Editor’s Note: Linda Cheek is a family practice and alternative medicine physician in southwest Virginia. In June, Cheek pleaded not guilty to a 173-count federal indictment accusing her of distributing oxycodone and other painkillers without a valid certificate from the Drug Enforcement Administration. Cheek’s license to practice medicine is currently suspended and she is free on bond. Her trial is scheduled to begin in November.
God always answers prayer. In October, 2010 two hundred of my patients were suddenly without a pain management physician. The U.S. Attorney’s office had coerced the doctor treating pain patients at my office to give up her DEA certificate. Luckily, a doctor was found within 24 hours that agreed to help.
Steven Collins, MD, a family practice physician, agreed to allow me to meet my patients in his office an hour away. He evaluated them after me and continued their treatment.
Dr. Collins graduated in 1995 from Albany Medical College in New York, practiced medicine in the military for three years, and then set up private practice in Roanoke, Virginia. Being very patient oriented, he saw right away that about half of the complaints that bring a patient to a doctor are related to pain. So, like me, he decided to learn how to treat pain so he could take care of his patients. He taught himself, as I did, by going to pain management seminars and meetings of the American Academy of Pain Management.
Dr. Collins’s primary pain management is with opioids, but he also does steroid injections using fluoroscopy. His practice grew into three offices, and he supervised a nurse practitioner and a physician assistant at two sites. He also worked two half days at a methadone clinic in Roanoke, where he was responsible for admissions and discharges. So he has experience and knowledge with methadone prescribing that most physicians lack.
Dr. Collins is comfortable with most opioids, although he typically does not use morphine. Knowledgeable in the rules and procedures with opioid prescribing, he is careful to monitor patients, check drug screens, and watch for the “red flags” of abuse.
But in April this year, Dr. Collins was forced to make a decision that would change his life as well as that of most of his patients. He decided to stop treating pain. This decision was based on a warning he received from a colleague — that he was under investigation by the Virginia State Police.
Dr. Collins immediately worried that he might be arrested with some kind of charge about his treatment of pain patients. One of the common charges against physicians in the government’s war on pain doctors” is “prescribing without justifiable medical purpose.” In these cases, “medical purpose” is defined to be however the U.S. Attorney’s office wants to define it, not how a doctor would define it.
As a solo independent physician with a wife and four children, Dr. Collins couldn’t take a chance with his career. So he sent letters to all of his patients that he would no longer treat pain. This decision caused him to lose 40% of his patient base and, consequently, his income.
When asked what is needed in medicine for doctors to feel secure in practicing pain management, Dr. Collins told me, “We need a written set of guidelines to follow. If the documentation is there, how can we not be treating the patient correctly?”
Dr. Collins has had his own experience with government harassment. At one time he provided suboxone therapy for drug abuse. The local DEA agent came to his office to review Dr. Collins’ records.
After three days of being closed and unable to see patients, in frustration Dr. Collins offered to give up his suboxone certification. The DEA agent told him, “Well if you are going to do that, we’ll get out of here.” And they left.
The same agent also appeared one day at Dr. Collins’ office when he was evaluating and treating patients sent from my office. All he had to say to send his message of intimidation was, “We’re watching you.”
It was then that Dr. Collins informed me that he would no longer see my patients.
Dr. Collins is the seventh doctor that I know of in southwest Virginia forced to stop treating pain by the Gestapo tactics of the U.S. Department of Justice. There are probably many more.
Most of the doctors in southwest Virginia don’t treat pain because of fear. Those that do risk getting their medical license or DEA certificate suspended or revoked. A few face criminal charges and most of those accept a plea agreement to avoid a trial or prison sentence.
Having neither money nor fear of prison, but faith in God, I intend to show the world what our Justice Department is all about. My trial is scheduled to start November 5.
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