Four-and-a-half years of disruptive and needless litigation primarily showed that the State Medical Board (SMB) was: (1) without competent pharmacology knowledge as demonstrated by their referral to Adipex as an amphetamine in their complaint and (2) possessed an inability to determine appropriate medical therapy for the treatment of obesity. The Honorable Commissioner, John J. Kopp, had no difficulty understanding the FDA-approved therapeutic options for obesity.
One might wonder why the Honorable Commissioner is more knowledgeable about the medical care of patients than a group of eight physicians. Such reckless litigation by the Board of Healing Arts is but one of many examples of egregious government waste, it is abuse of good doctors, it does nothing to protect the public, and the SMB's actions may even be harming the public.
Comments and suggestions are welcome.
For clarity, Adipex is the trade name for the generic drug "phentermine."
Phentermine does have some actions similar to amphetamine, but one would expect a group of physicians to know that
"Phentermine is a natural monoamine alkaloid derivative and a sympathomimetic stimulant with appetite suppressant property. Phentermine, which was part of the Fen-Phen anti-obesity medication, stimulates hypothalamic release of norepinephrine, a neurotransmitter involved in stress responses (fight-or-flight reactions), and reduces hunger sensation. Phentermine also causes the release ofepinephrine or adrenaline outside of the brain, resulting in breakdown of stored fat.
The d-form of AMPHETAMINE. It is a central nervous system stimulant and a sympathomimetic. It has also been used in the treatment of narcolepsy and of attention deficit disorders and hyperactivity in children. Dextroamphetamine has multiple mechanisms of action including blocking uptake of adrenergics and dopamine, stimulating release of monamines, and inhibiting monoamine oxidase. It is also a drug of abuse and a psychotomimetic.
Even though Dr. Pakson did not prescribe the patient S.K. "amphetamine," the SBRHA claimed that he did.
The SBRHA also claimed that Dr. Pakson inappropriately prescribed the medication for the treatment of obesity.
Since the case was archived, and removed from the Administrative Hearing Commission (AHC) website, I wanted to make the case publicly available and easily accessible so that we can learn from the mistakes. I thought this especially important since the Board left their list of complaints on the AHC website, but removed the Honorable Commissioner's verdict. Such a presentation of information is potentially misleading about the alleged justifications for the disciplinary actions by the Board. Four-and-a-half years of litigation with the filing of numerous untrue claims about medical care in court is simply mind-boggling. No patients were helped or made safer by the Board's actions... Anyone can evaluate a case about a doctor that sexually abuses a patient. It doesn't take a medical degree to realize that such as person should not be placed in a position of authority over patients. However, when it comes to the technical matters of the practice of medicine, the Board should be able to determine whether care was appropriate. Instead of identifying deficiencies in Dr. Pakson, this case presents numerous examples of clinical knowledge deficits of the Medical Board.
Evidence-based medicine isn't opinion-based medicine. As the practice of medicine shifts further-and-further from opinions to evidence, we might be prudent to ensure that our regulations shift from "expert opinion of Board Members" to "evidence." In this case, as in Dr. Adem's case, the Honorable Commissioner was more adept at determining appropriate medical care than were the physicians on the Medical Board. It appears that the Board members relied on their inaccurate pharmacology and obesity treatment opinions. In contrast, the Honorable Commissioner relied on a combination of evidence-based medicine as well as expert opinion. When those two are used together, persons with no medical training have repeatedly demonstrated a fund of clinical knowledge that is significantly superior to that of the opinion-based Medical Board.
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