Screen teens for HIV: American Academy of Pediatrics

From Reuters Health:

All sexually active adolescents should be screened for HIV, the American Academy of Pediatrics said Monday (Oct. 31) in a new policy statement that broadens earlier recommendations.

And in areas with higher rates of the infection, all teens over 16 should get the test, the group added in its statement.

More than 1.1 million Americans are infected with HIV, and 55,000 of them are between 13 and 24 years old.

"Forty-eight percent of the youth who are infected don't know they are infected," said Dr. Jaime Martinez of the University of Illinois in Chicago, who helped write the new report, published in the journal Pediatrics.
"It's important to realize that those who don't know they are infected drive the epidemic," he told Reuters Health.

HIV usually proceeds to AIDS in the absence of treatment, but newer drugs can keep that from happening for many years. And knowing you're infected may also help stem transmission of the disease to others -- a benefit that isn't seen with cancer screening, for instance.

Today, many doctors only offer testing to patients they deem at risk, such as prostitutes, drug addicts and homosexual men. But since 2006, the U.S. Centers for Disease Control and Prevention have urged everybody older than 13 to get an HIV test regardless of risk factors in areas with many undiagnosed cases.

The new statement is a bit more conservative, said Martinez, lest pediatricians be uncomfortable testing younger teenagers. He added that in 12th grade, more than 60 percent of adolescents say they are sexually active -- and that often they're having sex while under the influence.

An HIV test costs about $14, according to Martinez, and is accurate more than 99 percent of the time.

Standard of care: People skills

From the New York Times:

Doctors save lives, but they can sometimes be insufferable know-it-alls who bully nurses and do not listen to patients. Medical schools have traditionally done little to screen out such flawed applicants or to train them to behave better, but that is changing.

At Virginia Tech Carilion, the nation’s newest medical school, administrators decided against relying solely on grades, test scores and hourlong interviews to determine who got in. Instead, the school invited candidates to the admissions equivalent of speed-dating: nine brief interviews that forced candidates to show they had the social skills to navigate a health care system in which good communication has become critical.

 Read more about it here.

No. 1 prescriber of Hydrocodone nabbed in pill mill bust: DEA

KHOU reports:
     HOUSTON – A Houston doctor and 18 co-conspirators have been arrested in connection with illegal pain-management clinics in the area, the DEA announced Wednesday.
     According to the DEA, Dr. Gerald Ratinov -- a licensed and registered Texas physician – was the No. 1 prescriber of Hydrocodone in the state.
     Hydrocodone is a prescription painkiller that’s sometimes taken with Alprazolam and Carisoprodol – a combination popularly described as the "Houston Cocktail."
     Investigators said Ratinov acted as the medical director of at least three pain clinics in Harris County without proper certification and while he was under judicial review by the Texas Medical Board.
     The clinics – Hobby Medical Clinic on Reveille Street, Abundant Life and Weight Loss Center on Hillcroft and Astrodome Pain Clinic on Westridge – were used, along with select pharmacies, to fill fraudulent, medically unnecessary prescriptions for clients, the DEA said.
     Thanks to the arrests, the clinics and their four related pharmacies can no longer dispense illegal pharmaceuticals on the streets of Houston.
     Harris County District Attorney Pat Lykos applauded the efforts leading to the arrests.
     "This is an example of the superb cooperation between federal and local authorities to protect our citizens." Lykos said. "The DEA conducted a brilliant investigation and has stopped a dirty doctor and his cohorts from continuing to profit from the wretchedness of addiction. We will do our part to vigorously prosecute Ratinov and his co-defendants."
     The multi-agency investigation was led by the DEA and the Harris County DA’s Office, with participation from the Texas Medical Board, the Texas Pharmacy Board, the Texas DPS, the Fort Bend County and Harris County sheriff’s offices, HISD, HPD, Pasadena police, Harris County Precinct 2, Harris County Precinct 6 and the National Insurance Crime Bureau.
     "Doctors and pharmacies have an obligation to comply and operate within the parameters of the law. Dr. Ratinov chose not to do so, which lead to an investigation by DEA and our law enforcement counterparts, resulting in the arrest of Dr. Ratinov and others who blatantly violated the law," Thomas E. Hinojosa, Acting Special Agent-in-Charge of the Drug Enforcement Administration, said.

TMB to begin selling data through website

Watch our homepage for a new link that will let you purchase TMB data products online! The products are the same as before -- new physicians, complete listing of TMB licensees and disciplinary actions, etc. But now, instead of sending an email and a check to us, you can complete your transaction electronically.

Launch is expected this Friday, March 4 .....

From the Houston Chronicle

15 Texas doctors cited in illegal drug sales

7 physicians from the Houston area disciplined in ongoing crackdown

By CINDY HORSWELL
HOUSTON CHRONICLE

Feb. 26, 2011, 7:14AM

The Texas Medical Board this month disciplined 15 doctors — including seven from the Houston area — for improperly dispensing dangerous drugs, part of an ongoing crackdown of a burgeoning illicit industry of doctors and pharmacists illegally dispensing prescription medicine.

Houston in particular has become a national hub for the illegal sale of prescription drugs, especially a narcotic known by such brand names as Vicodin, anti-anxiety drugs and muscle relaxants.

"These numbers just show how pervasive the pill problem has become. Both the appetite for the drugs and the willingness to prescribe," said medical board spokeswoman Leigh Hopper. "The crackdown on the prescription drug problem is one of our big priorities. We are taking full advantage of our new authority to investigate pain clinics that was granted in the new law that took effect in September."

The new law mandates stricter regulations such as requiring all pain management clinics be doctor-owned.

Four pain clinics - three in Houston, one in Highlands - suspended

On Friday, February 18, 2011, a disciplinary panel of the Texas Medical Board temporarily suspended without notice the pain management clinic certificates of four clinics, three in Houston and one in Highlands, barring them from operating as pain clinics.

     On August 20, 2010, the Texas Medical Board issued four pain management clinic certificates to Akili Graham, M.D., as owner and operator of the clinics.

     On January 6, 2011, during an investigation of prescribing habits at the clinics, board staff obtained information that the clinics were not owned by Graham or any other physician, a violation of state law.

    

     The clinics are:

·         Imed Clinic Inc., 6806 Longpoint Rd. Suite G in Houston, owned by Danny A. Muhammad, a non-physician.

·         Preferred Medical Clinic, 1314 Federal Rd., in Houston, owned by Durce Muhammad, a non-physician.

·         The Oaks Medical Clinic Inc., 444 S. Main St. in Highlands, owned by Danny A. Muhammad.

·         UMAT Clinic, LLC, 7632A Park Place in Houston, owned by Tamu Muhammad, a non-physician.

     The temporary suspensions were based upon the panel’s determination that the continued operation of the clinics poses a continuing threat to the public welfare, due to the fact that large amounts of dangerous drugs and controlled substances are being prescribed at a clinic in violation of statutory requirements for operating a pain clinic.

     Houston media report that Danny Muhammad is a Houston Police officer, currently suspended with pay.

     Stay tuned.

TMB suspends doctor prescribing controlled substances from home

     On February 18, 2011, a disciplinary panel of the Board temporarily suspended, without notice, the medical license of Annie Christine Z. Walker, M.D., of Forney, after determining that Dr. Walker’s continuation in the practice of medicine constitutes a continuing threat to the public welfare.
     The panel found that Dr. Walker inappropriately prescribed controlled substances to seven patients including one who died from an overdose January 1, 2011. Dr. Walker acknowledged that she had no medical records for any of the seven patients.

     In addition, Dr. Walker admitted prescribing to her daughter, son-in-law and grandson, and kept no medical records for these patients.
     Dr. Walker is 88 and unable to walk unassisted. She saw all patients in her home, where she kept prescription pads unsecured and charged patients $20 per prescription given. She'll have an opportunity for a hearing, with notice, in at least 10 days.

Pain Clinic actions taken

Since the Sept. 1, 2010 deadline for registering pain clinics with the Texas Medical Board - a new requirement under last session's Senate Bill 911 - the TMB and the Texas State Board of Pharmacy, with help from the Drug Enforcement Agency, have taken the following pain clinic-related actions:

• Oct. 21, 2010 - TMB suspended without notice the license of David Shin, M.D., of Houston. 
• Oct. 21, 2010 - TMB suspended without notice certificate of Better Life Pain Clinic, where Shin worked.
• Oct. 25, 2010 - TSBP suspended license of H&W Pharmacy in Houston.
• Oct. 25, 2010 -  TSBP suspended license of H&W pharmacist Victor Egbulefu.
• Jan. 11, 2011 - TMB suspended without notice certificate of Spring Wellness Center in Houston.
• Jan. 14, 2011 - TMB suspended without notice the license of Julia Renee Ward, M.D., of Houston. Previously, the TMB denied certification of Tejas Urgent Care Clinic, where Ward worked.
• Feb. 4, 2011 - TMB accepts surrender of Spring Wellness Center's certificate from Dr. Jesus Caquias of Brownsville.

Stay tuned.


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New medical director joins TMB!

Gage-White

The Texas Medical Board announced today that Linda Gage-White, M.D., will become Medical Director of the agency in mid-January. 

Gage-White, an ear, nose and throat specialist, served on the Louisiana State Board of Medical Examiners from 2002 to 2010 as president, vice-president and as a member of the Licensure Committee and the Board’s Malpractice Committee.

 

“We’re very pleased to have someone of this caliber join the agency,” said TMB Executive Director Mari Robinson, J.D. “Dr. Gage-White’s extensive, relevant experience and her passion for patient safety will help fulfill the Board’s mission of public protection.”

 

A native of Fort Lauderdale, Florida, Gage-White graduated from Duke University and received her medical degree from the University of Miami School of Medicine. Gage-White interned at Mount Sinai Medical Center in Miami and completed her residency in otolaryngology at the University of Iowa Hospital and Clinics.

 

She has been affiliated with Louisiana State University Health Sciences Center for 25 years; she founded and served as director for the institution’s  multidisciplinary cleft lip and palate clinic. She was in private practice for 10 years before accepting her most recent academic appointment in 2000. She is board-certified in otolaryngology and has taken part in charitable medical missions throughout the world.

 

Dr. Gage-White fills a position vacated by Alan T. Moore, M.D., TMB’s previous medical director. State law requires that if the agency’s executive director is a non-physician, a medical director be hired.

Get the most out of the TMB website

Periodically, on this blog, I'm going to point out different features of the website. State law requires all of TMB's public information to be available, and much of it is right here. (Some of these tips may seem obvious, but you'd be surprised what I get asked about.)

Whether you're a patient or a health professional, you may want to look at a physician's public profile on this site. On the left hand side of the home page, click on "Look Up A Licensee." Or go to this link: http://reg.tmb.state.tx.us/OnLineVerif/Phys_NoticeVerif.asp Next, click on "I Accept the Usage Terms." That brings you to the search page.

You might want to see a list of all allergy specialists in Houston. Fill in the blank for city and use the pull-down menu for the specialty. (You'll end up with a long list.)

Or you might want to look at the profile of a particular doctor. Fill in all or just a few of the search terms. Click on the name that best matches the search results and voila! Scroll through the profile and you'll see where the doctor went to school, where the doctor has hospital privileges, and whether the doctor has been subject to any board disciplinary orders.

Reading our news releases may pique your curiosity about a particular provider. If you want to read the actual legal document describing the basis for a disciplinary order, go to the search page and fill in the doctor's name or license number. When you reach the doctor's public profile, scroll down to "TMB Actions and License Restrictions." Beneath that, you'll see a "View Orders" button. That's it!