Alt Weeklies: Pill Mill Enablers? Print
Written by Tara Pihn   
Friday, 30 September 2011 00:00

I Read the News Today Oh, Boy!

Earlier this month I read Bernd Wollschlaeger's post:   Pill Mills Under Pressure.  It's an upbeat article highlighting recent achievements in shuttering pill mills and "choking off" the supply of prescription drugs being sold illegally in Florida.   So feeling cheery, I decided to break for lunch.  I grabbed a copy of the Broward/Palm Beach New Times as my meal companion.   I enjoy the feature articles exposing local government corruption, the events calendar and the restaurant reviews.   And I must admit I sort of like the Savage Love column.

So there I was eating a sandwich and a bag of chip and I couldn't help noticing that there are a lot of ads for pain management clinics.  For example in the September 8 edition of Broward/Palm Beach New Times, there are 36 ads for clinics and physician offices offering pain management services.  Sadly and perhaps ironically, there are also several ads offering to treat opiate addiction.  I also see ads for very inexpensive MRI's, less than $200 (more on this later). The other alternative weeklies in the area, Miami New Times and City Link, also run these ads.  And these ads look very sleazy.  Click HERE to watch a video.  One clinic offers pain management services with "NO LIMIT".  Another beckons new patients with this message:  "Has Your Doctor Closed?".  Others will "Meet any Competitors Offer" or deliver "Full Service Pain Management".

These papers have wide circulation in the 25-45, single, urban lifestyle demographic. According to my sources these ads cost $200-$850 per week. Trying to keep an open mind, I thought, perhaps, these operators are legitimate and providing some benefit to the community. But would a legitimate operator get value from this type of marketing expenditure?   To this type of audience?  And if they are not legitimate, could they operate openly by running ads in the alternative weeklies?   

I needed feedback from some experts. So I asked my pal, Jeff Herschler, Publisher of FHIweekly and, if he could survey his audience.   The survey response was remarkable. Some evaluated the situation from a completely economic view point by calculating a hypothetical ROI.  "Assume a $70 gross rev per visit with 40% margin. Do the math for the cognitive component excluding the technical component and other mark ups..." one Healthcare Consultant wrote. Others were pragmatic, suggesting clinics could meet the letter if not the spirit of the law.  "There is so much scrutiny on these clinics now I have to assume they are doing everything possible to make money and avoid the authorities" a Healthcare IT Executive stated.  But most of the respondents felt the clinics were at best barely legal with serious moral and ethical issues:

"Some of the same clinics are advertising pain management and addiction treatment.  So the suppliers are meeting the demand and in that process creating demand for a new service."   Advertising Executive

"The ease of getting these drugs eventually brought in real druggies who gamed the system in order to get pills to consume or sell. Come here and see a few different pain clinics and a drug dealer can get lots of oxy codone to sell."   IDTF Owner

"The readers of New Times who pay attention to (respond to) pain clinic ads are generally interested in pain meds and other controlled substances for non-medical (abuse, profit) purposes."   M.D. Broward
"I have called and will call those doctors drug dealers in white coats. They should not be confused with legitimate pain management specialists who apply multiple treatment modalities to treat pain. We must undertake  all efforts to stop those pain mills."  M.D. Miami Dade

"Any real pain physician would not advertise in those papers."   Practice Management Consultant, Miami Dade

"I remember....,  the truly scary scene where a motley crew of tattooed low lifes and dazed & pierced  hipsters were about to riot because the Doc's office was locked up with a note saying the good doctor was on vacation (probably in the Caymans depositing some cash)."     Healthcare Professional, South FL 

Submit a READER RESPONSE for possible publication.

In sum not a single respondent believes legitimate Pain Management Clinics would or should advertise in an alternative weekly.  Oh, and what about those $199 MRI's?  According to a healthcare professional familiar with the economics of imaging in Florida, "It is hard to imagine earning a profit on an MRI at $200 after subtracting the cost of capital, rent, materials, the tech and the read." Legitimate IDTF operators have long believed these rock bottom priced MRIs are shoddy or even counterfeit studies. To get a scrip the patient needs a study in his chart.  But that film might not be his or her body part.  Thus the pill mills have apparently spawned a cottage industry of questionable MRI providers. 
This survey is hardly scientific.   However it does include a broad cross-section of the healthcare community in S. Florida:  men and women with the education, experience and geographic proximity to evaluate what's going on. Please follow this LINK to view the complete Reader Response. 

It seems reasonable to suggest that New Times, part of Village Voice Media, and City Link (Tribune Company) need to rethink who they are doing business with.  One could make the "Freedom of Speech" and "Victimless Crime" argument with regard to the Adult ads.  It's hard to defend the Pain Clinic ads.
In addition, it is apparent to me that if you are a law enforcement official charged with Pill Mill crackdown, finding suspects must be like shooting fish in a barrel.
Please Read this Report:

Prescription Drug Abuse in Miami-Dade, Broward, and Palm Beach Counties            (Thanks to the BCMA for providing)  
Please contact your Florida State Representative. 
The above link will take you to a web page that (after typing in your home address) will lead you to another web page where you can draft e mails to your State Representative.
Please write a Letter to the Editor:
Last Updated on Thursday, 13 October 2011 09:36