Dr. Paul Volkman specialized in mitigation of pain. Did he ever. From 2003 to 2005 he was the most prolific prescriber of Oxycodone and related opioids in the entire country. He was recently sentenced to four life terms in prison for the deaths of four patients. There were eight additional overdose deaths associated with his practice, but these lacked enough evidence to prosecute. Patients came from hundreds of miles away and were charged $125 to $200 in cash for visits to see a doctor. Volkman’s distribution system had a devastating effect on southern Ohio, where he based his practice.
Prosecutors said Volkman rarely, if ever, counseled patients on alternate treatments for pain, such as physical therapy, surgery or addiction counseling. Volkman denied the allegations and said he always acted in good faith. A month before his conviction, he dismissed his attorneys and defended himself. His skills as an attorney appear to be totally in sync with his skills as a physician.
Street Creds and Credentials
Volkman went to work at the Tri-State Health Care and Pain Management clinic in southern Ohio in 2003. The clinic was operated by Denise Huffman and her daughter Alice Huffman Ball, who have pled guilty to one count of operating Tri-State as a business whose primary goal was the illegal distribution of prescription drugs. Denise has been sentenced to 12 plus years in prison; her daughter is serving five years. Both testified against Volkman, as did a horde of witnesses including pharmacists, police investigators, clinic employees and patients who received pills from Volkman.
What is striking about this case is the harsh sentencing. Four life terms is the kind of sentence you rarely see applied to white collar criminals; Volkman was sentenced as if he were a run-of-the-mill (pun intended) drug kingpin, which, minor differences aside, he was.
Through the wonders of the internet, we learn that Volkman had a three star rating from his patients and earned his medical degree at the University of Chicago Pritzger School of Medicine in 1974, followed by a residency at Duke Medical Center. After that, well, something went terribly wrong. Nonetheless, with his impressive creds, he’s sure to be a very popular man for the rest of his highly circumscribed life.
Posts Tagged ‘pill mills’
Dr. Paul Volkman: The People’s Pusher
Tuesday, February 21st, 2012Florida is getting tough on the pill mills
Thursday, September 8th, 2011Florida doctors bought 89% of all the Oxycodone sold to practitioners nationwide last year and thousands of outside visitors flocked to the state to buy drugs at the 1,000+ pain clinics. But armed with new legislation, the state is cracking down hard by shutting down pill mills and suspending the licenses of about 80 physicians who were high-volume prescribers. And physicians are now generally barred from dispensing narcotics from their offices. In October, things will get even tougher as a new prescription drug monitoring system will be implemented.
Lizette Alvarez reports on on the Florida pill mill crackdown in The New York Times, stating that “As a result, doctors’ purchases of Oxycodone, which reached 32.2 million doses in the first six months of 2010, fell by 97 percent in the same period this year.” This article has some eye-opening observations about the scope of the prescription drug problem: “Last year, seven people died in Florida each day from prescription drug overdoses, a nearly 8 percent increase from 2009. This is far more than the number who died from illegal drugs, and the figure is not expected to drop much this year.”
You can read more about how authorities are going after medical licenses of over-prescribers in a Miami Herald article by Audra Burch. This article discusses some egregious abuses, including a physician who dispenses from the back of a car and an office with long lines waiting outside and many cars with out-of-state license plates in the parking lot.
Related Resources
The issue of physician dispensing is one that our colleague Joe Paduda has covered extensively. See:
Physician dispensing – Exactly how much more does it cost?
Why Florida’s work comp costs are heading up
Florida’s dispensing legislation clarified
The issue of transparency related to a physician’s relationship with pharmaceutical companies is one that ProPublica has been taking on in their Dollars for Doctors campaign. See:
Patients Deserve to Know What Drug Companies Pay Their Doctor
Piercing the Veil, More Drug Companies Reveal Payments to Doctors
For more about Prescription Monitoring Programs, see:
Alliance of States with Prescription Monitoring Programs – The Alliance was formed in 1990 to provide a forum for the exchange of information and ideas among state and federal agencies on prescription monitoring programs. Since then, it has grown to be a valuable resource to all those concerned with combating the increase in prescription drug abuse, misuse and diversion. Currently, 48 states and one territory either have operating Prescription Monitoring Programs, or have passed legislation to implement them.
Pharma in Parma
Tuesday, July 12th, 2011Dr. Jean Zannoni, 77, runs a family practice in Parma, Ohio. It would be a mistake to assume that by specializing in families, she is not interested in treating injured workers. She treats them all right – to pill after pill after pill. She was recently sentenced to two years probation and ordered to pay more than $7,500 in fines and restitution after pleading guilty to theft, attempted workers’ compensation fraud and telecommunications fraud.
According to authorities, two Ohio Bureau of Workers Compensation (BWC) undercover agents were provided narcotic medications without proper medical examinations and BWC was billed improperly for the office visit.
Dr. Zannoni instructed her staff (in writing!) to bill all injured workers under the same code and charge BWC $75, regardless of the circumstances of the visit. She also manipulated “pain” ratings to ensure that patients qualified for narcotics. And she continued to prescribe narcotics to patients who were known doctor shoppers, even after receiving warnings from pharmacies, parents, spouses, social service agencies and police departments. Some family, some practice.
A Microcosm
In the scheme of things, Dr. Zannoni is a bit player. But when you try to figure out how narcotics became such a major cost driver in workers comp, you have to take into account doctors like Zannoni, who parlay a little pain into big profits.
Given the scale of her crimes – she overbilled WBC by $65,000 – the penalties in this case (small fine plus probation) seem a bit modest. On the other hand, the (Feel)Good doctor, at 77, is probably nearing the end of her practice, which may well have played into the decision to let her off relatively lightly.
Ironically, if you Google her name, Zannoni’s patient ratings are uniformly high (pun intended). One anonymous patient even commented on an article describing her conviction as follows:
This is one of the sweetest most nieve (sic) people on ths planet. I know her personally and she has no idea what goes on. All she knows is how to do is practice medicine and nothing about finances at all. God bless her and I hope everything works out for her sake.
We’ll let that stand as written. And one thing is certain: those seeking pills in Parma may not be able to count on Dr. Zannoni any longer, but surely they will find other sources to make their pain go away, to get a little buzzed, and, who knows, make a little money on the side.
