Pubdate: Fri, 08 Feb 2002
Source: Shelby Star, The (NC)
Copyright: 2002sThe Shelby Star
Contact:  http://www.mapinc.org/media/1722
Author: Cassie Tarpley

TALLEY OUT OF BUSINESS?

GROVER - Although Dr. Joseph Talley has yet to face a criminal charge from 
federal authorities investigating him, his 35-year practice is essentially 
at an end.

And Talley said even if he's eventually cleared, it could take a year or 
more to get his federal Drug Enforcement Administration number back - the 
one that allowed him to prescribe narcotics.

That number was taken away Jan. 30 by DEA officials.

Talley said he has been working this week to get patients transferred to 
other physicians, and Dr. Ron Delaney, a part-time associate since 1998, is 
helping him do that.

Reacting to Thursday's news that the DEA is linking Talley with at least 23 
deaths in two states, Dr. David Barker, co-chairman of Cleveland Regional 
Medical Center's Ethics Education Committee, said that for a lifetime of 
practice, that's not a lot.

"If he's only been linked to 23 and has been there for 30 years, you wonder 
if there's culpability," Barker said. "That would be my question."

The DEA show cause order obtained by The Star alleges those 23 deaths were 
due, in part, to drug overdoses.

The quiet little border community of Grover stayed quiet Thursday, despite 
the swirl of controversy surrounding Talley's Grover Medical Clinic - one 
of only two doctor's offices in town.

Rain kept the usually bare winter streets even barer.

At the post office, a person or two acknowledged they knew about the doctor 
in trouble but preferred to stay silent.

Grover resident Lynn Boone, however, said she had heard the "pill mill" 
talk about Talley and now, with the DEA accusations, thinks he should give 
up his medical license.

"If he gave it up now, voluntarily, it may help him more."

Mrs. Boone added, "There are some things no doctor can control - if people 
will take other people's medicines or take more than they should. But there 
is one thing they can control, and that is giving prescriptions to people 
who don't really need it."

Talley's prescribing habits are a big part of the DEA's focus.

One charge is that Talley retained discarded patient medicines in his office.

In response to that, Talley said he was acting on instructions of DEA 
agents: "Years ago it was explained to me that Schedule II substances we 
received back were to be kept until the person who owned them might use 
them again, because it was theirs, or until DEA agents came and got them. 
Later I was told that I was supposed to give them back to the patient, but 
that sounded so medically irresponsible to me that I felt I should not do it.

"To give back narcotic medicines they did not need would be foolish," he said.

Talley himself directed agents to a locked cabinet brimming with medicine, 
some of it several years old, he said.

Medicines might be discarded for a number of reasons, he said - allergic 
reaction, the medicine didn't work well on the problem being treated, or it 
wasn't needed because the condition for which it was prescribed was no 
longer a problem. However, in virtually all cases, he said, he was 
replacing those medicines with similar substances.

Talley also said he did not encourage patients to destroy narcotic 
medications themselves, because then they could not be accounted for by anyone.

In another allegation, the DEA said Talley circumvented federal regulations 
against narcotic refills by post-dating prescriptions.

When this question came up after the investigation began last fall, Talley 
said he consulted a DEA rules expert in Washington, D.C., David Durkin.

"He advised that as long as I was in compliance with state law, I was in 
compliance with DEA regulations. North Carolina law allows the practice of 
writing these prescriptions in advance with 'do not fill until' dates," he 
said.

However, still uneasy, Talley said he talked to other medical professionals 
in the state, who confirmed that the practice was acceptable.

Talley said he used this post-dating method only after making the decision 
that a three-month follow up was appropriate for the patient in question.

Anyone expecting a three-month follow-up now must find it with someone else.

"I'm just helping Dr. Talley clear up now," Delaney said, "because this 
clinic is for all intents and purposes closed."

Patients continue to come to the small office at 318 Laurel Avenue. From 
the outside, business seems normal.

Inside, Talley, Delaney and their staff are making arrangements for 
patients, most of whom have been taking controlled medicines for pain and 
mental problems, to be seen by other doctors, or get them into 
detoxification centers.

"And to help them in some cases to wean off these medicines until they can 
find Plan B," Delaney said.

In contacting pain control clinics, Talley said, "I'm having trouble 
getting them to absorb our patient load."

"This is a big problem," Delaney said, "We have 60 to 70 a day coming 
through here that we're trying to cope with."

People who were patients of Talley's former partner, Dr. Richard Crowley, 
are being handed a small piece of paper with his new office address and 
telephone number on it.

Crowley, who refused any comment to The Star, resigned abruptly in December 
after DEA agents raided the Grover office and confiscated cartons of 
medical records.

Helping patients find other care is further complicated by the lack of 
those records, Delaney said.

"The DEA is aware that we're having this problem," he said.

The majority of those records were confiscated in December, packed in boxes 
and hauled away, presumably to investigators' offices, but their 
whereabouts are uncertain, Talley said.

"I think we probably have some problems coming," agreed Barker of the 
ethics education committee. "I'm concerned that there will be a lapse in 
these folks being able to identify the source for medicines they need.

"Will the pain centers that are being pushed and touted by the government, 
will they take time to work out the patients' needs in a way besides 
telling them to just sit at home and live with the pain?" Barker asked.

Talley stands by his three decades of practicing medicine on a cutting edge 
most doctors won't risk, he said.

"There ain't much strategy to the truth," he quipped, and suggested he 
might repaint his office sign out front to read "Dangerous Joe Talley," 
reflecting federal authorities' assessment of his work.
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MAP posted-by: Keith Brilhart