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Pain-clinic doctor to set rules?

By Carol Gentry
6/2/2010 © Health News Florida

Dr. Joel Rose, chairman of the Florida Board of Osteopathic Medicine, has appointed himself to a state panel that makes rules to control pain clinics, even though records show he works for at least three clinics that appear on the state registry.

The physician that Rose ousted to make way for his own appointment to the Joint Committee on Pain Management, Allan Escher, learned of it Tuesday in an e-mail from a staff member at the Department of Health.

Escher said he was “taken aback” by Rose’s self-appointment. “In effect he’ll be regulating himself,” Escher said.

“It’s an obvious conflict of interest,” said Robert McCann, a former chair of the osteopathic board who served on the pain-rule panel until earlier this year.  

(Updated: But Dr. Rose says that he has no conflict of interest because the clinics he works for, owned by Physicians Group LLC, are not really pain clinics. They applied to be on the state’s pain-clinic registry and were approved in March, but withdrew in May, he said. 

(They don't meet the criteria the state has set for registering as pain clinics, he said, because they don't advertise as pain clinics and less than half their patients receive prescriptions for pain  medications.

(They applied as pain clinics in the first place in an abundance of caution, Rose said. )

Fred Bearison, chairman of the Joint Committee on Pain Management, said he knew nothing about all of this until contacted by a reporter Tuesday night.

“I would think that if you work in or own a pain clinic it could be seen as a conflict of interest,” Bearison said, but suggested contacting the panel’s counsel, Assistant Attorney General Ed Tellechea. He could not be reached Wednesday morning.

Physicians Group LLC, according to state records, is controlled by Gary Kompothecras, a chiropractor who is a close friend of Gov. Charlie Crist. Crist appointed Rose to the Board of Osteopathic Medicine in 2007.

The company runs controversial TV ads inviting people who have been in traffic accidents to call "1-800-Ask-Gary.”

The pain-rules committee was set up by the 2009 Legislature to determine the minimum standards for pain clinics and the professionals who work in them, a response to Florida’s black eye as the capital of pain-pill pushers.

The Board of Osteopathic Medicine holds two slots on the joint pain committee, and the Board of Medicine holds five.

For the second slot on the committee, Rose appointed Ron Burns, an osteopathic physician who ran unsuccessfully against Escher for chair in 2009. McCann describes Burns as a political ally of Rose and say they both view Escher as a rival.

“It’s a shame that this internal politics is interfering with the committee’s work,” McCann said. Prescription-drug abuse “is a very serious issue, and somebody’s got to stop it.”

The news of his ouster came to Escher in an e-mail from the acting executive director of the osteopathic medicine board, Christy Robinson.

The Department of Health license lookup site shows Rose as having board certification from the American Osteopathic Board of Family Physicians. It does not list any specialty training in pain management. 

Escher holds board certification from the American Osteopathic Board of Anesthesiology with a specialty in pain management. Records show he is now affiliated with the University of South Florida, practicing at H. Lee Moffitt Cancer Center.  

--Carol Gentry, Editor, can be reached at 727-410-3266 or by e-mail