By Bob Stiles, Tribune-Review, Greensburg, Pa.
Jul. 13–Holly Pedder and Missy Dahlstrom said they scrambled for about two months to find a new doctor after their former physician, Dr. Antoine Francis Cawog, was arrested for peddling prescriptions for pain pills and closed his Irwin office.
The sisters said they were turned down by other physicians or their office staffs, apparently because they were patients of Cawog.
They aren’t alone.
Other patients of Cawog, 63, of 102 Foxwood Drive, Unity, found themselves in similar straits.
Cawog faces a preliminary hearing Thursday before Greensburg District Judge James Albert on 24 drug-related counts and 10 counts of attempting to commit Medicaid fraud.
Authorities allege that he was selling prescriptions to patients, often for pain medicine, without doing proper examinations or any examinations at all.
Dahlstrom, 29, of Arona said she was turned down by four doctors or their staffs before finding one willing to take her on as a patient.
“They don’t want nothing to do with him, which I can understand … but it’s not our fault,” said Dahlstrom. She and her sister have seen Cawog since they were children.
“They would not see me,” said Pedder, 31, of Penn Borough. “They didn’t want to go to jail. I said, ‘I don’t understand.’ They said, ‘I can’t see you.’ “
Part of the difficulty for patients in finding another doctor is the volume of pain medicine dispensed by Cawog, said Pedder, Dahlstrom and other patients who didn’t want their names to be used. Another reason is that patients have been unable to obtain their medical records, they said.
Many of Cawog’s patients were on medical assistance.
Ruth Brown, 48, of Jeannette said a Greensburg doctor began seeing her late last month on a temporary basis. That doctor cut back on the pain medicine she had been taking, she said.
Brown said at least five other doctors or their staffs turned her away before she found the Greensburg physician.
“As soon as I mentioned (Cawog’s) name, they refused to see us,” Brown said.
Her current doctor has advised her to go to a pain clinic, she added.
Dr. Tom Whitten, of the Westmoreland Pain Management Center in Unity, said he has been treating about 10 of Cawog’s patients since his arrest, and all were using pain medicine.
“We’ve had some. To be honest, I have to look with a very, very jaded eye,” Whitten said.
He said all of the patients were taking short-acting narcotics, such as Vicodin, and he changed the medication for those in severe pain to control-released pain medicines, which he described as less harmful, with a lower potential for abuse.
“That’s the standard of care recommended across the board,” Whitten said.
Personnel at MedTech Rehabilitation, a methadone clinic in Hempfield, said the number of their potential clients rose by at least 10 percent the first week after Cawog’s arrest, although they could not directly link the increase to the doctor.
Joanne Bergquist, executive director of the Westmoreland Medical Society, said physicians are not required to accept patients, and most doctors dispense pain medicine sparingly.
“It’s really just seeing if they can find people willing to see them,” she said. “The majority of doctors don’t like to prescribe painkillers unless it’s absolutely necessary.”
Bergquist said another complication is that there aren’t enough doctors in the area. Some left for other states to avoid high premiums for medical malpractice insurance, she said.
“Physicians can only see so many patients, and we’ve lost physicians across the state to elsewhere. The sheer number of patients remain, but not the doctors,” Bergquist said.
“Unfortunately, if a doctor could see more patients, he would, but many times he’s already at maximum. I don’t have a solution for it. I don’t have a recommendation (for people unable to find a physician).”
Stacy Kriedeman, state health department spokeswoman, said she has no solution for the former Cawog patients having trouble finding a doctor, except to keep trying or contact their local medical society.
Cawog’s attorney, Tim McCormick, didn’t return phone calls seeking comment.
Local and state authorities allege that some of the transactions involving Cawog, a native of Syria who became a naturalized U.S. citizen in 1980, included him driving to rendezvous spots, sometimes in his Cadillac Escalade.
Other prescription exchanges occurred inside Excela Health Westmoreland Hospital in Greensburg, where Cawog formerly was on staff, police said. Money orders allegedly were sent to his home for prescriptions, or people did work at his residence in exchange for prescriptions.
Federal authorities have charged Cawog with money laundering. He is accused of sending $275,000 to a bank in Lebanon with the intent of “concealment of assets in connection with a bankruptcy case,” according to court papers.
Records with the state Board of Medicine show that Cawog’s medical license came into question in 1994 after he pleaded guilty in 1991 to one count of filing a false income tax return, a felony.
Cawog, who told examiners that he was unfamiliar with the income tax laws and procedures, had his medical license suspended for 18 months, but that decision was stayed because Cawog met the terms of his federal court sentence, according to the licensing board’s ruling.
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