Page 49 - TPA Journal March April 2022

prescribing authority, the elements of conspiracy to doctors, he kept prescribing them drugs too. The
distribute controlled substances are: “(1) an pharmacist was so troubled that she contacted the
agreement by two or more persons to unlawfully Drug Enforcement Administration for the first time
distribute or dispense a controlled substance in her career. The government contends that Lee
outside the scope of professional practice and was a key part of the scheme. It says she reviewed
without a legitimate medical purpose; (2) the failed drug tests, knew some patients had substance
defendant’s knowledge of the unlawful purpose of abuse problems, and prewrote prescriptions for
the agreement; and (3) the defendant’s willful Taylor to sign. She was also in charge of the clinic’s
participation in the agreement.” finances, which improved dramatically as the clinic
concentrated its practice on pain management.
Even by the standards of our adversarial system,
the difference in the parties’ portrayals of the clinic Because the jury found the defendants guilty, we
is stark. The defendants’ story is that they ran must honor the government’s telling if it is backed
Taylor Texas Medicine as a legitimate pain by evidence. It is. The government called seventeen
management operation. Taylor says that he witnesses, including the pharmacist who reported
carefully examined patients, refused to prescribe to Taylor to the DEA, the patient’s wife who asked
patients who tested positive for illegal drugs, and Taylor to stop prescribing drugs to her husband,
attempted conservative treatments before resorting undercover officers who pretended to be patients,
to others prone to abuse. He acknowledges that, in an actual patient, medical experts, clinic staff, and
retrospect, he may have made some mistakes. But case agents. It also introduced documentary
he contends he acted in good faith and trusted his evidence like financial records, patient files, and
patients to accurately report their pain. Lee, for her prescription data. Taylor testified too. All this
part, asserts that she knew nothing about the evidence was more than enough for the jury to
prescriptions Taylor wrote. According to her, she convict on. What follows is just a sampling.
was an innocent office manager.
Taylor is not a pain management specialist, yet the
The government tells the story of a “pill mill”—a clinic shifted its focus to pain patients when he and
medical practice that serves as a front for dealing Lee began having financial difficulties. Eventually
prescription drugs. It portrays a clinic packed with 80% of the clinic’s patients were pain patients. The
drug users and dealers, where one person would proportion of prescriptions Taylor wrote for the
often pay for multiple patients’ visits. Also commonly abused drugs hydrocodone and
consistent with patients’ trafficking drugs is that, alprazolam grew from about 50% of prescriptions
on follow-up visits, many tested negative for the in January 2010 to over 80% by August 2011.
medication Taylor had prescribed them. Others Almost all those prescriptions were for the
tested positive for illegal drugs like cocaine. maximum dosage. He seldom offered patients
Despite the red flags, Taylor kept prescribing these conservative treatments not prone to abuse.
patients drugs. Even when a patient’s wife begged
Taylor to stop feeding her husband’s drug Taylor did little to justify the prescriptions. By
addiction, he kept prescribing the husband drugs. 2011, he was seeing 40 to 50 patients a day. The
And when a pharmacist who filled many of undercover visits confirmed the brevity of the
Taylor’s prescriptions told him that some of his examinations; Taylor spent between two-and-a-half
patients were also receiving scripts from other and eleven minutes per visit with the pretend

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