N.H. Can't Monitor This Elderly Doc's Painkiller Prescriptions, and Now They're Shutting Her Down
Did a small number of complaints get used to punish bureaucracy-rejecting physician?

New London, New Hampshire, a community of 4,400 is not bursting at the seams with doctors. Nevertheless, there may soon be one fewer, thanks to state regulators.
The state's Board of Medicine has taken away 85-year-old Anna Konopka's medical license, and they're resisting her efforts to get it back.
Konopka's problems started with an accusation earlier in the year that she wasn't properly treating a 7-year-old with asthma. She says the child's mother wasn't following her instructions, but the Board of Medicine reprimanded her.
Since then, four additional complaints have been filed against Konopka, but the details have not been disclosed. When the board began disciplinary procedures, she agreed to voluntarily surrender her license, but said she was essentially forced to do so or the board would have shut her down immediately. The "voluntary" surrender allowed her to practice to the end of October. She's gone to a judge to ask to get her license back.
It may well be those complaints are serious, but a significant detail in the matter may have been overlooked: Konopka is mostly computer illiterate. She has no computers in her office, keeps patient records in filing cabinets, and says she doesn't have the time to learn how computers work.
This has made it impossible for her to comply with reporting guidelines put in place in New Hampshire in 2014 to "fight" the opioid overdose crisis, according to the Associated Press. Doctors who prescribe opioids are supposed to participate in this reporting program and check a patient's drug history in the register before prescribing them.
Also worth noting: Konopka often takes care of the medical needs of people without insurance who feel like they don't have many choices or treatment alternatives. From the Associated Press:
She often attracts patients who have run out of options, many with complicated conditions, such as chronic pain. She also draws patients who have no insurance and little means to pay. She takes anyone willing to pay her $50 in cash.
"I'm interested in helping people. I didn't go to medicine for money, and I didn't make money," she said, noting she works alone and can't afford things like and administrative assistant or even a nurse.
So Konopka's inability to participate in the opioid reporting program would be a terrible reason to revoke her license. In fact, in the hearing with the judge Friday, several of her patients came to speak on her behalf, and one claimed that she helped him get off oxycontin and use other remedies. He said that his previous doctor was responsible for overprescribing medications.
We're well along in the mistaken belief that prescription-based pain treatment is the source of our opioid overdose crisis, and the Trump administration is buying into it. Jacob Sullum explained just last week that this narrative is misguided and that the risk of overdose among patients seeking a doctor's assistance for fighting chronic pain is relatively low. In fact, it's government crackdowns and interventions in pain management that are sending patients to the much more dangerous black market.
Poor New Hampshire residents may have one fewer treatment option because the state decided a doctor wasn't keeping records the way the state wants her to. And those demands are, in part, guided by a mistaken grasp of the opioid crisis.
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85? Just stuff a pillow over her face and end her misery.
HOW ABOUT SHE PRESCRIBES A SIZE GRANNY BOOT FOR YOUR ASS
You should have went with "an orthopedic walking shoe up my keyster," because it's funnier.
Not without caps it's not.
Funnier, and more likely to cause a climax.
She was still prescribing cocaine and laudanum, wasn't she.
Just old enough to be Ginsberg's replacement.
It may well be those complaints are serious, but a significant detail in the matter may have been overlooked: Konopka is mostly computer illiterate. She has no computers in her office, keeps patient records in filing cabinets, and says she doesn't have the time to learn how computers work.
I'm counting half a dozen HIPAA violations here. This doctor's issues go way beyond pain prescriptions, the state doesn't want doctors that do business in this way... in business.
To be serious for a second...I don't see any.
Maybe I stepped on your joke.
Seems to me that she could have avoided the whole mess by getting a secretary, admin, or nurse to handle the "healthcare" side of her business while she stuck to the "actually helping people" side of things. Does not excuse the dick move by the state however.
And her practice could afford that by...?
Too easy.
First, daddydotgov't actually provides free outpatient charting software, or "EMR." (Electronic medical record).
Second, woman says she is too busy to learn computers. By implementing one of the free charting programs and hiring a tech-aware 19 year old scribe who aspires to one day go to medical school, research has shown that clinicians can see 17% more patients.
"I'm interested in helping people. I didn't go to medicine for money, and I didn't make money," she said, noting she works alone and can't afford things like and administrative assistant or even a nurse"
Translation: Pill Mill...."Get your red hot norcos here......"
Seems like if the state is going to require records be computerized they should provide a data-entry clerk to facilitate it. Just another way for the government to indirectly attack small business
Yeah, I was thinking the same thing. One lone 85 year old physician without any staff and no computers? That place is definitely getting shut down, and frankly that's a blessing. The amount those fines could add up to would put her business under, for sure, and I wouldn't be surprised if she ended up in prison.
I'm not saying I agree with that type of health policy, but frankly in todays climate they did her a favor in doing things the way they did. The State and Board could have done so much worse to her.
She takes anyone willing to pay her $50 in cash.
Hashtag: Pill Mill
Granny is money laundering!
She takes anyone willing to pay her $50 in cash.
History's greatest monster
She's a lot like your mom in that way.
Mom only takes bitcoins.
Is that what they're calling black cocks nowadays?
Don't be ridiculous and insensitive. You know his mother doesn't discriminate.
Oh, she discriminates alright.
Many have tried to fork her blockchain.
Make it hard for some bureaucrat to check a box like a thug, lose your job helping people like a thug.
Is she a danger to her patients? That's not the issue here, the issue here is that she can't generate paperwork - which we'll ignore as long as she pays her fees ... er, as long as she remains in good standing - so we can say with an empty, ... er, clear, conscious, that she wasn't a danger to her clients until she was.
People don't think that's how regulation be, but it do.
If she hasn't bothered to figure out how computers work, AT ALL, then I might question her ability to stay current in medical practice.
I think this is not a good hill to die on.
Agreed - I am glad the government is there to tell this woman how to take care of her patients. Without government intervention how would the lower classes receive care?
To be fair, many states do not allow online CME to be applied (or limit the percentage that can be applied) toward the annual requirement for license renewal. There are many ways to earn CME that these licensing boards consider better than online, such as conferences and seminars. Also, many journals offer CME exams based on the articles they publish. If she wasn't getting her required annual CMEs somewhere, she wouldn't have been able to renew her license all these years.
(CME=continuing medical education)
Yes! I am sure she would have gotten so much from the conferences. (So many attendees spend their time elsewhere in town, or on the beach!) My staying up to date only got comments from other physicians like "You act like you think you are smarter than us!" The politics being as they are, the CME is just another one of the con games the "boards" are running! But, it just looks good on paper!
Yank her license.
It's laziness like hers that makes the job twice as hard for the rest of us who are doing it the right way.
"Chronic pain" is not a "complex" medical issue. It's a bullshit diagnosis used by people to get their hands on drugs that they shouldn't be using in the first place. And if they were to justify her incompetent way of doing things, this opens the door to an even bigger industry of physicians selling opiate 'scripts for cash and blowjobs.
I hope you break your back one day. I hope when that happens you get handed Tylenol and told to suck it up. I hope you die from liver failure when you OD on the Tylenol trying to control your pain.
If you're a doctor, please surrender your medical license immediately.
He could never be a doctor. He does not even know what doctors do.
I am a physician! I also get treated for neuropathic pain from a post-traumatic cauda equina syndrome. It happened when a fall caused an explosive fracture of the second lumbar vertebra. His comment seems to be representative of most of the arrogant pricks who think ten minutes with a patient is maximum time allowed! (Most chronic pain patients need more time allotted for their care.) Funny that the usual billing code for an established patient, paid by Medicare, requires 15 minutes of one on one physician contact with the patient. Most likely, 99% plus of the doctors, seeing Medicare patients, do not meet this requirement for filing their charges! It's only the good ole boys system that keeps them safe!
Folks, don't come to Dr. Larry here thinking you're gonna tell him how you feel. He will tell YOU how you feel and probably yell something about blowjobs.
Do you ever lose sleep thinking about all the people you've driven to suicide or overdosing on fentanyl-laced heroin?
How many times were you dropped on your head as a child?
Until any of you cockbags have spent a shift seeing patients in my emergency department, you will continue to say ridiculous things like that.
These patients are practiced manipulators, claiming to have developed allergies to all the non-narcotic drugs that are typically prescribed for the "pain" they claim they have. Oddly, these patients can never remember the name of their blood pressure medication, but they always remember that "dilaudid" works for them and they are never allergic to that. And while I've encountered hundreds of patients who are allergic to "benadryl," a drug that is actually used to treat drug allergies, I've never encountered one who is allergic to heroin, fentanyl, or cannabis. Imagine the odds.
Their most recent prescription has always been "stolen" by someone they don't want to report, or the cap fell off and the entire contents of their most recent prescription "fell into the toilet." Yet here is how many people come in trying to get a refill on their blood pressure medication after such an "accident:" zero. It's like there is some kind of magnet in the toilet sucking in all the narcotics that repels any uncontrolled substance.
Then when we drug test a patient who has a prescription for lets say Norco, their urine will test positive for benzos and cannabis, but there won't be a stitch of opiates in their urine...for those of you who are naive to this phenomenon, it's because they are demanding an opiate for their "chronic pain," but then selling or trading the pills to buy Xanax and marijuana.
I don't lose a stitch of sleep, because I'm not the one contributing to the epidemic of prescription drug abuse. And having worked in urban America as a paramedic to pay my way through college, you might find it helpful to know that heroin ODs are almost always recreational, not because someone was in pain and didn't know how to dose themselves.
If you are another snoozer seeking to escape reality under the guise of "chronic pain," please stay the fuck out of my emergency department. I know you think you are getting one over on the providers, but everyone has you figured out the instant you walk in the door.
Here is who is going to get more than 15 minutes of my time; that is the patient who actually contributes to their own well-being. The majority of the people coming in have spent a lifetime abusing themselves and are disinterested in lifting a finger to make a life change to improve their own health. It's always someone else's fault.
Why does Mamie Eisenhower insist on not using a modern filing system? IDGAF how old she is or what scrimshaw she accepts for payment...the bitch needs to modernize. Are we meant to believe she also has no staff other than her Labrador retriever and her autistic nephew?
Given that autistic people have on average significantly higher IQs and EQS than normies, I doubt she would need any.
Live Free or Die?
You're obviously some kind of monster if you think a doctor's primary job is relieving suffering.