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UD r a rn wo X ZJ A m a X rm m< fl. r+ �n 1 Patricia L. Morgan 17D From: Mitchelllan [lanMitchell @colliergov.net] Sent: Thursday, December 16, 2010 8:39 AM To: Patricia L. Morgan Subject: FW: Attention: Commissioner Fred Coyle Attachments: Comments before the Collier County Board of Commissioners 14 December 2010.doc Regards, Ian Mitchell Executive Manager, BCC (239) 252 -8097 phone (239) 252 -6406 fax ianmitchell @colliergov.net From: nopainenogain@comcast. net [ mai Ito: nopainenogain(abcomcast.netl Sent: Wednesday, December 15, 2010 8:42 PM To: MitchellIan Subject: Attention: Commissioner Fred Coyle Dear Sir, Yesterday I was one of the speakers addressing the Board in Reference to the proposed moratorium on "pill mills." Commissioner Coyle requested a copy of my comments which are enclosed. Please forward to him these remarks as well as my email address. I am available should he require any further information. Thank you for your assistance in this matter. Gregory F. Paine, M.D. Comprehensive Pain Center of Naples 11161 Health Park Blvd Naples, FL 34110 239 - 436 -6711 nopainenogain(a),comcast. net �orid,. ,,i v e tt�aN ;0d ,,, d(3 i,e InI rt1_,r e I i ad i a' . u ,r,I 4 �n r, ,r;, 1`,t ±o a p ubl e, re o!(IS rYq,u sI d« ",«( ser,,i e rt4v k!! tt gad " , 'r, =. , t'-re o" 17D Comments before the Collier County Board of Commissioners 14 December 2010 Gregory F. Paine, M.D. Good morning, my name is Dr. Gregory Paine and I am a board certified anesthesiologist, fellowship trained and board certified pain specialist and am representing today both the Collier County Medical Society as well as the Lee - Collier County Chapter of the Florida Society of Interventional Pain Physicians. I have lived in Collier County for five years and previously served in the U.S. Navy and was the Assistant Pain Fellowship Director for the Navy's only Pain Management Program. I bring the military ethos to my practice. We as physicians have seen firsthand the carnage caused by the rampant spread of prescription substance abuse and welcome the opportunity to partner with law enforcement and local government to eradicate this problem in our community. However, the urgency for action must be balanced by a wise and prudent course of action. In principle, we support the institution of a moratorium of new pain clinics in the county as an emergency measure until a reasonable and effective ordinance can be formed. The ordinance must not impede the practice of medicine, but rather prevent the establishment of criminal enterprises who operated under the guise of providing medical care. We must allow law enforcement the tools to arrest and be able to prosecute those trafficking in narcotics. Unfortunately, the current language in the moratorium creates a few problems. The physicians who are working act at the pill mills are medical charlatans who will morph and find loopholes in whatever rules are passed as we are already witnessing with the S.B. 2272. For example, Pain Clinics are changing their branding to that of a Family Care or Urgent Care practice, and some are even offering injections (interventional pain procedures, not injections of narcotics) or physical therapy on site. The reality is that their patients are only interested in medical management, that is obtaining their pills and want nothing to do with injections or physical therapy. The moratorium will not halt those physicians masquerading as another form of practice from continuing to operate as a pill or prescription mill. Additionally, no protection is provided to existing physicians who may have their group practice disband or wish to expand or move their practice to another location. Some means of protection should be included in the language of the moratorium to accommodate these concerns. Medicine is the highest regulated profession and we as physicians do not want any further regulation as it adds to our ever increasing overhead while our reimbursements continue to decline. We ask the Board of Commissioners to allow us to help write, edit and have comment on any future ordinance to be brought before the Board prior to it becoming an agenda item. We need sufficient time to act and provide valuable input to create an instrument that is in the best interest of patients, physicians, law enforcement, government and the citizens of Collier County. 17D 3 > r '0 z m m ^iv 3!" rn co m 2 N m y � v n c TO 0n Pt 1 61 n 0 13 72> o m D z s 3rn (I n m u�irn O rn m ~ j v 3 rn D X - F O 7i cl m ~ ~ D „„= m 3 xzrn PI z O � Dz a Z Z i � F< O _ ►'�� m r N m i co a w mW � 1 ` r co n ,-, - rn G� w m 3 z' ITI Z D -I 0� 3 l ` X O El z r m = crni) p O co � m 70 Dew 1 ', p v 0 � z < v a c ° i_ o } �RO11 co n -i o 0 \mil fl 2 0 = zD n Nt-1 m rn � z \ c� rn CO -I > -1 N� 3 to O 6622 p z 3 -l ° m 73 a c z g Q i N n .a O z � 22 70 rl• m a o, � (C (D p p rno� 1 � _ -.i m o7arn 3 O u ° vA ) 1* RI o z r7, tD -I - �` C m m 3W -I �l 0 rn '1 _ 7-1731- x- m N p C _O Z m 'a = o� c a X `CD tD r 170 ... n (f) n 7J n 3DO > m m /'\ m .� �;- m m z 73 3 C 000 = a ni r- m m � ^ z as N 3 a m ~ ∎ z 'f �" O = 00o o rr rn (,.:) iv 3 m rn � z f O O z T • .-E 1-1 z .-I * z z 2 -i = .� o 72 m m m _1 Or oN- -0 N > m W w 2 r r- zW 0 r z D � rn rn c� 0 'I. m OCr XI i O o mo v a 0 0 0zo v° u u) n C D c x m N 0 —ip � z 3 = zDZ cn 7 = 3 m.6") z n m co con • 0 0 > v m 3 -Ir 0 > a 0 0 -A. a CD z 3rcor, ca O � 3z %. 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