doctor, and a doctor came to me and said, "I want to use your DEA registration," I would ask, "Why can't you use yours?"
A: We can go around and around about this, but I thought there were so many protective things in place that nothing could go wrong. Harvard had a requirement that you had to have an account with them. I did everything in my opinion to show that I was protecting myself. How often does Harvard open an account for two doctors at one address? That's not usual. I thought I was protecting myself, but I was acting in a way based on a knowledge that I had not on knowledge that I did not have. I didn't know that he was in trouble and already reaching his limits for ordering drugs. This guy already should have been stopped long before I had been asked to use his license.
Q: How could this CRNA friend of yours get a center accredited?
A: He was going to help him get the appropriate documents, which is something he has done for 15 to 20 centers. I said, "I need to help this guy get accredited." He said, "I will help you to do it, but I don't want to do it myself."
Q: Why didn't he want to do it?
A: Because he didn't know Dr. Robinson. He thought it was a way to get me involved and to use the center as a way to get me doing something other than straight-up anesthesia.
Q: He was helping you become a consultant, basically?
A: Basically, yes.
Q: Why would you want to leave medicine to start working as a business consultant? Did you need the money?
A: I didn't really need the money per se. That's the funny thing. My wife and I thought, "Is this really worth it for that much money?" This was just going to be another option for me to go and work and do anesthesia, too, but I didn't need the money.
Next: Where does a troubled doc find work? The 1-800-GET-THIN clinics.
Related Posts and Series:
Q&A with Dr. Scott Bickman, Part 1: An insider's view of a painkiller mill and a dangerous clinic
Photo credit: Erich Ferdinand via Flickr