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Reader Response: Are Pain Management Clinics that Advertise in the Alternative Weeklies Legit? Print E-mail
Written by Jeffrey Herschler   
Sunday, 18 September 2011 15:13

I worked in the advertising department at New Times in the ‘90’s.  I don’t recall a single pain management clinic advertising at that time.  It’s a little like the twilight zone when look at these ads.  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 new services.  And all of this is being done in the open by licensed practitioners with prominent street signage, billboards and print campaigns.  
-Advertising Executive, Ft. Lauderdale

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.  These are the same people I try to screen out during the new patient scheduling process.
– M.D., Broward

10 years ago there was more of a mix of really damaged people; whether military veterans or people who were just plainly hurt. These were people whose pain was physically evident. Many of these people could not afford real pain intervention doctors or had become addicted to their pain medication. Pain meds are extremely habit forming.  They came to us to get a bi-annual MRI or CT if there was metal in their body and often times there was. So it was largely real pain patients who came for MRIs back them to justify the continued prescription for Pain Meds. But there was no control to how many doctors patients can see for meds and the opportunity to abuse the drugs is easy.  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 codeine to sell.  This is when the business became swamped with more clinics and out of state "patients".   
-IDTF Owner, S. FL

These clinics would not be advertising in the weeklies if they weren't getting the patients, that's the bottom line. 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, so whether they are legitimate or not it doesn't matter. It's like the ads for all the escort services and massage places in the sports section.
-Healthcare Technology Executive, Miami

Right. But are there enough legitimate cases of chronic pain in the Broward population that one newspaper in that community has over thirty advertising clients to serve this single category?  Where did this epidemic of chronic pain come from?                              
-Healthcare Executive, Dade County

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. I think you will find there are significant profits to be had with life long volume in repeat biz.  The specialty was created in answer to shrinking margins of anesthesiologists due to managed care
–Healthcare Consultant, Miami

In my view, a legit client would want to distinguish themselves from these other clinics that may or may not be 'pill mills'.  So I would recommend they find other avenues for marketing.
–Practice Manager, Broward

Most of those " doctors" advertising in these newspapers are looking for cash paying customers willing to pay any fee to obtain a prescription narcotic. These  "doctors" issue any prescription for any drug at any desired quantity. I have called and will call those doctors drug dealers in white coat. They should not be confused with a legitimate pain management specialist who applies multiple treatment modalities to treat pain. We must undertake all efforts to stop those pain mills. They serve no legitimate medical purpose.
-M.D. Miami-Dade

Interesting question. Years ago I owned several pain clinics. The answer is yes they would get value, but at what price?  The pain clinic would receive patient traffic from majority of patients "shopping" for prescriptions. Any real pain physician would not advertise in those papers. They would rely on referring docs (ortho, neuro).  Pain docs and pain clinics have such a bad reputation and for good reason, especially Broward County.  South Florida prescribes more pain meds than the entire country.
-Practice Management Consultant, Miami-Dade

Last year I was an IDTF Marketing Rep calling on the Pain Doc’s offices.   Here is what I remember:  parking lots full of revelers, (is this the doctor’s office or a tailgate for a UF football game?),  seeing the same “patients” in multiple doctors' waiting rooms on the same day,  the truly scary scene where a motley crew of tattooed low lifes and dazed & pierced hipsters were about to riot because the doc’s offices was locked up with a note saying the good doctor was on vacation (probably in the Caymans making a deposit in his offshore account).
– Healthcare Professional, South Fl

I know many of these pain clinics are nothing but drug suppliers no different from some guy on a street corner so I imagine the demographic for these publications is very much their target audience. But with that, a lot of people who have ‘legitimate’ issues will also go to them.  It stands to reason that younger people have more pain needs (that require pain management) than older folks.  They have car accidents, sporting accidents, back problems, etc.  The old-old have chronic pain, but not generally in need of pain mgmt, per se. Finally, we have a pain clinic in our building, and the jury’s out on how legit they are.  In terms of patient traffic, we see many more young people (25-45, probably more 25-35) than older folks.
-Practice Management Consultant, Broward

As is usually the case with most seedy industries, there is probably a small kernel of good that pain management businesses can do.  My guess is that it doesn’t generate enough net income to sustain a business so honest folks looked elsewhere.  After discovering the prescription/seedy side of the business, these people started making good money because it probably legitimately helped some folks.  When others saw this, they started jumping in and milking it for all that it is worth.  After 10 or more years operating like this, the industry ends up where it is currently.
-CEO, Radiologic Services Firm, Miami-Dade

Last Updated on Thursday, 22 September 2011 10:02
Florida Docs Blog Print E-mail
Written by Bernd Wollschlaeger, MD   
Thursday, 15 September 2011 09:46
A progressive viewpoint and healthcare vision....

PDMP Goes Online! 
Fla. prescription database goes into operation.

United Health On the Move
United Healthcare will acquire the management arm of Monarch HealthCare, an Irvine, Calif., association that includes approximately 2,300 physicians in a range of specialties.  This serves as an example of how lines are blurring between insurance companies and health-care providers.

Pill Mills Under Pressure

Accomplishments made despite the initial resistance by the current administration in Tallahassee.

                       Reader Response, click HERE.  
Last Updated on Thursday, 15 September 2011 09:50
Why Rep Ryan's plan doesn't go far enough Print E-mail
Written by Tara Pihn   
Wednesday, 07 September 2011 16:24

OK.  Let's recap.   There has been a lot of talk about unfunded liabilities and monstrous debt accumulation by the US government.    We've known this was coming (for at least the last thirty years) but there has been little political appetite by either party to face the music.   The Great Recession (and the easy money policy response) exacerbated the problem and our leaders decided to finally address it.   The Bi-Partisan Debt Commission recommends over $4 trillion in budget cuts (over ten years) with heavy hits to entitlements.  But these recommendations are not adopted.  Nothing happens.  The 'Pubs engage in a bit of brinkmanship and refuse to raise the debt ceiling.  Meanwhile the Ryan Plan recommends an austerity plan ($6.2 trillion in budget cuts over ten years) that includes re-shaping Medicare.  He is careful to exclude citizens over 55 (he states in the WSJ on April 5 "But because government should not force people to reorganize their lives, its reforms will not affect those in or near retirement in any way.").  The Dems deride Ryan's Plan and staunchly stand up for all citizens and the Medicare benefits to which they are entitled.  Rep Ryan's Path to Prosperity is promptly tabled since Progressive and even moderate Republicans won't support it.   At the 11th hour, the debt ceiling deal goes through with massive budget compromise.  Only $2.4 trillion is cut, some of it fake.  Nobody is impressed.  Including S & P.  Downgrade in US credit rating results.  Then we have a global financial market meltdown.
It is allegedly extreme but in reality Rep Ryan's plan doesn't go far enough.  We have to cap Medicare benefits now, for everybody.  For those over 55.  For those over 60.  Hell, for those over 70.   To quote the Prez, "we all need some skin in the game".  Now, before relegating me to the lunatic fringe, click on this link: US BIRTHS 1947-1964.  As you can see the Demographic Bulge is happening right now.  It's peaking right now.  The people enjoying benefits and about to benefit are hitting their maximum numbers over the next decade.  That's why it is Mission Critical to reform Medicare immediately with no Sacred Cows.

See related article from the New York Times:  Federal Budget (2011 and 2012) - Obama and Ryan Budget Plans

submit a READER RESPONSE for possible publication.

Give Me Liposuction or Give Me Death Print E-mail
Written by John Leighton Esq.   
Wednesday, 31 August 2011 17:35


Another incident of death on the liposuction surgery table has occurred.  It is outrageous and must be stopped. How can so-called rejuvenation centers continue to get away with multiple incidents of catastrophic injures?

With South Florida a Mecca of cosmetic surgery facilities, more needs to be done to ensure the safety of patients undergoing procedures. Lack of licensed medical personnel, botched surgeries and improper procedures resulting in seizures, vegetative states and death are occurring all too frequently.  And Florida does not even require these health care providers to carry any liability insurance.

Before undergoing cosmetic surgery, a patient should research their physicians and any medical facility online to check for prior claims and what insurance is maintained.  They should also speak with friends and colleagues to check out the credentials of the provider and learn of their reputations.  Much can be found online through the Florida Department of Health.

If you have a story of catastrophic cosmetic surgery, send your comments to

Mr. Leighton is the Managing Partner of Leighton Law.  Contact him at 888.395.0001 or visit

                                  Reader Response, click
Last Updated on Wednesday, 07 September 2011 16:29
Insurance Industry "Concerned" About Mandatory Adoption of Health Policy Summary Form Print E-mail
Written by Bernd Wollschlaeger, MD   
Wednesday, 31 August 2011 17:16


A recent article in WSJ reports that, as part of the health-care overhaul law, federal regulators will unveil the proposed health insurance policy summary form.  This will lay out the details of each policy, from deductibles to how much it might cost to have a baby. The requirement is supposed to take effect next March.  Currently, states mandate certain disclosures from health insurers, but they vary by state. The information often comes as part of a document known as the certificate of coverage or evidence of coverage, which can run to dozens of densely written pages and is often supplied ONLY AFTER a consumer has signed up for a policy. Employers offering coverage typically provide materials to their workers, but these also don't follow any common national format. 

The proposed new summary is expected to closely follow a draft version from a committee convened by the National Association of Insurance Commissioners, people with knowledge of the matter said.  Health and Human Services is expected to finalize the form after a public comment period. Insurers said they were concerned about the potential cost and administrative burden of the new requirement, particularly if they have to create different iterations of the form for every possible plan design a consumer could explore and for every single employer.

"Insurance companies will make every effort to maintain the status quo, which disenfranchises the consumer." 


Of course they are concerned because for the first time the policies will be readable, comparable and can form the basis of rational decision making in a complex market place.  Who does understand his/her current health care policy? I don't!  I still struggle to understand how much my insurance will cover for a colonoscopy and how much I have to budget for this procedure.  If we want a free market place then we should allow for measures that create accountability and transparency.  Currently, insurance companies will make every effort to maintain the status quo, which disenfranchises the consumer.  We should support this new federal regulation and express our opinions during the public comment period.  Let's not miss this opportunity.  
Comment on this Story       
Last Updated on Wednesday, 07 September 2011 16:51
READER RESPONSE (late August 2011) Print E-mail
Written by Various Readers   
Wednesday, 24 August 2011 18:25

RE:  Entitlement Reform

In a recent article about the Eurozone, the author stated "The high government debt loads threaten to trap countries in a vicious cycle: The debt weighs on economic growth -- and austerity measures aimed at attacking the debt only put a further drag on their economies."  This is the reality for the US as well.  Remember too that the government will choose cuts to providers as more politically practical than cuts to beneficiaries.  Although in the end both will suffer a lot.

Healthcare Consultant, N. Miami

RE:  Pay Per Call Arrangements

I would point you to FL Statute 817.505 which prohibits pay-per-call arrangements in Florida.  There is an exception for "referral" services under section (3)(i) of this statute, but even this exception prohibits linking a fee to substantive lead, as this could clearly be interpreted as "...based on the potential value of a patient or patients..." (Which is prohibited under Section (3)(i) 4. of the statute.

Healthcare Banker, Broward County

Click HERE  to submit your comments to Reader Response

Last Updated on Wednesday, 24 August 2011 18:37
READER RESPONSE (early August 2011) Print E-mail
Written by Various Readers   
Wednesday, 10 August 2011 10:27

Regarding Examining the Demographic Bulge and the Dynamics of Capitalism:  Why the Pundits are too Gloomy

Well said. I also remain confident. There is no movement without friction. Every generation has had its obligation to overcome immense obstacles at long odds.  America may get a downgrade from S&P and Moodys, but I remain bullish. I think most of us are positive even with the bad news. It's part of our American DNA.  -IDTF Owner, Miami

Regarding ASK BEN

Thank you for publishing Mr. Frosch's columns.  His advice and insights are invaluable. -Practice Administrator, Orlando
Last Updated on Wednesday, 24 August 2011 18:36
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