When the Virginia Board of Medicine summarily suspended the license of primary care physician and self-proclaimed pain management specialist Roger M. Phillips in February, it left 400 patients without care, without their medical records and without access to the prescription drugs they used.
"It's a total nightmare. These particular meds, you can't take them and then not," said Tony Anderson, a cash-paying patient who has been taking OxyContin for seven years. "I don't get a buzz, my back hurts so bad. Otherwise I'd be on disability."
Anderson, 51, was putting in 11-hour days as a maintenance lead on a 24-hour production line while under Phillips' care. Now, after two weeks of "crawling the walls" at home, he is back to work on reduced hours because the pain from degenerated discs and an artificial disc has ramped up. His Suboxone therapy for withdrawal is costing him $3,500, not including the medication.
"I've got MRIs to show I need pain management — or the government can pay me to sit on my butt," he said.
He expressed shock at reading the board's allegations against Phillips — 43 pages outlining 33 instances in which the physician may have violated state law. The accusations mostly regard the overprescription of narcotics, including the death of one patient in Florida, and one alleging inappropriate romantic involvement.
"He actually cared about you," Anderson said. "There's a whole lot of people he's helped a whole lot."
The board suspended Phillips' license on Feb. 20, shuttering his Prime Care Medical Group office in Newport News. A hearing at which Phillips may contest those allegations has been scheduled for May 28 in Richmond.
He blamed the state's charges against him on a disgruntled former employee and some of the 81 patients he dismissed over the years for drug abuse and other treatment infractions.
Now many of Phillips' patients are having trouble finding new physicians.
"Every doctor refuses us treatment," Anderson said. "All of us have been given the cold shoulder."
In an interview with the Daily Press, Phillips said his patients are running into a virtual boycott. He expressed his disgust with the medical community and the Board of Medicine, noting that it can take two to three months to get an appointment with a pain doctor on the Peninsula.
"Regardless of what I may or may not have done, they don't deserve this. They are innocent victims of regulatory zeal," he said. "There's no compassionate consideration."
However, one major barrier to his patients finding care has been their inability to obtain their medical records. By law, Phillips has 15 days to comply with a written request for records, but patients have little recourse if that deadline is missed. After initially stalling, Phillips said he started sending the records out in mid-March, a handful each day.
He estimated late last week that he has supplied about 50 abbreviated records, covering just the last six months of each patient's care, and that his patients should anticipate a wait of up to six weeks. One who received his records, Gregory Seltrecht, said they contained only the past three months of the nine years of care he received for multiple sclerosis.
"He left a lot of people high and dry," said James Thompson, a patient who said he paid Phillips $300 in cash the day before the practice closed, and was never notified that his appointment had been cancelled. "A lot of doctors aren't going to take you."
Nola Harrell, a retired nurse, requested her records on March 14 and has made an appointment with a pain doctor in Williamsburg in June in the hopes she'll have them by then.
"Those records are mine," she said. "It's a big deal to me. What pain doctor is going to see you without records? We're in a Catch-22."
Along with request forms for records, Phillips left his patients a list of potential doctors. Forty of the 400 patients immediately sought care at nearby Hampton Roads Orthopaedic and Sports Medicine, HROSM.
Jeremy Hoff, an HROSM physician who is board-certified in physical medicine and interventional pain medicine, said Phillips' patients essentially have been abandoned.
"It's a very difficult situation for patients and providers," Hoff said. "The patients are the ones that are truly suffering. The sad part is the difficult spot that he's put patients in."
He cited the high doses of benzodiazepines (Xanax, Valium, etc.) that Phillips prescribed together with high-dose opiates, both of which repress the respiratory system. "I've found that there aren't any providers willing to deal with these very dangerous chemical mixtures," he said. "It's really unfortunate."
Absent any records, Hoff was able to check the state's Prescription Drug Monitoring Program to determine what the presenting patients had been prescribed in the past year. "It's a huge lifesaver to have that program in place," he said. It also includes the neighboring states of Maryland and North Carolina.
He referred 39 of the 40 patients to Suboxone therapy and detox programs in the area; the sole exception was a post-operative patient who had only been seeing Phillips for a month. "I don't have a license to treat addiction," he said.
Suboxone therapy is an "antabuse" medication that controls withdrawal while providing some pain relief without the euphoria, Hoff said.
"It's an alternative, a way to reduce the dose and get off in a safe way," said Newport News psychiatrist Douglas H. Chessen, who offers Suboxone therapy. "If they can't get off narcotics, this is a safe way they can be maintained."
Patients develop tolerance
Chessen said patients tend to develop a tolerance to narcotics that leads to increased pain and the need for ever-higher doses to achieve the same relief. The tapering off with Suboxone can take weeks to years to accomplish, he said.
Many patients feel stigmatized by the charges against Phillips and vilified by association. Linda Crewe described herself and her son as legitimate patients. Unable to get their records, they went to Sentara Urgent Care where they were advised to find a new primary care provider and get a referral for a pain doctor.
Phillips "was a good doctor. A very, very good doctor, really thorough," she said. "He was so smart, so intelligent."
Rodney Erb agreed, describing Phillips as "a genius." Erb's wife has suffered from reflex sympathetic dystrophy, or RSD, for 15 years. After a lengthy search for a doctor they found Phillips, who treated her with opiates. "I think he's not getting a fair shake," said Erb. "We're back to the same desperation."
Christopher Lindsay, of Carrollton, claimed to have been rejected by 18 doctors over the past couple of months. "I'm angry, frustrated, depressed and tired," he said. "I'm having a major problem that no other doctor in the area will take his patients. I have a spine that's so twisted and bent, the only thing left is pain management."
Any doctor can write prescriptions for pain medications, but physiatrists, neurologists and anesthesiologists are the specialists most used to it.
"As long as you follow the guidelines, you're OK," said Robert Winfield, a board-certified physiatrist with Riverside Orthopaedics. He noted the difficulties inherent in the field. "It's hard to try to figure out what to do with these patients. You're trained to listen to their needs," he added. "The empathy part wants to let me give you more."
Winfield has taken a few of Phillips' patients, mostly those whose primary care physicians are within the Riverside Health system. He has told other would-be patients that he will only treat them in tandem with an addictionologist.
Winfield said some of Phillips' patients were taking 10 times what he would consider a normal dosage, with no documentation as to why they were having pain.
"One who was referred was on 160 mg of OxyContin three times a day as well as short-acting 30 mg pills of OxyCodone four times a day," Winfield said. "That's like a cancer treatment in the last couple of weeks of life."
Salasky can be reached by phone at 757-247-4784.