Asbury Park Press

March 24, 2002 Sunday

Doctor’s abrupt departure stranded patients TOMS RIVER PSYCHIATRIST CHECKED INTO DRUG-REHAB PROGRAM



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IT was an office answering machine that told Judy Rivera that her Toms River psychiatrist, Dr. Debbie L. Miller, had temporarily suspended her practice.
Miller was on extended medical leave, the recorded message stated in late December, and it noted three telephone numbers patients could call in order to continue their care with three other psychiatrists.
Two of the doctors on the list didn’t know Miller and were not accepting new patients, said Rivera, 42, of Point Pleasant.
The third number was for a Chinese food restaurant, she said.
Unknown to Rivera at the time, as well as several other patients interviewed, Miller had entered a drug-treatment center in Pennsylvania and would shortly surrender her medical license for at least six months.
The patients said Miller’s departure left them without a psychiatrist and with few places to turn for continued care.
No one from the state Board of Medical Examiners, which regulates physicians, or the not-for-profit Medical Society of New Jersey, which helps impaired physicians recover from substance abuse, offered assistance or advice, Rivera said.
“It makes you not trust the medical field,” Rivera said. “They are supposed to protect us, but they are protecting drug-addict doctors.”
Three months later, Rivera still doesn’t have access to her medical records, which detailed her treatment and medication history. After failing to reach Miller, Rivera said she turned to her general practitioner to help wean her off the drugs Miller had prescribed for depression.
Miller’s patients suddenly found themselves without a psychiatrist when the doctor left her practice Dec. 21 and voluntarily surrendered her license on Feb. 13.
“I had to have the pills, you just can’t stop taking them,” said Rivera, 42. “I was angry, I felt deserted. I felt stupid, because in my gut I knew something wasn’t right.”
Sharon M. Joyce, acting director of the state Division of Consumer Affairs, which oversees the medical board, said she did not know Miller’s patients did not have access to their medical records.
But she said in other cases, Consumer Affairs has helped patients obtain their records. Joyce said patients in such a situation should contact the department at 1-800-242-5846.
Patients interviewed said they hold little hope of quickly obtaining their medical records from Miller. They would like to know why Miller was able to take over the practice of Dr. Richard Fort, a Manasquan psychiatrist who died unexpectedly just over a year ago, given Miller’s history of prescription-drug abuse and relapses since 1978.
In a prepared statement to the Press, the medical society said it and its Physicians’ Health Program, which treated Miller, “are NOT responsible for a physician’s medical records. If it is a solo practitioner, it would be the office manager’s responsibility.”
The only other person who in December worked in Miller’s East Water Street office in Toms River, her then-companion Maria Baldasarre, said she was exhausted and weak when Miller went into rehabilitation Dec. 21. A few days later, Baldasarre said she checked herself into Community Medical Center, Toms River, before leaving for Florida to stay with her parents. Miller was the only doctor in the practice.
The medical society said patient records are confidential and only can be released to another physician.
“It is PHP’s understanding that Miller’s attorney is handling the patients’ records,” the medical society said.
The state Board of Medical Examiners said Miller had no attorney in February when she surrendered her license. Spokeswoman Beth S. Rosenberg said that Dr. Louis E. Baxter Sr., medical director of the Medical Society’s Physicians’ Health Program – which helps doctors with substance abuse problems regain sobriety – traveled to Marworth Alcohol and Chemical Dependency Center in Pennsylvania to obtain Miller’s signature on the order.
On Friday, however, Bridgewater lawyer Steven I. Kern said an attorney in his office has been retained to represent Miller. Neither that lawyer, Joann Pietro, nor Miller could be reached for comment.
Mark Davis, director of media relations for Geisinger Health System, which operates the Marworth facility, said Miller was not a patient there Friday.
When Miller was admitted to Marworth on Dec. 21, it was not her first time dealing with drug abuse.
Miller, now 52, received her medical license in 1994. According to public records from the Board of Medical Examiners, Miller first abused drugs in 1978 and relapsed in 1984, 1985 and 1995. While the medical society’s health program was conducting weekly tests of Miller’s urine in 1996 to check for drug abuse, Miller would hide someone else’s drug-free urine on her body and submit that during her “direct witness” exams, the doctor told the board in 1998.
“Direct witness” urine tests mean “eyeball to urethra,” according to Gregory J. Rokosz, the immediate past president of the medical board.
Miller surrendered her license in 1997 when the PHP learned of her relapse. In July 1998 when the medical board issued Miller a limited reinstatement of her license, the board required her to participate in the PHP treatment. The board also noted Miller’s “long history of relapse and intermittent drug abuse.”
In July 2000, Miller received an unrestricted license and agreed to participate in the Physicians’ Health Program, or PHP.
Kathleen Loughran, of Lakewood, one of Miller’s patients, said she received a telephone call from someone who said that her December appointment with Miller would be canceled because the doctor needed gall bladder surgery. When she called to obtain her medical records, the answering machine directed her to call the Brick law office of Michael E. Wilbert, who was the executor of the estate of Miller’s predecessor. But Wilbert’s office had no access to her medical records.
Loughran said while she found Miller to be knowledgeable and compassionate, she felt the doctor betrayed her trust by leaving her practice without warning.
“She made no provisions for her practice and has not made it easy for people to transition to another physician,” Loughran said.
“I understand that she is having difficulties,” Loughran said, “but as a psychiatrist, she had a responsibility to her patients.”
But Loughran also said the medical board doesn’t make its disciplinary orders well known to the public.
“They have a duty to protect the unsuspecting patients of these doctors they know are or have been impaired,” she said.
The last three times 30-year-old Brick resident Shawn Mills saw Miller, he said it seemed to him that there was something wrong. Miller was losing weight, was shaky, had difficulty writing. Mills said Miller told him she had Lyme disease and personal problems.
Miller, however did not leave Mills without prescriptions. In fact, Mills said, in November, the doctor gave him three months worth of lithium refills and said she was going on vacation.
“It discourages you from going to see anybody else,” he said. “What do you have to do? Do a background check on everybody you see?”
When Manasquan psychiatrist Fort died of a heart attack in New York on March 18, 2001, there was no time to delay in finding other doctors for Fort’s patients to see, said attorney Wilbert, who was Fort’s longtime friend and executor of his will.
“He had an extremely large practice,” Wilbert said. “I went to New York to identify the body, and I was told by his then-medical assistant that we needed someone immediately because patients were backing out the door.”
The Medical Society’s PHP recommended Miller, Wilbert said. Within days, Miller was sitting at Fort’s desk and treating patients, he said.
“We were advised that she was practicing in Monmouth Medical Center and she would come in on an interim basis and pick up the practice and medicate the patients,” Wilbert said. “I had no idea she had a problem.”
Wilbert, who said he was not aware that the PHP’s mission is to help physicians with drug and alcohol abuse histories, said had he known the full background of Miller, he would not have allowed her to take over the practice.
“If I had known that she had problems, I don’t think that we would have said, ‘bring her in,” he said. “I think basically, with someone who has those problems, you have to say, ‘send somebody else.”
The public disciplinary records concerning Miller’s relapses are on file with the state medical board. The medical society said the PHP “had NO responsibility to inform Wilbert about Miller’s background.” The society cited state confidentiality laws as the reason for not mentioning Miller’s drug abuse past.
Wilbert said a number of Miller’s patients called his office in December in an attempt to gain their medical records. He said he referred those calls to the medical society.
“I assume that if she can’t continue her practice, then someone would make a recommendation for her replacement,” Wilbert said.
Miller can reapply to the state medical board in September to regain her medical license.