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

Heading: Recruiting Physicians

Text: Dr. Mary Kay Ross testified that, in February 2011, she responded to the advertisement recruiting physicians to work part time at East Health Center. Dr. Ross set up a lunch meeting with Clark and LeFrancois, who told her that doctors working at the clinic would dispense pain medication to patients in, what she felt, were “very, very large amounts.” They explained that the clinic already had out-of-state patients waiting for appointments, and the patients knew what medicines they would be prescribed. Dr. Ross asked about medical malpractice insurance, and Clark and LeFrancois stated that they had no need for it. Dr. Ross also observed that neither Clark nor LeFrancois had medical backgrounds, yet they owned a clinic and were well versed in pain medication. After lunch, Dr. Ross contacted a law enforcement official because she thought it was odd that the clinic would dispense 150 to 190 pills at a time and that patients would come from out-of-state for pain management. Dr. Ross stated that she was sensitive to “drug seekers” based on her previous experiences working in an emergency room. However, Dr. Ross admitted that she was not board certified 5 Case: 14-13703 Date Filed: 11/10/2015 Page: 6 of 60 in pain management and that her perspective may be affected by the fact that emergency rooms provide for patients’ short term needs, while primary care physicians and specialists provide long term care. A narcotics officer suggested that Dr. Ross look at the clinic and “see what else there was going on.” Dr. Ross agreed and visited East Health Center, which she found to be “inadequate.” It was small, did not have many medical supplies beyond a scale and a blood pressure cuff, there was a safe from which medications could be dispensed, and there was no laboratory for processing tests. Dr. David Hatmaker, an emergency room doctor who was not certified in pain management, testified that he also responded to East Health Center’s advertisement. After electronically communicating with LeFrancois, Dr. Hatmaker visited the clinic, which he stated “did not meet [his] expectations.” Dr. Hatmaker described the facility as a “lower scale” clinic in a “less-than-attractive community.” There were no nurses and only basic medical equipment–nothing to read an x-ray or an MRI. Dr. Hatmaker met with LeFrancois at the clinic, and LeFrancois explained that East Health Center did not take insurance, accepted cash and credit card payments only, and would pay Dr. Hatmaker $2,000 per day in cash for his services. LeFrancois also stated that there was no need for medical malpractice insurance. The clinic’s primary purpose was “treatment with narcotics.” 6 Case: 14-13703 Date Filed: 11/10/2015 Page: 7 of 60 LeFrancois stated that they did not advertise and wanted to keep a “low profile.” Finally, he asked Dr. Hatmaker to move his Drug Enforcement Administration (“DEA”) number to the clinic so that he could bring narcotics to the facility and dispense them directly to the patients. Dr. Hatmaker also testified that he met Dr. Azmat during his tour of the clinic. Dr. Hatmaker watched Dr. Azmat examine a patient in a cursory fashion and then prescribe four narcotic prescriptions. Dr. Azmat told him that some patients came from out-of-state to visit East Health Center. After this meeting, Dr. Hatmaker called a friend at the DEA to suggest that law enforcement look into the clinic because it did not appear to be legitimate. On cross-examination, Dr. Hatmaker stated that the clinic was not directly dispensing medication at the time of his visit. Thus, Dr. Azmat began working at East Health Center at some point prior to Dr. Hatmaker’s interview. LeFrancois testified that he and Dr. Azmat communicated about the open position by phone and email. LeFrancois told Dr. Azmat that he would be paid $2,000 in cash each day for pain management services. LeFrancois explained that the patients would be from out-of-state and would be expecting oxycodone. LeFrancois also mentioned his experience at the Florida pill mill and stated that East Health Center would be the same type of operation. Dr. Azmat told LeFrancois that he had experience in a pain 7 Case: 14-13703 Date Filed: 11/10/2015 Page: 8 of 60 management facility, held multiple DEA licenses, and would be able to “take care of everything.”