I hate to say that we should follow the Fox Mulder School of Paranoia on this one, but the evidence is clear. You can go to prison for what others do with your credentials. Being a doctor comes with incredible privileges, or at least it used to. Now, with the corporate takeover of medical care, we get to work ourselves to death and be hung out to dry if someone’s unhappy or has a bad outcome. And sometimes, even if they don’t.
Let’s look at the case of Dr. Wendell Lewis Randall first. Dr. Randall is a 71-year-old doctor from North Carolina. Dr. Randall had his own independent medical practice as well as working for a group of pain clinics owned by L5 Medical Holdings. These clinics had contacted Dr. Randall, asking if he would serve as their medical director. This role would require him to review some protocols and procedures, but he would not need to work there in person. This sounds like a great role for an older physician with decades of experience.
The problem that most doctors don’t realize is that these companies may not actually want anything from you besides your credentials. Once you fill out all the forms, they have everything they need, including your DEA number and a copy of your signature (on the contract). Now, if they choose to, they can start calling in medications for “patients” through “telemedicine.” I put these in quotes not because there is anything wrong with telemedicine. It is a wonderful way to provide about 70 percent of patient care. And patients are in quotes because, during COVID, many companies popped up looking to make a fast buck. These companies would COVID test the same people daily for weeks or would offer ADD and pain medications online without an in-person visit. Again. Don’t get me wrong. Many legitimate companies offer these services and I have nothing against companies making money. The problem comes when corporate management starts telling doctors how to practice medicine or, worse yet, goes around them.
Where I do draw the line is when a company takes a physician’s information and starts phoning in medications in their name without the doctor’s knowledge. This happened to Dr. Terry Sasaki, a young physician of Japanese descent working at New York University. Dr. Sasaki was embroiled in a whistleblower lawsuit with the university when he found evidence of physicians overbilling for VA care not provided. His reward for calling this out was to be dismissed from a prestigious combined neurology-radiology residency just before graduation. Basically, he is putting his entire medical career on hold. To stay busy and earn some income, Dr. Sasaki agreed to review charts for a telemedicine company. Let me be clear. He never authorized anyone to prescribe anything in his name. But this didn’t stop the telemedicine company from doing so, using the DEA number of Dr. Sasaki with their complicit pharmacy.
Now, pharmacies are being blamed for filling controlled medication prescriptions under the argument that they “should have known” the prescriptions were not necessary. This illustrates either a profound ignorance or willful blindness to the truth on the part of the government. No pharmacist can ever say which patient needs what medication or how much. Only an MD is qualified to do this with schedule II medications. While ANPs and PAs can prescribe schedule III, etc., a few pharmacists go on to become clinical pharmacists and would have this knowledge, but most do not. MDs are THE experts on who needs which medication. That being said, it doesn’t take a business genius to know that many more people want certain medications than should have them. To the business, these are lost income opportunities; to the physician, these are patients who do not need those medications; and to the authorities, these are good excuses to lock up as many people as possible if they end up getting a prescription.
In the case of Dr. Randall, the government claims that he knew his credentials were being used wrongly and that he “rented them out” to L5 with full knowledge that it was a crime. I think it is much more likely that when the DEA came to the owners, Greg Barnes and Duane Dixon, they folded and agreed to rope in Dr. Randall, sending texts saying in effect, you know this was illegal, right? To which he would text back, “Oh god! I hope the DEA doesn’t find out!” which, of course, is why texting was invented. So they can track your every thought, I guess. This would give the DEA everything they needed to argue mens rea, a guilty mind, on the part of the doctor. In this case, a nurse practitioner and another employee named Charles Wilson Adams, Jr. were also convicted. It is said that Dr. Randall received over $300,000 for “renting out” his credentials. This is hard to square. Why would a professional in their 70s be willing to risk incarceration for so little reward?
They go on to say that some of the medications were schedule II, like oxycodone, morphine, hydrocodone, etc. While they also complain about Suboxone being prescribed. Suboxone is a schedule III partial opioid agonist that is considered by many to be the safest medication for opioid use disorder or addiction. The article said that Dr. Randall allowed “unqualified medical personnel” to prescribe for him and treat opioid dependence. This is an issue. When you prescribe a schedule II medication, the patient must be sitting in front of you, and you must wet sign a paper prescription or electronically send one. Make sure that no one has access to your crypto key and login, etc., for the electronic system. You can postdate prescriptions, and while this is easy for paper ones, those are easier to forge; electronic prescriptions can be post-dated also and should be created the day you see the patient.
They should also clearly say, “Do not fill until xxx date.” When we had paper prescriptions, I ordered embossing seals like a notary uses and told the pharmacies not to accept anything submitted without the seal pressed into the prescription. Dr. Randall will be spending 18 of his remaining months behind bars in a federal prison. The others will likely be there longer, especially an unnamed defendant charged with drug conspiracy, health care fraud, wire fraud, and false statements. That’s not good, as Buster Scruggs once said. Also, remember to run a reverse check on your name using your state’s and all other available prescription monitoring programs. Have your staff compare names against your patient list and look closely at the locations, too. An Rx for 250 Ritalin to someone in Hollywood, CA, when you are from Kentucky, should stand out. Lastly, trust no one, not even the DEA. Here’s why.
When Dr. Sasaki became aware that the company he had been just reviewing records for was using his identity to prescribe medications, he called the DEA immediately. They said come on down and tell us all about it. He did, telling them the truth about everything. But just because he told the truth doesn’t mean everyone else involved will. If a patient gets caught with a bottle that has your name on it, he can say, “I forged a prescription” to make sure he goes away for even longer, or he can say, “The doctor told me I could and took cash!” and get out of jail free. Now a protected witness, a victim even, of a rogue and dastardly doctor.
I don’t want to say that the DEA always encourages people to lie to get convictions because sometimes, they are willing to lie themselves. Two years after Dr. Sasaki spoke to the DEA, he found himself indicted and rolled in with everyone else in the company. There was absolutely no evidence against him, but one DEA agent said he “confessed” to taking money for the scam. How hard is it to conflate “took money to review charts” to “took money to look the other way.” They can always say he knew, should have known, or was willfully blind. Arguing to a jury that you would never throw away your medical career for so paltry a sum implies that you would do so if the price were right. You can’t win. Which is why you should not play at all. Do not try to match wits with the DEA. They are trained in both deception and the Reid technique. A method of coercing confessions is based on the premise that the suspect is always guilty. Call your attorney. Talk to no one else. The stakes are just too high to get this wrong. Let a professional health care specialist attorney with criminal trial experience fight for you.
You wouldn’t refer a patient to a dermatologist for brain surgery, so don’t put yourself in the wrong hands. Mulder was right: Trust no one.
L. Joseph Parker is a distinguished professional with a diverse and accomplished career spanning the fields of science, military service, and medical practice. He currently serves as the chief science officer and operations officer, Advanced Research Concepts LLC, a pioneering company dedicated to propelling humanity into the realms of space exploration. At Advanced Research Concepts LLC, Dr. Parker leads a team of experts committed to developing innovative solutions for the complex challenges of space travel, including space transportation, energy storage, radiation shielding, artificial gravity, and space-related medical issues.
He can be reached on LinkedIn and YouTube.
