VERNAL — State regulators have stripped a Utah doctor of his license to prescribe controlled substances following an emergency hearing where it was determined that he poses "an immediate threat to public health, safety and welfare."
Dr. Paul Marie Gahlinger, however, said his treatment program for opioid dependence is saving lives and the state's case against him lacks merit.
"The really preposterous thing is that Utah has a lot of doctors that prescribe opioids such as Oxycontin and other abused medications," Gahlinger told the Deseret News. "That creates a problem and we are solving the problem."
The state Division of Occupational and Professional Licensing contends, however, that Gahlinger doesn't have enough contact with his patients to "properly evaluate or take a medical record" before prescribing Suboxone, a medication used to wean people off more powerful painkillers or illicit drugs like heroin.
That's because Gahlinger lives on the island of Saipan and only sees patients at his Medicruiser Clinic — operated out of his assistant's Uintah County home — via online video conferencing, according to the emergency order that suspended the doctor's prescription drug license.
"Telemedicine is a legal way to treat patients," Gahlinger countered by phone Wednesday. "This is how you reach rural patients who otherwise would not be able to get care."
The emergency order identified three of Gahlinger's patients by their initials. One patient was an obese man with high blood pressure. The other two were pregnant woman. All three received prescriptions for Suboxone and dealt almost exclusively with Kelly Reyes, a woman who works as Gahlinger's assistant but lacks any kind of state license, regulators said.
When the two female patients gave birth at Ashley Regional Medical Center in late 2013, their babies had to be monitored for withdrawals from Suboxone, according to the emergency order.
"It is generally not a drug that is recommended for women who are pregnant," said Dr. David Bestenlehner, a pharmacist at Ashley Regional. "However, if you have a woman who is trying to get off narcotics or some sort of pain medication, it is acceptable, but it has to be closely monitored."
In the case of one of the women, Gahlinger, who does not have privileges at and is not affiliated with the hospital, did "little physical monitoring" of her condition and "did not communicate with (her) OBGYN," the emergency order states.
It's an allegation Gahlinger flatly disputes.
"In fact, we were in touch with the obstetrician and worked with him and the patient," he said. "So this is just preposterous. Every one of (the division's) facts of finding is wrong."
Jennifer Bolton, spokeswoman for the Division of Occupational and Professional Licensing, said Gahlinger has 20 days to request a hearing on the emergency order.
Gahlinger believes the division failed to follow its own procedures for investigating allegations of physician misconduct. He said he wants his name cleared and indicated that he may take legal action against the state.1 comment on this story
"They took the most extreme kind of action — an emergency order — that is normally reserved for the most egregious kind of malpractice," he said. "I hate to say this, but there may be cause here for a lawsuit against DOPL for defamation of character and loss of income.
"Right now we have 65 patients who are dependent on us who are very distressed because they will no longer be able to get their medication," Gahlinger added, "so this is causing great injury to the community."
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