Medical Board of California Accusation Leads to Surrender of La Habra Physician’s License

SACRAMENTO—Facing an Accusation of unprofessional conduct by the Medical Board of California, La Habra physician John L. Johnson, M.D. has surrendered his license to practice medicine. The stipulated surrender of his license was ordered on June 10, 2005 and became effective on June 15, 2005.

The Medical Board accused Johnson of violating multiple sections of the Business and Professions Code, including section 2234(b)(c)(d) (gross negligence, repeated negligent acts, and incompetence), section 2242 (prescribing without a good faith exam), section 725 (excessive prescribing), and section 2266 (failing to maintain adequate and accurate records) in his care and treatment of one patient.

The Accusation alleged that Johnson was grossly negligent for prescribing narcotics and sedatives without medical indication and that from January 2001 to April 2002, Johnson prescribed Prilosec, Vicodin, Soma, Tagamet, Premarin, Ativan, Valium, Bacitracin, Zantac, Midrin, Norco and Phentermine to the patient. Johnson’s examinations of the patient consisted of nothing more, with minor exceptions, than checks of blood pressure, pulse, height and, on one occasion, temperature. In addition, Johnson’s simultaneous prescribing of Valium, Soma and Ativan subjected the patient to a significant risk of over sedation and addiction.

Although Johnson was aware that the patient was also being treated by another physician, he did not know the name of the physician and never discussed the patient with the other physician who, from January 2001 through at least February 2002, was prescribing Zyprexa, Restoril, Paxil and Cogentin, and therefore failed to warn the patient of the possible interactions of the drugs being prescribed by both doctors.

California Medical Association finally names a Kaiser doc president

The California Medical Association installed a Kaiser Permanente physician as its president for the first time March 20 at the association’s annual convention.

Michael Sexton, M.D., took the helm of the association, which represents many, but far from all of the state’s physicians, at the conclusion of the group’s annual House of Delegates. Sexton, 58, is board certified in emergency medicine and has been a member of Kaiser’s Permanente Medical Group for 30 years.

Jack Lewin, M.D., its longtime CEO, continues to run the organization, which represents about 35,000 California physicians, on a day-to-day basis.

An emergency physician on the medical staff at the Kaiser Foundation Hospital in San Rafael, Sexton is the first Permanente physician elected to head the CMA, which in an earlier era looked down on Kaiser doctors as advocates of “socialized medicine” or worse. But those days are long gone, and Kaiser physicians now make up 11.4 percent of its membership.

Sexton headed the emergency department at Kaiser San Rafael from 1977 to 1983 and presided over its medical staff from 1979 to 1981. He has been active in local, state and national medical societies for more than 30 years, serving as chair and vice chair of the CMA’s Board of Trustees and as president of the Marin Medical Society. He has been a member of the CMA board for 11 years.

In a March 20 address to the House of Delegates’ 700 members, Sexton called on the CMA to take an aggressive role in championing health-care reform in California, CMA officials said, arguing that “crushing economic pressures, confusion surrounding quality and the crippling numbers of the uninsured demand that the physicians of the CMA lead California to a better place for our patients.”

Still to be seen: How much actual clout Sexton will have in his new role, which has often been more ceremonial than not.
Warner Pacific to rep Kaiser

Warner Pacific Insurance Services, a Westlake Village-based insurance brokerage, says it’s been named as Kaiser Permanente’s first general agency partner, a wholesaler that works with retail brokers on behalf of its clients.

Oakland-based Kaiser, which has traditionally stuck to its traditional HMO products, is branching out in new directions and wants to use thousands of insurance brokers statewide to help.

“We’re excited to offer (Kaiser’s) medical plans to more than 20,000 agents and brokers throughout California,” John Nelson, a Warner Pacific vice president, said in a statement. Warner Pacific will broker Kaiser’s small-group health plans, including:

* Co-payment plans with varying benefit levels and co-payments.
* Deductible plans featuring co-insurance for hospital services and co-payments for outpatient and pharmacy services.
* Point-of-Service plans with three tiers of member access.
* Dental and chiropractic riders through San Francisco’s Delta Dental of California and American Specialty Health Plans of California.

Tom Carter, Kaiser’s Oakland-based vice president of sales and broker relations, said the deal is Kaiser’s “first direct contract with a general agent,” although it works with other G.A.s indirectly on its CalChoice and PacAdvantage programs.
Pharmacists’ network sold

The California Pharmacists Association, which a few weeks ago reported that it’s launching a new subsidiary, Premier Pharmacists Networks, is selling its 21-year-old Pharmaceutical Care Network Medicaid PBM to National Medical Health Card Systems Inc. of Port Washington, N.Y., for $13 million in cash, along with potential additional payments based on performance.

The deal has unique dynamics, according to the attorneys at San Francisco-based Pillsbury Winthrop law firm, which handled the M&A deal, in that a nonprofit entity (CPA) sold a for-profit subsidiary (PCN) to a public company (NMHCS). Maureen Corcoran led a team of Pillsbury Winthrop attorneys involved in the deal.

Just three weeks ago, this column reported that the Sacramento-based CPA, which links 5,500 pharmacists statewide, was launching its new PPN subsidiary to help California pharmacists “meet the cost- and quality-related medication needs of the health-care marketplace.”

At the time, Michael Negrete, Pharm.D., the new subsidiary’s CEO, said it will be seeking business directly from consumers, as well as from employers and third-party payers such as HMOs, Medicare and Medi-Cal. He also predicted that by month-end it would be accepting applications from Bay Area and other pharmacists.

Curious Parents Family Health Resources

It’s inevitable. With more than 200 viruses known to cause the common cold, sooner or later this year you’ll end up with the telltale sniffles, cough, and scratchy throat of a cold. In fact, statistics show that most adults experience four to six colds each year, with children being even more susceptible—catching on average nine colds or more.

When it comes to battling this unwelcome visitor, Wal-Mart pharmacist Lori Mendoza recommends hand washing as your first line of defense. “Colds come on gradually and spread easily, usually through hand contact or from sneezing and coughing,” she says. “Wash hands frequently and be sure to keep your hands away from your eyes, nose, and mouth since these are the easiest areas for germs to enter your body.”

Other ways to prevent the spread of the cold are simple:

* Avoid close contact with people who have a cold. Stay away from crowded places. If your child has a cold, wash his or her toys after play to minimize the risk of spreading the virus.
* Get plenty of rest. Staying well rested keeps your immune system strong so it can fight off germs. It also helps keep stress at bay, another trigger that can weaken the immune system and make you vulnerable to colds.
* Practice common sense. It sounds simple, and it is. Change washcloths, sponges, and dishtowels on a regular basis. Replace your toothbrush frequently. Clean surfaces you touch with a germ-killing disinfectant.
* Prepare now. Before cold season hits, stock up on the essentials—nasal decongestant, cough suppressant, tissues, and pain reliever—so that you are ready at the first signs of a cold.

Despite your best efforts, colds are extremely difficult to prevent entirely. If the cold catches up with you, expect to experience a stuffy or runny nose, sore throat, sneezing, coughing, and mild fatigue. These symptoms show up between one and three days after you are infected by a cold virus and typically last for about three days. At that point the worst is over, but you may feel congested for a week or more.

While there’s no cure for the common cold, over-the-counter medications can provide temporary relief of symptoms. “As soon as you feel a cold coming on, start treating your symptoms,” said Mendoza. “Adults with a cold might want to start with something as simple as acetaminophen or ibuprofen to help body aches.”

For other cold symptoms, like coughing and congestion, Mendoza recommends a nasal decongestant and cough suppressant like DayQuil during the day or NyQuil for nighttime use. And there’s no substitute for bed rest and plenty of fluids to ensure a speedy recovery. Remember, antibiotics are ineffective against viruses, so they won’t help your cold.

For help choosing the right over-the-counter medications for your cold symptoms, check with your local Wal-Mart pharmacist. If you have unusually severe cold symptoms, high fever, ear pain, or a cough that gets worse while other cold symptoms improve, call your doctor.

Doctor’s Drug Treatment of Osbourne Probed

The state medical board is investigating a complaint that Dr. David A. Kipper, a Beverly Hills physician with a celebrity clientele, overprescribed addictive drugs to rock star Ozzy Osbourne.

Authorities have asked Kipper to turn over copies of Osbourne’s medical records and have scheduled a meeting with the British singer and his wife, Sharon, according to people familiar with the probe.

In November, the Medical Board of California accused Kipper of overprescribing habit-forming drugs to other patients and running an illegal detoxification program for addicts. The board has postponed a ruling on that case until its investigation into the Osbourne complaint is finished, the sources said.

Kipper’s attorney, John D. Harwell, said the doctor was “always pleased to cooperate with the medical board.” He declined to comment further.

Osbourne filed a complaint with the board in early March, contending that Kipper had him taking excessive quantities of powerful medications for more than a year.

The singer first aired the allegations in a Times article published Dec. 7. Osbourne blamed Kipper for causing the disoriented behavior he exhibited on his hit reality TV series, “The Osbournes.” The singer said he had been swallowing as many as 42 pills a day at Kipper’s direction, including Dexedrine, Valium, Zyprexa and other potent drugs.

“I was wiped out on pills,” Osbourne said at the time. “I couldn’t talk. I couldn’t walk. I could barely stand up. I was lumbering about like the Hunchback of Notre Dame. It got to the point where I was scared to close my eyes at night – afraid I might not wake up.”

Osbourne, who has battled substance abuse for decades, had sought Kipper’s help in June 2002 to kick a dependence on prescription narcotics. Kipper administered a 10-day detoxification regimen at Osbourne’s mansion and soon began accompanying the singer on tour to monitor his recovery. Kipper was a frequent visitor to the Osbourne mansion and appeared on the TV series

Then Osbourne suffered an emotional collapse after his wife was diagnosed with colon cancer. According to the couple, Kipper began treating the singer for anxiety and depression.

Prescription records indicate that he put Osbourne on an array of potent drugs over the next year – including opiates, tranquilizers, amphetamines, antidepressants and antipsychotic medications.

Kipper also prescribed anti-anxiety medications for Sharon Osbourne and installed a team of nurses at the couple’s home. Kipper charged the couple $650,000 for his services from June 2002 until they fired him last September, records show. The medications he prescribed cost them an additional $58,000.

The couple initially planned to file a complaint with the board in December, but postponed the action after Osbourne was seriously injured that month while riding an all-terrain vehicle on his estate in southern England.

Kipper, an internist, has offered addiction treatment to celebrity patients for years. Treating them in their homes or in luxury hotels, he used a variety of medications to wean addicts off drugs quickly and painlessly.

In Hollywood circles, the program was seen as a discreet alternative to traditional drug rehabilitation, which can last months and require years of follow-up therapy.

In its earlier investigation of Kipper, the medical board contended that he operated an unlicensed detox program and overprescribed habit-forming drugs to eight patients from 1999 to 2002. Harwell has said he hoped to reach a settlement with the board that would allow Kipper to continue practicing.

Deputy State Atty. Gen. Richard D. Marino, who is helping the medical board conduct its investigation, declined to comment, as did the Osbournes.