Patients on ‘amazingly large’ amount of opiates result in fine, probation for doctor

The Kansas medical board has fined an Overland Park doctor $2,500 and put his license on probation after an investigation revealed improper and potentially dangerous opioid prescribing.

The Kansas Board of Healing Arts order released this week says the board investigated Joseph Baker began after a pharmacist made a complaint. The pharmacist was concerned that Baker, who now works at Vein Clinics of America at 10777 Nall Ave., was over-prescribing to someone with whom he didn’t have a legitimate doctor-patient relationship.

The company’s national medical director, Satish Vayuvegula, called the Star Friday. He said the incidents outlined in the board’s order happened before Baker was hired by Vein Clinics of America last year, but the board placed no restrictions on Baker’s ability to practice medicine and the company is supporting him during his probationary period.

The medical board’s investigators got two years of Baker’s prescribing history and found that he violated guidelines in prescribing controlled substances to at least seven patients.

When the investigators requested an explanation, Baker wrote back that “although the amount of opiates many of these people are taking is amazingly large, they tolerate it extremely well.”

But Baker acknowledged he had violated best practices by prescribing some of them opioids and benzodiazepines, a dangerous combination, at the same time.

Baker didn’t respond to a message left Thursday at Vein Clinics of America.

Vayuvegula, the companies medical director, did offer a statement.

“We do not believe this matter affects Dr. Baker’s ability to provide proper vein care to his patients,” Vayuvegula said.

Vayuvegula said the treatments provided at Vein Clinics of America are minimally invasive and its doctors don’t usually prescribe pain medications because over-the-counter drugs are sufficient. He also said Baker told the board he did have a legitimate treating relationship with the patient who spurred the initial pharmacist complaint.

The board’s order didn’t specify how much opioid medication Baker’s seven patients were on and Vayuvegula said he had no further information he could provide on that front.

The Kansas Board of Healing Arts doesn’t have specific limits for how much medication physicians should prescribe each patient. Instead, it uses its medical expertise to determine on a case-by-case basis whether the prescriptions are medically appropriate or potentially harmful.

In Baker’s case, the board said he failed to meet its standards for the seven patients “to a degree that constitutes gross negligence.”

The board said the patients’ records didn’t include adequate examinations to determine the cause of their pain or lab testing necessary to support the diagnoses Baker gave them. Instead, he inappropriately prescribed controlled substances for “suspected fibromyalgia” and didn’t document refills of the prescriptions.

Baker’s license will be on probation until he completes continuing education courses on prescribing controlled substances and medical record-keeping.

A record 64,000 Americans died of drug overdoses in 2016, with the majority of them taking too many prescription opioids or illegal heroin. About 2 million Americans are addicted to prescription painkillers, according to the American Society of Addiction Medicine.

This story was originally published February 16, 2018 at 5:00 PM with the headline "Patients on ‘amazingly large’ amount of opiates result in fine, probation for doctor."