This book was generated out of the catastrophic events for my patients and me over the last 10+ years.
The Montana board of medicine from 2013 to 2015 conspired with National officials and perpetrated fraudulent findings.
The cost of this was a pyrrhic victory for me. The IRS seized my assets, the Dream Clinic Urgent Care Plus was shut down. These actions cost me $350,000 in legal fees, and my business and my building. These actions cast a pall over prescribing practices in Montana.
I tried to continue treating pain patients until Dr. Chris Christiansen, 78, was convicted of manslaughter in late 2017. It became clear to me that I was now practicing in a hostile regulatory environment, as the board of medicine reported me to the drug enforcement administration (DEA) and they came to my office to investigate me.
The agent said: “Dr. Ibsen, you’re risking your freedom as well as your license by prescribing to Patients like these.”
I said, “Patients like whom?”
They said, “Patients who might divert their pain medication.”
I said, “Isn’t that everyone?” (who might divert or sell their pain meds).
A 1989 cross-roads moment between my white coat and saffron robes, a kind of “Eat, Pray, Love” opportunity in India at an ashram, the leader, Gurumayi, guided me in a private audience:
“What if a baby would fall from the sky?” after noting my baby- faced appearance. And eight years later, my daughter was born.
Next traveling to Kolkata, where as a volunteer for Mother Teresa who described herself as “I am just a pencil in the hand of God.”
I incorporated this into my spiritual and medical mission, and newly emerging spiritual life. My comeuppance showed up like this: hotshot ER doc finds himself on the lowest rung of the hierarchy in an international location.
With Mother Teresa in Kolkata, I experienced the oppressive, grinding nature of poverty. I was blowing black stuff out of my nose every evening and black stuff out of my heart every day.
In the Ramayana, the epic spiritual Scripture of Hinduism, Lord Krishna declares to the warrior Arjuna, “Do your duty and surrender the fruits of your labor.”
In India, I had the opportunity to observe that Saints are not necessarily always surrounded by saintly people.
I was continuously confronted when given an assignment by someone. “Did this come from the guru or Mother Teresa, or did this come from your ego?” Ultimately, I decided it didn’t matter, and that I needed to love them all; let God sort them out.
Prior to India, the medical industrial complex controlled my agenda. It was all I knew. In India, I surrendered to Spirit. In the conventional medical model, I had attained a certain confidence.
Did I need to reinvent myself? To show myself that I could? To find a place in which I would?
In response to my query, DEA agent Addis said, “We are not doctors, we can’t tell you what to do.”
Yet, the charge of over-prescribing is evidence of their de facto practice of medicine, by imposing regulations without guidelines, citations, or evidence. And if I was guilty of over-prescribing, then so were all the doctors who prescribed for these patients before they sought my help.
I was more successful, according to David Scrimm, the administrative law judge supervising the hearings, than the government’s expert witness at weaning patients off of opiates. My success rate was 80%. I truly anticipated an award for this accomplishment.
I was exonerated after these hearings, proving that no patient was harmed, most were helped. Parenthetically, one bitter pill from this is that six of my patients died after losing access to my care, not before.
Despite the burden of proof put on me, I was able to demonstrate the treating of pain refugees was not illegal, in fact, it was crucial—a noble calling.
The courtroom loss and my vindication was a bitter pill for the board of medicine to swallow. To save face, their next mission creep was to sanction me for my documentation. Not only were the documents I gave them ultimately out of order, when I reviewed their notes, they criticized my handwriting as illegible. I responded only that “they’re encrypted.”
I was selected as the best doctor in Helena in 2014, and out of business by 2015.
What’s wrong with this picture?
Judge James Reynolds ruling in the District Court appeal, overruled the suspension of my license and found that the board of medicine violated my due process rights.
In 2016, I returned to India as a volunteer with Hands on Global, a local Helena non-governmental organization, (NGO), who were tasked with opening the hospital the Dalai Lama built in Zanskar. This is the last intact Tibetan civilization on the planet and while his Holiness wants the population to make progress in health, he also wants to preserve this precious ancient culture.
When the Dalai Lama came to inspect and celebrate the completion of the hospital, he came into the examining room.
He noticed the ultrasound machine I was using. He said, “Oh, ultrasound, I know this!”
I called his attention to two stuffed pillows I had brought with me; one a yellow Labrador Retriever, and one a kitty cat.
I said, “Your Holiness, we also have labs and CAT scans available!”
He responded, “Ho, ho, ho,” as robust as Santa Claus.
Love them all; let God sort them out, continues to inspire me. I have realized that self-pity and resentment are not my friends. As my recovery work progresses, I use more friendly slogans like let go and let God.
As a dog musher from 2001 forward, I also learned to let go and let dog!
After Dr. Christianson’s conviction on manslaughter charges, I saw the writing on the wall. Montana has become a hostile regulatory environment for me.
I retired from prescribing opiates.
Sadly, six of my patients died after losing access to my care. I welcome you to Doctor Bison’s Fables.
Dr. Ibsen has shown us the courage needed to take care of patients in this new world where the government decides which medications a patient is able to have. He has opened the door for us to see and feel the damage our government is inflicting on physicians who are desperately trying to do the right thing. Thank you too to Dr. Jay Joshi who has undergone similar trials and he too continues to fight for all of us. We are forever indebted to these incredible physicians!
I am ordering many copies of Dr. Ibsen’s book and they will be distributed widely to every physician and patient I can find.
I already intended to purchase your book Dr. Ibsen, once it is available in print. This prologue “cements” that decision. I expect the entire book will be just as an enjoyable and informative “read”. It will look good alongside Dr. Joshi’s excellent read, The Burden of Pain.
Looking forward to reading this. Thank you Dr Ibsen for ALL you do for the Chronic Pain Community and more!!
May the rest take note and see and actually understand what is and has been happening. This is a CHRONIC PAIN CRISIS, not a fabricated Prescription Opioid Crisis. Which has always been an Illicitly Manufactured Fentanyl Epidemic, brought on, with strict purpose, to harm the sick and weak.
If you haven’t been affected by this BS Crisis yet, you will, in some shape or form. You are all one vehicle accident, work injury or diagnosis of a painful disease away…. No one is immune from this. Millions of people can’t be wrong and millions of people are NOT addicted. But yet millions are abandoned, or force tapered to non therapeutic doses of medicine that has worked for thousands of years . Unlike alcohol, that has NO medicinal purpose what so ever. Just as many die from alcohol related issues. 2019, 93,000 deaths. Where’s the outrage in this?
This brings to mind an abandonment problem in my adopted Arizona. Two years ago our term-limited governor persuaded legislators to give away some of the State Opioid Settlement to fund a few group homes to kprovide transitional care to patients with serious mental illness. My friend Barby put a plan together that would use $100k from the State some private donations, and a lot food bank and other resources, to house and provide followup care to mental patients who had nowhere to go once discharged.
Psych diagnosis is a sticky wicket. When they get it right the first time, meds restore a lot of functionality quickly. When they don’t, other problems emerge. The patient with an intact family will get sent back for more help. The patient homeless in the street gets robbed of their psych medication, has ongoing stress, and eventually has another psychotic break that puts them back in the hospital. From a fiscal viewpoint, this is a dumb expensive state policy. Getting it right is better than having relapses merely in terms of money spent. From a medical erhics standpoint, preventing relapse is the humane thing to do. But the way our new Governor saw it, a bipartisan agreement had produce the bill on her desk. She did not think of it. She would get no political credit for it. So she vetoed it and keeps dumping patients back on the streets.
Her opponent in the last election, a former news anchor, took a camera crew out one Saturday to one of the camps full of homeless abandoned mental patients and discovered a woman with a conjoined fracture of the right tibia, who broke the bone fighting with robbers who took her medicine. She was in considerable pain and needed the ER, but delayed four days hoping someone would promise to feed her pet cat while she was laid up.
The candidate/news anchor, who grew up on a farm in Iowa, promised to care for the cat, gave the woman a ride to the hospital, and has been following up on the story.
Not everyone who serves the public actually cares about the people they serve. Thank you, Dr Ibsen, for caring.