Police haul away rural doctors

PIKEVILLE, Ky. - More than a dozen Appalachian doctors, many of them recruited to work in the medically underserved region, have been taken away from their patients in handcuffs for allegedly supplying drug addicts with powerful narcotics.

In eastern Kentucky alone, seven small-town doctors are in prison or on their way for illegally prescribing drugs like the painkiller OxyContin. At least six others have been arrested in the hills of West Virginia, Virginia and southern Ohio.

Advocates for the mountain region say that while the loss of so many doctors leaves a void, in these circumstances, the departures can only improve medical care.

"As badly as we need more physicians, we certainly don't need the type that will violate their oaths and do much more harm than good," said Ewell Balltrip, executive director of the Kentucky Appalachian Commission.

Federal and state law enforcement agencies began cracking down on wayward physicians in Appalachia in 2000 after OxyContin, intended for cancer patients and others suffering from severe pain, began showing up in large quantities on the black market.

The first eastern Kentucky physician snared in the crackdown, Dr. Ali Sawaf, 61, of Harlan, had turned to illegally prescribing OxyContin and other painkillers after he lost his $250,000-a-year job at a regional clinic.

Assistant U.S. Attorney Roger West said at the time that Sawaf handed out prescriptions almost as quickly as he could write them.

The latest physician to plead guilty, Dr. David Procter, 52, of South Shore, traded painkillers for sex. He admitted to a federal judge that he had sexual relations with two female patients after they became hooked on the drugs.

Most of the doctors caught in the past two years had been recruited to the region to help care for rural residents, said Assistant U.S. Attorney Pat Molloy.

"They may not have stepped over the line before they got here, but clearly they were corruptible," Molloy said.

Legitimate doctors have nothing to fear when they prescribe medications, Molloy said. The doctors prosecuted, he said, were flagrant violators.

The problem is not confined to Appalachia. A Florida doctor was convicted of manslaughter in the OxyContin overdose deaths of four patients. A Connecticut physician, nicknamed "Dr. Feelgood" by police for the prescriptions he wrote for OxyContin and other painkillers, was convicted last year on multiple counts.

Authorities blame abuse of OxyContin for scores of deaths in the Appalachian region and beyond.

If taken properly, the drug is released slowly into the body. But abusers circumvent the time-release by crushing the pills and inhaling or injecting the powder to get the same kind of euphoric high that heroin brings.

In an effort to get more doctors into rural Appalachia, area leaders got a medical school established in 1997. As of this month, the Pikeville College School of Osteopathic Medicine will have graduated 168 doctors.

The new doctors will immediately begin to narrow the physician-to-patient ratio, easily replacing the physicians who have been sent to prison, said Dr. John Strosnider, dean of the college.

Strosnider said he has no doubt that, as a result of the crackdown, physicians are more careful about prescribing OxyContin and other potent painkillers.

"They're leery that patients may be trying to fool them," Strosnider said.

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