Wednesday, August 18, 2004

Idaho suspends medical license of eye surgeon

Arizona and Utah medical boards also impose probation


By PAT MURPHY
Express Staff Writer

The Idaho medical license of the Wood River Valley?s only resident ophthalmologist, Dr. Stephen J. Gra-ham, has been suspended for five years for violations of the Idaho Medical Practice Act that involved prescribing thousands of medications for thousands of patients he hadn?t seen or examined.

In an unrelated matter, Graham also faces a Sept. 9 jury trial in 5th District Court in Hailey of a patient?s lawsuit alleging he lost sight in one eye following cataract surgery con-ducted by Graham.

This is the latest in a series of problems that have dogged Graham, 50, of Ketchum, in at least five West-ern states.

In addition to losing his Idaho license for five years and facing the lawsuit, Graham also:

 Has been placed on probation in Arizona and Utah by those states? medical licensing boards.

 Lost his federal registration to handle controlled substances.

 Has faced and settled patient com-plaints in Arizona, New Mexico and Colorado.

In the state disciplinary actions against Graham, Idaho, Arizona and Utah medical boards found he had prescribed medications to thousands of patients he?d never seen or exam-ined but only talked to on the tele-phone.

In exchange for his prescriptions, he was paid fees by Internet pharma-cies that filled the prescriptions.

For that, the Idaho Board of Medi-cine on June 11, 2003, suspended his license for five years. The board?s mission, explained on its Web site at www.bom.state.id.us/about/index.html, has the ?primary responsibility and obligation ? to protect patients through proper licensing and regula-tion of physicians and other health care professionals.?

If Graham applies for reinstate-ment of his license at the end of sus-pension, the board requires him to complete an ethics course, to provide any hospital where he practices with a copy of the suspension order, and to pay a penalty of $2,000 for any future violation of prescription regulations.

Idaho?s medical board action was followed a month later in July 2003 by a year of probation imposed by the Arizona Medical Board, which like-wise found in its own investigation that Graham engaged in the same business of collecting fees for Internet prescriptions without personally ex-amining patients. Arizona fined him $10,000, describing ?the conduct and circumstances? as ?unprofessional conduct,? ordering Graham to take 20 hours of ethics education as well as 20 hours of instruction in prescribing.

Graham agreed to the discipline in both states by signing consent agree-ments, although he denied the allega-tions of misconduct.

Then, reacting to the Arizona dis-ciplinary action, Utah?s Division of Occupational and Professional Li-censing also placed Graham on pro-bation for a year, beginning in No-vember 2003.

In a related action, the U.S. Drug Enforcement Administration in Feb-ruary this year cancelled Graham?s registration to deal in controlled sub-stances for patients.

Graham remains licensed as an optometrist in Idaho to provide eye examinations and prescribe eye-glasses. His license as an ophthal-mologist is valid in Arizona and Utah during his probation. Unlike oph-thalmologists, optometrists cannot perform surgery.

Graham maintains the Boston Eye Center in Suite 201 at 180 First Street West in Ketchum. His office manager said he also spends two days a week each in Arizona and Utah. She would not say whether he was working as an ophthalmologist or optometrist nor where he was working.

Messages left over a period of several weeks by the Mountain Ex-press with his office manager for Graham requesting comment were not returned. His Boise attorney, Richard Hall, also declined to comment on any of the disciplinary matters or the pending lawsuit by Dr. Jerrold Gold-man, a retired Sun Valley physician. Hall said his instructions to Graham also would be to decline any com-ment.

Graham was licensed in Idaho in 1997.

He also was licensed in 1986 in Massachusetts, where he performed his residency; licensed in 1989 in Colorado, where he?s now inactive; licensed in 1991 in New Mexico, where he also is inactive; licensed in 1997 in Montana, where he?s inac-tive, and in 1997 Utah and Arizona, where he is active.

In the Idaho and Arizona investi-gations into Graham?s Internet pre-scription activities, both state medical boards found he had written thou-sands of prescriptions for several thousand patients he had never seen.

In Idaho, Graham, according to the medical board?s investigation, issued at least 14,000 prescriptions to 3,544 patients from coast to coast, collecting $25 per prescription, ac-cording to documents of the state medical board. At that rate and based on the medical board?s estimates of the number of prescriptions he issued, Graham could?ve earned some $350,000 between March 2001 when he began the activity and January 2002 when it ended.

Graham, according to the board?s complaint, prescribed a wide range of pain killer medications through two Internet outlets, PrescribeUS.com and MyPrivateDoc.com. The outlets linked patients with Graham, who, according to the Idaho Board of Medicine, talked briefly on the phone with patients, then prescribed medi-cation. The patients were not neces-sarily suffering eye conditions.

Among the more than a dozen medications he prescribed were hy-drocodone, Fiortol, Butalbital, Am-bien, Plaquenil, Carisoprodal and Diazepam.

In a series of complaints naming recipients of prescriptions throughout the nation by initials only, the Idaho Board of Medicine said Graham:

 ?... advertised the practice of medi-cine in an unethical and unprofes-sional manner.?

 ?... allowed others to use his li-censes to practice medicine when they are not authorized.?

 ?... provided health care which fails to meet the standard of health care provided by other qualified phy-sicians in the same or similar com-munities.?

 ?... engaged in Internet prescription of controlled substances for various patients without personally examining the patients or conducting any lab work or radiologic studies.?

 ?... shared or split fees with non-physicians in exchange for referrals.?

 ?... prescribed or furnished nar-cotic, hypnotic, hallucinogenic, stimulating or dangerous drugs for other than treatment of any disease, injury or medical condition.?

Although denying the allegations, Graham signed a stipulation that waived any rights to a hearing, ac-cording to the medical board. He did so, the suspension order stated, ?to buy his peace and to avoid the costs of litigating.?

In Arizona, the state board alleged that Graham, while working for Pre-scribus.com (spelled differently from that in Idaho records), wrote 10,723 prescriptions for 3,558 patients be-tween March and December 2001. Total dosage, according to the con-sent agreement on file in Arizona, amounted to 692,855 doses. Graham is said to have been paid $20 to $25 per prescription, suggesting his in-come at $20 per prescription could have been at least $214,460.




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