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.
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