http://www.medscape.com/viewarticle/748811August 30, 2011 — Fourteen physicians in southern Florida have been indicted as members of what one agent with the Federal Bureau of Investigation calls "the nation's largest criminal organization" involved in illegally distributing opioid analgesics such as oxycodone.
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The 14 physicians worked in 4 pain management clinics that the federal indictment, which was made public August 23, depicts as set pieces in a gangster movie. Drug addicts and drug traffickers, most from out-of-state, packed the waiting rooms, and if they were not fighting each other, they were having drug-induced seizures. Security guards tried to maintain order. Opioid analgesics were dispensed and prescribed on an assembly line basis, and were paid for with cash and credit cards. Clinic employees hauled their money to the bank in large garbage bags. During a 2-year period, the clinics raked in more than $40 million from illegal drug sales, a federal grand jury stated.
The physicians prospered in the process, according to the indictment. The owners of the clinics paid most of them according to how many patients they saw, which ranged between 40 and 100 patients per day. The average physician earned more than $1 million a year this way.
The indictment states that the physicians prescribed opioid analgesics without a basis in medical necessity, but engaged in subterfuges to make it look otherwise. Before their visits, for example, patients were routinely directed to a mobile magnetic resonance imaging facility that operated 7 days a week past midnight in a strip club parking lot.
The clinic owners were careful to recruit physicians who supported their business plan, the indictment states. Applicants did not need any experience in pain management, only a willingness to write scripts every 10 minutes. During employment interviews, "the physicians were asked whether they would agree to prescribe large quantities of oxycodone, Xanax, and other controlled substances."