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After the Doctor is Arrested, What About the Patients?

At the start of  June, Doctor Harold C. Spear was arrested in Kauai for allegedly engaging in problematic prescription of pain medication. Today, weeks later, there’s an article in the Honolulu Star-Bulletin raising the obvious follow up question:what about all the people he was treating?

Authorities seized more than 3,000 patient files, according to the article. That’s 3,000 people who used to have a doctor but don’t any more.

U.S. Attorney William Shipley told U.S. Magistrate Judge Leslie Kobayashi he doesn’t believe all of the 3,000 people whose records Spear maintained are patients in urgent need of care. He said some are on the mainland and may have called Spear’s “dial-a-doc” service just once. And he said copying all 3,000-plus records will take time.

Kobayashi ordered Shipley to provide her a list of patients whose records he objects to returning and ordered Green to provide a list of patients who are in urgent need of care.

Spear says he knows of at least six of his patients who have gone to the emergency rooms on Kauai because they have been unable to get their pain medications.

Emphasis added. It’s truly a weird situation when it’s up to a federal prosecutor to decide who is and who isn’t “in urgent need of care” and when a doctor has the burden of making a sufficient showing to get back patient records because the government is too busy to photocopy 3,000 pages.

Even if the evidence is extremely strong against a particular doctor, shouldn’t there be some protocol in place to transfer copies of patient records to an independent third party who actually has medical training so that he or she can made an intelligent evaluation of the medical needs of such patients? Forcing people to go to the emergency room because the government can’t be bothered to operate a photocopier just doesn’t make any sense at all.

Alex DeLuca wrote a post on a related theme around the same time Dr. Spear was arrested. His point was that patients were instantly and inappropriately being reclassified as “addicts” the moment their doctor was arrested. Burden shifting is a favorite legal tool for slicing up reality into manageable categories, but these kinds of blanket record seizures shift burdens onto third parties against whom there is no claim at all of wrongdoing.

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