The biggest drug bust in the history of the state of Kentucky took place last week. Aptly named “Operation Flamingo Road,” it was the culmination of a three-year, multi-agency investigation into the bustling “pill pipeline” that stretches from the pain clinics of South Florida to the hills of Kentucky. More than 500 arrest warrants were issued and so far more than 300 people across 34 counties were snared in this sprawling roundup.
A tsunami of pills from Florida is flooding Appalachia but so far it is unclear if any out of state doctors have been charged in this investigation. As Darren, Mariana and I learned shooting The OxyContin Express, it’s much easier for law enforcement to go after addicts and street level dealers than the doctors who prescribe the pills. We had difficulty getting to the doctors too. Mariana endured multiple hang-ups when she called for an interview and none of them would speak to us on camera. We were chased from a clinic within a matter of seconds of attempting to film from across the street.
Producing a story under these circumstance means you sometimes have to get a creative with how you film and report it. In addition to the hidden pen camera, there’s Craigslist. The website is often a useful tool when it comes to finding characters but here it provides a window into the economics behind the pain clinic boom underway in South Florida.
An Ad from Craigslist
It’s hard to believe that most doctors employed by these clinics are making half a million dollars a year for working two days a week, but with the volume of patients seen and the number of pills sold, it’s safe to say that many clinics are flush with cash. A busy clinic can handle up to 60 patients a day, each of whom pays an average of $500 per visit, making Florida’s pain clinics, which don’t accept insurance, cash-only cash cows.
Many states don’t allow doctors to dispense the drugs they prescribe, except in small amounts or in emergency situations, because it creates a medical and financial conflict of interest. But in Florida, where doctors prescribe oxycodone at a rate that is five times higher than the national average, this is legal. Most clinics are equipped with in-house pharmacies and are able to dispense medication onsite, which is why many of the job posts on Craigslist, like this one, are for doctors who have or can obtain a dispensing license.
An Ad From Craigslist
This ad is also interesting because of what it doesn’t mention as a requirement, namely experience in pain management. One former addict we interviewed in Florida said he is the only guy he knows that has been to a gynecologist. This doctor happened to be the physician he saw at a pain management clinic at the height of his addiction. We were also told that clinics often bring a doctor with a DEA number out of retirement to work at a clinic part time, which might explain why many of the ads on Craigslist use the work-to-compensation ratio to attract MDs:
An Ad From Craigslist
Florida is home to the top 50 dispensing physicians of oxycodone in the country and in the last half of 2008 the state’s dispensing doctors prescribed 85% of all the oxycodone distributed by physicians nationwide, primarily through pain management clinics in South Florida.
The number of clinics in the southern part of the Sunshine state more than tripled in 2008 and in Broward County alone there are over 100 “pill mills” operating out of strip malls, former travel agencies and even the occasional refurbished fast-food restaurant.
If you’re not a doctor, you can still get in on the boom because you don’t have to be a physician to own a clinic. A clinic in Palm Beach County is going for $120k and can be fully staffed and operational in three months. Serious inquires only though and you better act fast. I just called the number listed in the ad and I was told that an offer has been made.
Recently on the Vanguard Blog:
All you ever needed to know about Vanguard, and then some. – Mariana van Zeller
Kentucky Targets “The OxyContin Express” – Mariana van Zeller
A Shout-Out to Interns Everywhere – Tracey Chang
The economy is growing again. Where does that leave you? – Mitch Koss
Fallen Soldier – Lauren Cerre
November 2nd, 2009 at 10:22 pm
Although I agree with the idea of making sure doctors don’t overprescribe meds, you are wrong in the statement: “Many states don’t allow doctors to dispense the drugs they prescribe, except in small amounts or in emergency situations… “. The fact is that MOST states allow physician dispensing. You also go on to say that it is not allowed “because it creates a medical and financial conflict of interest”. That is not factual either. That is perception that is not substanciated. The reality is that MOST doctors dispense because it is a convienence to their patients, it increases compliance as well as reduces the chance for errors. Can it be corrupted by a few inscrupulous doctors, sure but the majority of the good guy/gal doctors are providing a much needed service.