Map of life expectancy at birth from Global Education Project.

Tuesday, March 09, 2010


I got your indignation right here. The money shot in this story is that these "pain clinics" employed five physicians who collectively wrote scrips for more than 2 million hits of oxycontin last year, and, oh yeah, were each paid about a million bucks for their "medical services."

My indignation in this case does not particularly extend to the entrepreneurs behind these businesses. They are no different from typical business people like tobacco merchants, the guys on the corner with the little plastic bags, WellPoint, or Monsanto. However, there ought to be a special place in hell reserved for the physicians involved. As a social problem, prescription drug abuse has been growing rapidly in recent years; in the U.S., it's a common gateway to heroin addiction for many young people.

Okay, that's bad. But it has a major secondary effect in that it makes it much more difficult for doctors to prescribe opioids legitimately. In the past, the DEA has not been appropriately selective about prosecuting doctors for inappropriate prescribing. There have been tragic instances of doctors having their lives ruined when apparently, they were just trying to do right by patients in need.

It can be a tough judgment as it is, but if you're constantly looking over your shoulder for the narcs you are going to end up depriving people with unbearable pain of the mercy they desperately need. Sure, you're going to have some people trying to get over on you but who's to say that occasionally erring by writing a prescription you should not have written is worse than not writing when you should? But with operations like this Florida scam going on, there are more people out there who have developed dependencies, a bigger market in general, and the risks for responsible physicians are that much higher.

What really gets my blood boiling, though, is that the competition to get into medical school and earn that license is almost as tough as the competition to make it in Hollywood. There are thousands of smart, altruistic, qualified young people who want nothing more their whole lives, and for all the right reasons, who never get that chance. If you are lucky enough to make it through a medical education, you can make a very good living by doing good. You do not have to become a criminal psychopath in order to achieve affluence and status. And here these schtickdrecks are fucking it up for everybody. Federal prison is much too good for them.

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