Pain Management Clinics aka Pill Mills

[AAP]

Damn they pull some fucking mega bucks.

Two brothers that are not even doctors were pulling in 14 million last year in this biz. All they did was get a location, business license, hire docs on a per patient basis and sit back.

(then fucked up trying to launder 40 million dollars offshore)

But seriously... seems to be big money in this biz.

 

[chris302001]

You couldn't pay me enough to deal with pain mngmt patients

 

[pbhardbody]

Damn they pull some fucking mega bucks.

Two brothers that are not even doctors were pulling in 14 million last year in this biz. All they did was get a location, business license, hire docs on a per patient basis and sit back.

(then fucked up trying to launder 40 million dollars offshore)

But seriously... seems to be big money in this biz.

where you talkin abt bro? i heard the DEA raided several pain clinics in palm beach county a couple days ago

 

[HAYEZ]

i wouldnt want the responsibily of knowing i ruined many lives by preasrcibing them pain killers they dont need that will either kill them or lead to heroin addiction then death..to each there own though

 

[pbhardbody]

i wouldnt want the responsibily of knowing i ruined many lives by preasrcibing them pain killers they dont need that will either kill them or lead to heroin addiction then death..to each there own though

+1

 

[RottenWillow]

You couldn't pay me enough to deal with pain mngmt patients

You wouldn't do it for 14m a year?

 

[RottenWillow]

i wouldnt want the responsibily of knowing i ruined many lives by preasrcibing them pain killers they dont need that will either kill them or lead to heroin addiction then death..to each there own though

wow that's a huge assumption there. How do you know everyone who patronizes pain management clinics don't need it or that medicating them would ruin their lives?

 

[pbhardbody]

You wouldn't do it for 14m a year?

these "clinics" have to install bullet proof glass and have guard dogs cuz their "patients" will do abt anything to get those meds.

Plus you are going to work with stilleto - I got you all hooked up as the cleaning team manager for your $47k a year

 

[puddlemonkey]

You wouldn't do it for 14m a year?

I'd do it for 112k a year.

 

[AAP]

these "clinics" have to install bullet proof glass and have guard dogs cuz their "patients" will do abt anything to get those meds.

Dude, they don't keep meds on the premises. All patients that come in have to have a script faxed to the pharmacy, they don't even give out paper scripts.

 

[AAP]

where you talkin abt bro? i heard the DEA raided several pain clinics in palm beach county a couple days ago

Some were because the doctor licensed to write scripts was not in the office and another doc was writing them off on his license. Even though the doc knew about it and let it slide.

Then some failed to give a patient an exam or request records.

But you get a licensed doc to do that, have an exam on the first visit and try to secure past records, you just covered your ass.

 

[pbhardbody]

wow that's a huge assumption there. How do you know everyone who patronizes pain management clinics don't need it or that medicating them would ruin their lives?

they all dont Rotten. But they do have a bad rep down here in FL. Some countys have a moratorium on letting any new ones in because they are so bad.

 

[HAYEZ]

wow that's a huge assumption there. How do you know everyone who patronizes pain management clinics don't need it or that medicating them would ruin their lives?

because ive delt with them and the people that use them for the past 13 years...and almost everyone i know that uses them has a serious pill problem that turns into a HEROIN problem...and they end up dead...i just had an hour conversation with a family member last night about our cousin that died using heroin which all started from the ease of getting pain pills from these clinics...

 

[pbhardbody]

Dude, they don't keep meds on the premises. All patients that come in have to have a script faxed to the pharmacy, they don't even give out paper scripts.

actually some of them do. here is an article about one:

Palm Beach County shuts down new pain clinic

and here is a snip from the article:

The county this week researched the opening of West Palm Medical Center, a cash-and-carry pain clinic that caters to out-of-state clients and advertises aggressively, and discovered the business was operating without a certificate of occupancy.

 

[pbhardbody]

Federal, local agents raid 3 Palm Beach County pain clinics

btw - this article is about the 2 brothers that you mentioned AAP

 

[chris302001]

You wouldn't do it for 14m a year?

negative.

 

[RottenWillow]

they all dont Rotten. But they do have a bad rep down here in FL. Some countys have a moratorium on letting any new ones in because they are so bad.

See the problem is that legitimate pain management medicine is getting confused with this new breed of questionable joints exploding all over your area. When you guys say "pain management" I'm thinking of real PM clinics like the one that helped my mother with the bodywide neuralgia she suffered for years after chemo.

 

[pbhardbody]

See the problem is that legitimate pain management medicine is getting confused with this new breed of questionable joints exploding all over your area. When you guys say "pain management" I'm thinking of real PM clinics like the one that helped my mother with the bodywide neuralgia she suffered for years after chemo.

yea I agree

 

[mrplunkey]

Damn they pull some fucking mega bucks.

Two brothers that are not even doctors were pulling in 14 million last year in this biz. All they did was get a location, business license, hire docs on a per patient basis and sit back.

(then fucked up trying to launder 40 million dollars offshore)

But seriously... seems to be big money in this biz.

Isn't it curious how they aren't cracking down on the explosive growth of these clinics?

You are witnessing the emerging social safety net in health care.

Picture this scenario: A 55-year old patient presents with chronic lower back pain and intermittent radiculopathy. He's 100 lbs overwieght and suffering from type II diabetes.

Case 1: Treat the patient with bracing and anti-inflammatories. Also discuss stretching and strengthening exercises for him. Tell him to lose 100 lbs. He won't do the exercises or lose the weight, so of course his condition worsens. He's going to bounce between chiropractors, FP's, neuro and ortho guys. Eventually he'll find a guy dying to cut him and he'll get a one or two-level fusion. The fusion will have less than a 50% success rate, so he'll keep bouncing between doctors forever when all he really needed to do was lose 100 lbs and exercise.

Case 2: He runs to his neighborhood pain clinic and picks-up a $200/month prescription for Oxycontin. He spends the next 20 years stoned and happy sitting on his couch drinking beer and snorting oxy's every evening.

Not only can you implement Case 2 at a dramatically lower cost -- it also produces a more satisfied patient.

Welcome to the new Medicare/Medicaid.

 

[pbhardbody]

Isn't it curious how they aren't cracking down on the explosive growth of these clinics?

You are witnessing the emerging social safety net in health care.

Picture this scenario: A 55-year old patient presents with chronic lower back pain and intermittent radiculopathy. He's 100 lbs overwieght and suffering from type II diabetes.

Case 1: Treat the patient with bracing and anti-inflammatories. Also discuss stretching and strengthening exercises for him. He won't do the exercises and as his condition worsens, he's going to bounce between chiropractors, FP's, neuro and ortho guys. Eventually he'll find a guy dying to cut him and he'll get a one or two-level fusion. The fusion will have less than a 50% success rate, so he'll keep bouncing between doctors forever when all he really needed to do was lose 100 lbs and exercise.

Case 2: He runs to his neighborhood pain clinic and picks-up a $200/month prescription for Oxycontin. He spends the next 20 years stoned and happy sitting on his couch drinking beer and snorting oxy's.

Not only can you implement Case 2 at a dramatically lower cost -- it also produces a more satisfied patient.

Welcome to the new Medicare.

actually according to the news, they are cracking down on them... at least in FL. of course there are 900 pain clinics in FL already so it took them long enough to get started huh

 

[mrplunkey]

actually according to the news, they are cracking down on them... at least in FL. of course there are 900 pain clinics in FL already so it took them long enough to get started huh

They are cracking-down on the ridiculous ones that are way out of bounds. A pain clinic that keeps good records and builds a clinical argument for all the heavy painkillers they prescribe will be 100% untouched.

 

[pbhardbody]

They are cracking-down on the ridiculous ones that are way out of bounds. A pain clinic that keeps good records and builds a clinical argument for all the heavy painkillers they prescribe will be 100% untouched.

yea i agree

 

[HAYEZ]

Isn't it curious how they aren't cracking down on the explosive growth of these clinics?

You are witnessing the emerging social safety net in health care.

Picture this scenario: A 55-year old patient presents with chronic lower back pain and intermittent radiculopathy. He's 100 lbs overwieght and suffering from type II diabetes.

Case 1: Treat the patient with bracing and anti-inflammatories. Also discuss stretching and strengthening exercises for him. Tell him to lose 100 lbs. He won't do the exercises or lose the weight, so of course his condition worsens. He's going to bounce between chiropractors, FP's, neuro and ortho guys. Eventually he'll find a guy dying to cut him and he'll get a one or two-level fusion. The fusion will have less than a 50% success rate, so he'll keep bouncing between doctors forever when all he really needed to do was lose 100 lbs and exercise.

Case 2: He runs to his neighborhood pain clinic and picks-up a $200/month prescription for Oxycontin. He spends the next 20 years stoned and happy sitting on his couch drinking beer and snorting oxy's every evening.

Not only can you implement Case 2 at a dramatically lower cost -- it also produces a more satisfied patient.

Welcome to the new Medicare/Medicaid.

exactly

 

[SouthernLord]

We need less pain clinics and more marijuana dispensaries.

I need to self medicate my glaucoma with some danky nugz.

 

[PICK3]

Feds: 68 fatal ODs linked to Kan. clinic - Crime & courts- msnbc.com

 

[OMEGA]

Anyone that Peddles Oxys , Norcos etc ( the strong stuff ) to anything but the most serious cases deserves to be tortured in hell

 

[OMEGA]

Isn't it curious how they aren't cracking down on the explosive growth of these clinics?

You are witnessing the emerging social safety net in health care.

Picture this scenario: A 55-year old patient presents with chronic lower back pain and intermittent radiculopathy. He's 100 lbs overwieght and suffering from type II diabetes.

Case 1: Treat the patient with bracing and anti-inflammatories. Also discuss stretching and strengthening exercises for him. Tell him to lose 100 lbs. He won't do the exercises or lose the weight, so of course his condition worsens. He's going to bounce between chiropractors, FP's, neuro and ortho guys. Eventually he'll find a guy dying to cut him and he'll get a one or two-level fusion. The fusion will have less than a 50% success rate, so he'll keep bouncing between doctors forever when all he really needed to do was lose 100 lbs and exercise.

Case 2: He runs to his neighborhood pain clinic and picks-up a $200/month prescription for Oxycontin. He spends the next 20 years stoned and happy sitting on his couch drinking beer and snorting oxy's every evening.

Not only can you implement Case 2 at a dramatically lower cost -- it also produces a more satisfied patient.

Welcome to the new Medicare/Medicaid.

Brilliant post , thanks Plunky for the perspective

 

[OMEGA]

oh and about crack downs

its all about the local.

You can literally drive from one town to the other and either incur a Liberal or conservative Pharmacy/Doc relationship

So in one town 10 miles away its almost impossible to get a script OR pharmacy that has not blacklisted docs to where in the other town you can get it like candy

 

[PICK3]

oh and about crack downs

its all about the local.

You can literally drive from one town to the other and either incur a Liberal or conservative Pharmacy/Doc relationship

So in one town 10 miles away its almost impossible to get a script OR pharmacy that has not blacklisted docs to where in the other town you can get it like candy

I've never tried oxy's before but other opiate derivative drugs do absolutely nothing for me.

But I understand oxy's are much stronger.

 

[OMEGA]

OXYs are perhaps THE Devils Drug Mg per Mg it blows ANYTHING out of the water that is similar including Heroin

Its when you snort them and smoke them your toast. Oral consumption kinda makes you feel lame.

Takes 3 days and your Biologically HOOKED no more endogenous Endorphin production and you crash for about the same time

Time on = time Jacked

So you do it for 3 months Expect to feel like your in the Seventh Circle of Hell for 3 months
EVERY MOMENT OF EVERYDAY feels like your somewhere between Hell, a Saw Movie and Citizen Cain

Stay Away and if you have to use it for pain use it ONCE at night near bed...........if recreation-ally never more then Once on Rare occasion or NEVER

had a Run it with Opiates that started all from a Car Crash........

 

[puddlemonkey]

I haven't had one of my hydros in a couple months now

 

[puddlemonkey]

been pain free lately so no reason

 

[puddlemonkey]

c'mon back pain!!!

 

[ortiz34]

OXYs are perhaps THE Devils Drug Mg per Mg it blows ANYTHING out of the water that is similar including Heroin

Its when you snort them and smoke them your toast. Oral consumption kinda makes you feel lame.

Takes 3 days and your Biologically HOOKED no more endogenous Endorphin production and you crash for about the same time

Time on = time Jacked

So you do it for 3 months Expect to feel like your in the Seventh Circle of Hell for 3 months
EVERY MOMENT OF EVERYDAY feels like your somewhere between Hell, a Saw Movie and Citizen Cain

Stay Away and if you have to use it for pain use it ONCE at night near bed...........if recreation-ally never more then Once on Rare occasion or NEVER

had a Run it with Opiates that started all from a Car Crash........

true physical oxy withdrawl is only 3 days max, then some mental shit for a couple weeks or a more depending on how bad your habit was.

I was snorting 240-320mgs a day, that sucked coming off.

 

[bakemeacookie]

Damn they pull some fucking mega bucks.

Two brothers that are not even doctors were pulling in 14 million last year in this biz. All they did was get a location, business license, hire docs on a per patient basis and sit back.

(then fucked up trying to launder 40 million dollars offshore)

But seriously... seems to be big money in this biz.

are youy sure they're not in jail as we speak? Isn't all the governent and agencies cracking down on everyone.

YOu may be able to do it in tijuana.

c

 

[mrplunkey]

true physical oxy withdrawl is only 3 days max, then some mental shit for a couple weeks or a more depending on how bad your habit was.

I was snorting 240-320mgs a day, that sucked coming off.

There's a lot of biological variability there. I've seen people who kicked it quickly and I've seen people who've had trouble kicking it for years. IMO, it's a lot like alcohol in different people experience the drug in radically different ways.

P.S. Glad to know you aren't suffering longer-term effects.

 

[shrimp poboy]

Dude, they don't keep meds on the premises. All patients that come in have to have a script faxed to the pharmacy, they don't even give out paper scripts.

AAP i used to go to one right in your hood,my 1st visit with no mri(I bullshitted them and said I had one at a hospital)but they are still searching for it.paid my 150.00 1st visit fee.walked out with 90 oxy 80;s 120 roxicet 30's 120 adderall 30's 30 .25 halcions,and 60 2mg xanax.they would fill the meds there but because the oxys were so expensive i would take the script to walgreens on federal(they hated that shit)but i had insurance and those fuckers were like 8.00 each.You would see all the junkies chain smoking outside the clinic waiting to get there dope and then go straight to the BR where they would pop a couple.That place fucked me up bad and is now closed now the owner who was a dr got busted trading oxys for weed.advanced pain medical it was called.phyiatry and pain specialist the owner was named david if i recall he still has one in melbourne where if i wanted i can pay by cc over the phone and the fed x the meds right to the door no visit needed.TRUE STORY

 

[Smurfy]

AAP i used to go to one right in your hood,my 1st visit with no mri(I bullshitted them and said I had one at a hospital)but they are still searching for it.paid my 150.00 1st visit fee.walked out with 90 oxy 80;s 120 roxicet 30's 120 adderall 30's 30 .25 halcions,and 60 2mg xanax.they would fill the meds there but because the oxys were so expensive i would take the script to walgreens on federal(they hated that shit)but i had insurance and those fuckers were like 8.00 each.You would see all the junkies chain smoking outside the clinic waiting to get there dope and then go straight to the BR where they would pop a couple.That place fucked me up bad and is now closed now the owner who was a dr got busted trading oxys for weed.advanced pain medical it was called.phyiatry and pain specialist the owner was named david if i recall he still has one in melbourne where if i wanted i can pay by cc over the phone and the fed x the meds right to the door no visit needed.TRUE STORY

which is why he's closed

 

[Lambruh]

Hillbilly and farm country pain clinics are very self serve, all the townies in Prairy Village, Kentucky are floating in the world of oxycodone. The docs sure do love their returning patients in a population of 1,000

 

[pbhardbody]

Hillbilly and farm country pain clinics are very self serve, all the townies in Prairy Village, Kentucky are floating in the world of oxycodone. The docs sure do love their returning patients in a population of 1,000

So you are from KY bro?

That may explain a few things. lol

 

[chris302001]

What makes u guys crush that first pill and snort it?

 

[Lambruh]

So you are from KY bro?

That may explain a few things. lol

Went to Ohio Uni located in Athens Ohio, was nothing but a college town in the middle of nowhere. Roam 20min outsite and it's the boons. Buddy and I use to drive about 20min into the hills and visit this doc down there that would give us continual RX of Tramadol because we said we had trouble sleeping and adderal because we needed study aid for tests. The Doc scripted us addy's after tellin him we had insomnia lol, all we had to do is go back every two months

I don't even remember taking more than a couple adderrall to know how fucked up schizo they made me, all I know is they were those tab blue ones

 

[bakemeacookie]

Lot of my friends love buy8ing valiums. Give them nice sleep everynight. I use them on planes a lot too. I gotta find a good source for them now since mine dried up

c

 

[1500]

What makes u guys crush that first pill and snort it?

Good question!! I've been using opiates for years now due to legit chronic pain. Never had the urge to snort, crush, mainline anything. I'll pop an extra every once and a while for a buzz (I dont drink), but thats about as bad as I'll get with it. Not a fan of putting shit up my nose (cept my finger) or pins in my veins.

 

[SouthernLord]

I've tooted an Oxy one time. That shit rocked me out. After about thirty minutes the high was gone and contemplated asking my buddy for another line. I'm glad I didn't. That second line prolly would have done me in. Tooting oxys is definitely serious business.

It's ruined a lot of people I know. My cousin OD'd and died from oxys. Fucking sucks.

 

[OMEGA]

I am glad we all feel comfortable about talking about this stuff

 

[SouthernLord]

I am glad we all feel comfortable about talking about this stuff

My bed is comfortable. Wanna join me?

 

[ortiz34]

What makes u guys crush that first pill and snort it?

try it and you'll see

 

[puddlemonkey]

try it and you'll see

great advice

 

[shrimp poboy]

I love oxys after katrina we were looting flooded homes while we were handing out flyers for construction i found a bottle of 6o 160mg oxys(that they dont make anymore) needless to say the went right into the spoon with a qtip a little fire and into the crook in my left arm talk about heaven no blow job compares and i have had 100's

 

[bakemeacookie]

once weed is legalized and no longer fashionable - the next fad will be oxy, percacets, vico's, etc. Then legalize oxy campaign will start. People will always want to do some illegal shit - always been like that.

Even in hollywood weed is so passe now. All the parties are into coke, alchol and pills.

c

 

[treneriffic]

I love percocet/oxycodone. Best fucked up chemical concoction a lab ever made up for our selfish desires.
Too bad its so addictive and destructive.
I need a source haha

 

[javaguru]

You couldn't pay me enough to deal with pain mngmt patients

Don't like the DEA up your ass?

 

[chris302001]

Don't like the DEA up your ass?

Dont mind dealing with the dea, but when I did some work with a pain doc the avg pt was basically a high maintenance loser. Dealing with that bs all day is knot for me.

 

[javaguru]

Dont mind dealing with the dea, but when I did some work with a pain doc the avg pt was basically a high maintenance loser. Dealing with that bs all day is knot for me.

But the DEA will track every prescription you write Dr. Feelgood.

 

[chris302001]

But the DEA will track every prescription you write Dr. Feelgood.

I dont have any problems with that.

 

[PICK3]

Dont mind dealing with the dea, but when I did some work with a pain doc the avg pt was basically a high maintenance loser. Dealing with that bs all day is knot for me.

glad we don't have any of those here on C&C

 

[chris302001]

glad we don't have any of those here on C&C

lol i didnt wanna name any names

 

[javaguru]

I dont have any problems with that.

I need a prescription for 200 mg a week of test cypionate...I'm old...help a brother out.

 

[PICK3]

I need a prescription for 200 mg a week of test cypionate...I'm old...help a brother out.

Is this where you post your prescription wish list?

 

[javaguru]

Is this where you post your prescription wish list?

I could make it myself illegally by importing powder but it's easier for someone with a good career getting a prescription for hormone replacement...at least I know what I'm getting and can be monitored by an MD.

That's a bad argument because I paid out of pocket to get my health monitored by an MD all my life.

 

[shrimp poboy]

Ever plug a 3mg dilaudid suppository?Now thats the shit(pun intended)Had a whole box of those bad boys once and a case of roxanol 20mg or 10 cant remeber i was dope sick for weeks after that incident.BTW i aquired them bye breaking into a offshore hospital on a barge when i used to work in the gulf me and like 4 other bros.Damn we had a good time that hitch.

 

[PICK3]

Ever plug a 3mg dilaudid suppository?Now thats the shit(pun intended)Had a whole box of those bad boys once and a case of roxanol 20mg or 10 cant remeber i was dope sick for weeks after that incident.BTW i aquired them bye breaking into a offshore hospital on a barge when i used to work in the gulf me and like 4 other bros.Damn we had a good time that hitch.

also resume' worthy

 

[75th]

Even in hollywood weed is so passe now. All the parties are into coke, alchol and pills.

c

Because if we know one thing about Hollywood, its that they have their finger on the pulse of the average American.

 

[mrplunkey]

Dont mind dealing with the dea, but when I did some work with a pain doc the avg pt was basically a high maintenance loser. Dealing with that bs all day is knot for me.

That's where we're going to park the 100lb overweight smokers who don't want anything but a magic pill.

Abracadabra, muther fucker!

 

[Smurfy]

I love oxys after katrina we were looting flooded homes while we were handing out flyers for construction i found a bottle of 6o 160mg oxys(that they dont make anymore) needless to say the went right into the spoon with a qtip a little fire and into the crook in my left arm talk about heaven no blow job compares and i have had 100's

thats disgusting.

 

[ortiz34]

thats disgusting.

not really, it's quite blissful

 

[AAP]

What makes u guys crush that first pill and snort it?

Not having a martini to chase it down with.

 

[AAP]

Back when my partner had his shoulder surgery in 2001, you could still get Oxys filled via the mail. They would send you a 90 supply. He was Rx'd Dems and Oxys. He hated the Oxys. I tried them a few times and honest to god I could not understand why people claimed to get high off these. I took 2 of them, swallowing one, chewing the other and NOTHING.

Maybe it just doesn't work in me. But Dems would fuck me up and make me sit my ass down real quick in front of the tv. Oxys didn't do shit.

Funny thing is that the mail order kept filling the scripts 2x more even though he didn't have a Rx for it. So he ended up with 9 months of that shit before all the news started on about people dying from it and they yanked that shit. He must have had a combined total of about 900 pills of Dems and Oxys before flushing them down.

 

[shrimp poboy]

Best pain killer IMPO hand down were msir30's i used to have a bro in brazil sent me a k of em at a time.2 in the spoon little fire a 20 of water pull thru a qtip head hit that right crook and felt like i was roasting on a geaorge foremen grill.Those mf's were bad to the bone.You would be on fire before you even pulled the rig out and put a lil toilet paper on the blood running down ur forearm.Glad those days are over fuk

 

[shrimp poboy]

lot of junkies up in this thread just sayin

 

[AAP]

Best pain killer IMPO hand down were msir30's i used to have a bro in brazil sent me a k of em at a time.2 in the spoon little fire a 20 of water pull thru a qtip head hit that right crook and felt like i was roasting on a geaorge foremen grill.Those mf's were bad to the bone.You would be on fire before you even pulled the rig out and put a lil toilet paper on the blood running down ur forearm.Glad those days are over fuk

Dude we just want to get high easy. Not all this fucking needle and blood shit.

 

[shrimp poboy]

Dude we just want to get high easy. Not all this fucking needle and blood shit.

Those 3mg dilaudid suppository were the shit i went thru 2 boxs of em in a week to bad i couldnt shit for a week after with all that opiate blockage

 

[shrimp poboy]

An oldie but a goodie(open at you're own risk youve been warnede!!!!!!He was plugging caps of tarheroin because he didnt have any veins left that were not collapsed.YouTube - Bad case of diarrhea - Trainspotting toilet scene

 

[shrimp poboy]

Heres a better one you have been warned!!!!!!!!YouTube - Unforgettable

 

[AAP]

Ok serious question, where do they find docs who are willing to put up with patients like this every day? I can't imagine any of them enjoying showing up at work in the morning.

 

[miplank]

Ok serious question, where do they find docs who are willing to put up with patients like this every day? I can't imagine any of them enjoying showing up at work in the morning.

well...everyone here on EF deals with poboy on a daily basis. I imagine it's a lot like that.

 

[mrplunkey]

Ok serious question, where do they find docs who are willing to put up with patients like this every day? I can't imagine any of them enjoying showing up at work in the morning.

1) Foreign medical graduates who have trouble building their practice from scratch.

2) Struggling relatively new doctors who are having trouble building their practice or who didn't pay their dues long enough (i.e. missing fellowships, etc.).

3) Doctors who just want to get paaaaaaiiiiiiid (said with my best Flava Flave accent). It's a good way to make money if you have the support services you need to provide ancillary services (i.e. X-ray).

4) Activists who believe patient suffering must be addressed at all costs and who think the benefits outweight the risk (this is a tiny sliver of all pain docs).

 

[AAP]

well...everyone here on EF deals with poboy on a daily basis. I imagine it's a lot like that.

But not in PERSON!!!

 

[AAP]

1) Foreign medical graduates who have trouble building their practice from scratch.

That was my first thought. However, most foreign docs will be entering the country in order to work and get a green card (as opposed to already having one), so when they are working for a pill mill, that isn't exactly the best reference and credential to have on a prospective application as your sponsor and employer.

It used to be that anyone could open a pill mill. You didn't have to be a doc. You got the space, business license, insurance, etc... and just hired docs to write the scripts. You owned a medical practice business but you didn't have to be a doctor yourself. Just had to have one on premises. FL now requires (or will in the future) that the businesses be owned and registered to a licensed doctor. One who actually works there and not just lends his name.

 

[AAP]

3) Doctors who just want to get paaaaaaiiiiiiid (said with my best Flava Flave accent). It's a good way to make money if you have the support services you need to provide ancillary services (i.e. X-ray).

Most don't have ancillary services. They require their patients to bring an xray with them or have it done somewhere else.

The article I read had the two brothers charging $80-$85 per office visit. And they made 14 million. (not to mention the 40 million they made "somehow" they were busted trying to launder). So how much could docs possibly make? Out of $85 per visit, even if they made $50 per patient they would need to see 40 patients a day just to make it worth their time.

 

[mrplunkey]

Most don't have ancillary services. They require their patients to bring an xray with them or have it done somewhere else.

The article I read had the two brothers charging $80-$85 per office visit. And they made 14 million. (not to mention the 40 million they made "somehow" they were busted trying to launder). So how much could docs possibly make? Out of $85 per visit, even if they made $50 per patient they would need to see 40 patients a day just to make it worth their time.

Naw, it's much easier than that. Simple x-ray machines (used) aren't that expensive at all. CT's and MRI's get expensive in a hurry, but a basic x-ray isn't that bad. Plus, they make a technical fee by taking the x-ray and a professional fee by reading it. That piles on top of the office visit.

They also get their own DME number and sell bracing (i.e. back/knee braces) along with other mid-range devices like hot/cold therapy units and walking boots. On a larger scale, they can lease space in their own office to a small pharmacy, and offer their own physical therapy services.

And remember too, they'll have an army of fitters, nurse practitioners and physicians' assistants seeing patients. With enough help, a doctor can easily see 10x the patients per day.

And here's the next big thing (it's happening now): About 40% of all US orthopedic implants are sold via specialty distribution. Some doctors are forming their own specialty distributor and selling implants to themselves. Of course they are their only customer, but they capture the specialty distribution fees.

 

[mrplunkey]

And the money they were trying to launder was probably from cash visits.

Picture this: You are uninsured and out of work. You can go to the pain clinic and pay a flat $300 (or so) visit fee on a cash-only basis. You walk away with a prescription for qty 90 of Oxycontin 80mgs. Even without insurance, you can buy generic at walgreens for $1160 with a discount card.

So selling them on the street for $1/mg, the patient just made 7,200 in income with an all-in cost of $1460.

Those $300 fees are probably what they are trying to launder.