Opinion ID: 3153469
Heading Depth: 3
Heading Rank: 2

Heading: Dr. Azmat’s Role

Text: Dr. Azmat was the only doctor working at the clinic at its inception. He began on February 21, 2011, and was terminated on March 18, 2011. According to Wise, the office manager at East Health Center, Dr. Azmat was aware of the clinic’s marketing techniques because they were openly discussed within the office. Dr. Azmat knew that patients paid in cash and saw them congregating in 9 Case: 14-13703 Date Filed: 11/10/2015 Page: 10 of 60 front of the clinic. Wise paid Dr. Azmat in cash each day “[f]rom the daily take of whatever came in.” Furthermore, according to Wise, while Dr. Azmat may have been unaware of the terminology or the particulars of the financial arrangements, Dr. Azmat knew that “sponsors” would bring groups of patients to the clinic. Wise explained that “sponsors” were pill seekers who would pay for patients’ appointments in exchange for a portion of the pills prescribed during the visit. Wise had entered a guilty plea related to his involvement in the clinic. LeFrancois testified that he fired Dr. Azmat primarily because Dr. Azmat did not give patients what they expected to be prescribed, and pharmacies were refusing to fill his prescriptions. Wise confronted Dr. Azmat about why he was reducing prescriptions, and, according to Wise: Dr. Azmat would get frustrated and explain that it was his license on the line, that he wasn’t going to do what they wanted him to do, and he would increase the patients’ prescription on their next visit. He wanted to show that they weren’t starting off at a high amount. He wanted to show that they were getting less than what they were getting at a previous clinic. Barbuscia similarly testified that patients were angry that Dr. Azmat was not writing heavy enough prescriptions. Aside from issues with the prescriptions, LeFrancois was also upset that Dr. Azmat was refusing to treat patients seeking primary care because he did not have the proper medical malpractice insurance. Afthinos added that the clinic 10 Case: 14-13703 Date Filed: 11/10/2015 Page: 11 of 60 directors were angry that Dr. Azmat was spending 15 to 20 minutes with each patient, which was too long. The negative feelings against Dr. Azmat were compounded by the fact that he was an outsider to the group who had previously worked together in Florida.