By Mark David Blum, Esq.

Somewhere out there is a doctor and I am going to find him. This doctor is not just any doctor. Rather, this particular person and his actions behaved in a manner so unprofessional and dangerous that he should never be allowed near a patient again. (Though I am not sure whether this doctor is a male or female, I will continue to use the pronoun “he...” as I doubt any woman could be so cruel, selfish, and ignorant). To his defense, this same doctor’s behavior was both legal and widely practiced in modern medicine. If I catch this doctor though, I am going to change the landscape for all of us. Yes, in doing so, I am turning the doctor into a patsy. But I feel if I can string one doctor up by his nuts in the public square, then perhaps the medical industry will see the error of its’ ways and clean up its’ act before more doctors are pilloried in the public square.

So, let me tell you what this doctor did to draw out my ire. Before I do, I have to go back a step and share a little history. In my file cabinets is a file of a young man who did something stupid and by ‘stupid’, I mean really stupid. So stupid were his actions that he could have been justifiably killed had the right person been there at the time. Despite all my best efforts and the heroic efforts of others, it will be my job to hold the young man’s hand as I lead him to the gallows. What he did was wrong and he should answer. Why he did it is the focal point of this discussion.

One day the young man, who had a family and a well adjusted normal life with a job and a bright future, hurt his back badly at work. He went to his doctor who, after testing and evaluation, prescribed the client Percocet; an opiate. The young man used the prescription to his benefit and was able to return to work. Over time, however, the long term use of an opiate drug created in the young man a strong dependency to the point that his tolerance to the drug rose and his consumption increased to the point that he was high most of the time. Though he was under the care and supervision of a physician, the young man was just fed more and more pills and his dependency turned into addiction and he was hooked. Eventually and as a result of being stoned all the time, the young man lost his job. One month later, his employment based medical coverage ended.

Now we have a young man hooked on opiates prescribed by a doctor and the young man no longer has access to that doctor. Without medical insurance, the doctor wouldn’t see him again. Without a job, the young man had no ability to see his treating physician or find another. Applications for public assistance fell through and all he had to live on were his unemployment checks.

But he was still hooked on opiates. Over a very short period of time, the young man transitioned to buying more Percocet on the streets, eventually shifting to buying OxyContin from drug dealers. At a point the young man learned that heroin was far easier to get, resolved the withdrawal and bodily craving for opiates, and was much less expensive than pills. In the end, the young man was hooked and using heroin on a regular basis, sold all his assets to feed his habit, and ended up homeless and eventually in prison for a major felony.

In conducting the forensic analysis of his medical and psychological history, it became clear to me that the real criminal in this case was not the young man, but rather the doctor who hooked the young man on the drug and who then later abandoned the young man when the medical insurance ran out. Stated another way, the doctor not only did more harm to his patient but abandoned the patient while the patient was vulnerable resulting in the patient falling into hell.

In my discussions with forensic psychiatrists and physicians, I asked them about their industry and the obligations doctors have to their patients beyond the patient’s ability to pay. I felt that it was more than mere malpractice and that the treating physician had a moral, ethical, and legal duty to monitor and continue to treat the patient so as to assure the patient did not suffer more harm. After all, the doctor knew the patient was using large doses of opiates and the doctor had to know the dangers that go along with long term use of such drugs. So when the money ran out, I felt that the doctor still had a duty to his patient. Apparently, according to the medical experts I consulted, the business of medicine and the State of New York foist no such burden on doctors. If the patient doesn’t pay, the doctor can stop treating.

Compare that to my industry – Law. A client who comes to me and retains me to represent them in a criminal matter creates an obligation on me to do that job to the best of my ability regardless of whether the client pays or not. Most courts will not allow a lawyer to exit a criminal case for non payment by the client. This is why in criminal cases, lawyers demand all their money up front. Otherwise, we could be stuck working for free and that sucks. (Criminal cases are not like civil cases. Criminal cases have a person’s liberty on the line and are mostly tactical in how the defense attorney prepares. A civil case is just about money and it is far easier to get out of the case for non payment). Because the stakes are so high in a criminal case, the law is very protective of the accused an the attorney shoulders a heavy burden in a situation rife with danger for the client. We lawyers don’t abandon our clients as a matter of law and practice; though we do try.

So why is it that a doctor can put a patient in a situation of extreme risk and high danger and then just walk away without further thought for non payment? I respectfully submit that any doctor whose patient is in a dire situation, especially one caused by the treatment itself, that such a doctor must be shouldered with the same burdens as am I – to continue to treat the patient. At a minimum, the doctor should have at least helped wean the young man from his addiction before the doctor threw the young man out into the streets.

The law needs to change. Doctors, despite their powerful lobbyists in Albany and Washington DC, cannot be immunized from their duty to the public. We, the People, give doctors a great deal of social and legal privileges not available to the general population (such as writing a prescription) and thus these same doctors, I argue, owe a duty to the People who enabled the doctors to amass their fortunes. A doctor simply should not be allowed to abandon a patient mid treatment or be tossed to the street hooked on a powerful drug prescribed by the doctor himself. The President’s new health care law completely ignores this issue and lets doctors continue to skate. Our governor is more interested in taking guns than in protecting life and society from our own self inflicted wounds.

So, if the legislators wont take action, I will. If I ever ID this doctor, I will bring to bear the full power of my education, experience, expertise, and financial resources and make that doctor answer to a jury of his peers why he turned his back on his patient; the very patient he, the doctor himself, harmed. I will do what I can to hold up the doctor as a poster child for change that has to come from the medical establishment. Change has to come and legislators are too cowardly to take action. A lawsuit and the attention is will bring, combined with public shaming of the doctor, I hope will bring about what I see as a desperate need for change in the business of medicine.

I respect medicine and know that doctors in general do yeoman’s work saving lives and healing the ill. But I too do that same yeoman’s work except that I am saddled with mandatory pro bono obligations and compelled to stick with my clients through the end of their case. I want doctors to face the same obligations.

No doctor should be permitted to have a patient using powerful drugs to simply be tossed to the street. Doctors have an ethical duty to treat the patient in front of them. The young man in this tale was a patient and was being treated – and then the doctor simply turned his back and walked away because the patient couldn’t afford to fill the gas tank in the doctor’s Beemer.

We have to change the rules and it has to be done now. Lives are at risk; and not just the patients. There is huge collateral damage that happens as a result of throwing an iatrogenically addicted human being out into the streets and summarily cutting their lifeline.

In my mind, the doctor had a duty. He breached that duty. The patient was harmed as was the public at large. Change has to come. I am going to do what I can to make it so.