Pubdate: Sat, 23 Mar 2002 Source: Shelby Star, The (NC) Copyright: 2002 The Shelby Star Contact: http://www.shelbystar.com/ Details: http://www.mapinc.org/media/1722 Author: Barry Smith, Star Raleigh Bureau Bookmark: http://www.mapinc.org/people/Joseph+Talley TALLEY: 'I AM NO LESS FRIGHTENED' RALEIGH -- Experts on the treatment of pain spent much of Friday telling the N.C. Medical Board how they felt about the type of care that Dr. Joseph Talley provided his patients. Dr. Richard L. Rauck of Winston-Salem, who is the state board's expert witness, told the board that he felt that Talley's care did not met acceptable state standards. Talley's expert witness, Dr. Straton Hill of Houston, disagreed. He said that Talley had adequate information to make judgments on when it came to providing treatment regimens for his patients. When a grueling 12-hour session finally recessed Friday night, Talley himself said he was still concerned about the process. "I am no less frightened now than I was before," he said. "But I do not feel discredited about my own work." Friday marked the second day of hearings before the N.C. Medical Board. Board attorneys have accused Talley of deviating from accepted and prevailing standards of practicing medicine in the way he treats some patients and prescribes narcotics to them. The hearing is expected to conclude today. Talley's medical license could be taken away from him if the board agrees with the attorneys' allegations. The federal Drug Enforcement Administration has already suspended his privileges of prescribing controlled substances and linked Talley to 23 overdose deaths. However, Talley has not been charged with a crime. Rauck spent much of Friday on the witness stand, methodically describing, case by case, the care that Talley gave his patients. Rauck said that in many instances Talley would prescribe powerful narcotics without providing physical exams to his patients. "In any given patient, the symptom of pain may mean many different things," Rauck said. He said that Talley also did not order laboratory tests, which could help pinpoint problems and help determine if patients are taking their medicine. If other drugs are being used, such lab work could help determine that, he said. Rauck also said that Talley did not make sure that informed-consent contracts, which provide for a patient to get prescriptions filled at one pharmacy, were being adhered to. Hill disagreed with Rauck's conclusions. He said that ordering lab tests to check up on patients for drug abuse went against the trust that needs to be built between a doctor and a patient. "It's almost as if your patients are suspects," Hill said. "You do not introduce an element of suspicion to every patient and say, 'Take your clothes off and let me strip-search you.'" Hill said that he believed that Talley had sufficient information available to treat the patients. And he said he did not think that a doctor should be punished for failure to conduct a physical examination. Rauck, during his testimony, said that he felt that some changes in the medical regimen were inappropriate. And he said that Talley did ascertain from a female patient who could become pregnant whether, in fact, she was pregnant. He testified that the patient did become pregnant while under Talley's care. On cross examination, however, Rauck noted that initials on a medical indicated that the woman had been seen by Talley's associate, not Talley himself, at a point when the woman was five-months pregnant. Talley also took the witness stand Friday and discussed the treatment he gave a number of patients. He said he was surprised when he learned that one of his patients had overdosed and was found dead on his kitchen floor. "I thought everything was going well until his sister told me that he had died on the kitchen floor," he said. - --- MAP posted-by: Jackl