Shadow Practice Update: Doctor who sold prescribing license on the cheap finally pays price

Published on
April 29, 2011

Image removed.Exactly a year ago, Antidote told you about how the Madre Maria Ines Teresa Health Center in Santa Ana, Calif., had become a hot spot for prescription painkillers by using the license of the center's "medical director," Dr. Harrell Robinson. They ordered so many painkillers that Robinson maxed out the number that could be bought legally under his license.

So Robinson turned to Dr. Scott Bickman.

Bickman, an anesthesiologist by training, had been put on probation by the Medical Board of California for negligence that led to the death of a patient. Robinson was paid $10,000 a month by the clinic for the use of his license. He turned around and paid Bickman $2,000 a month. Their base of operations was the Hills Surgical Institute in Anaheim Hills, which has seen a series of troubled doctors, including Dr. Andrew Rutland.

By 2008, in one year's time, Bickman replaced Robinson as the new largest California purchaser of hydrocodone, a key ingredient in Vicodin, according to the DEA.

Amazingly, even though the Medical Board of California took Robinson's license away in 2009 and even though the DEA took away Robinson's ability to prescribe addictive drugs in 2009, nothing had happened to Bickman until this month. How one doctor could allow another doctor to use his license to order painkillers for a clinic being used as a front for a drug mill and still be allowed to operate with no restrictions on his license is a true mystery.

The DEA, at least, finally wised up. As of today, Bickman will no longer be allowed to prescribe addictive drugs, according to this filing by the DEA. (This news was reported first by the ever vigilant Courtney Perkes at the Orange County Register.)

What's troubling about this filing is the light it sheds on the disjointed and ultimately ineffectual physician discipline process. Because the medical board had not bothered to discipline Bickman – and still has not bothered – Bickman nearly escaped the DEA, too.

The federal case against Bickman went before an administrative law judge and the judge weighed the medical board's inaction in Bickman's favor. The filing says that the judge took note that Bickman's California license "is unrestricted and that he is authorized to handle controlled substances," a situation that supported the idea that "continued registration would be in the public interest."

Then the judge weighed other factors against Bickman, finding that he "knew or should have known that'' his registration was being used "to order controlled substances that were likely to be diverted." The judge also said that Bickman's "refusal to acknowledge his wrongdoing offers little hope for the prospect that if he retains his DEA registration he will act more responsibly in the future."

The DEA summed things up this way:

[Bickman] authorized Robinson to use his registration and then did nothing to determine how it was being used. He did not go to the clinic to see whether Robinson was maintaining records for even those drugs which would be used to provide anesthesia, or to see whether Robinson was, in fact, still performing surgery after the clinic lost its accreditation and could no longer legally do so. Thus, I conclude that [Bickman's] assertion that he was not "okay" with what happened is simply a case of crying crocodile tears. Because [Bickman] has not accepted responsibility for his misconduct and that misconduct manifests an egregious disregard for his responsibilities as a DEA registrant, I hold that [Bickman] has not rebutted the Government's prima facie showing that his continued registration is ‘inconsistent with the public interest.'

Whether the Medical Board of California takes any of this evidence just as seriously remains to be seen.

Next: How an unaccredited clinic kept seeing patients and stocking drugs

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Photo credit: vmiramontes via Flickr

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