Friday, August 03, 2007

Doctor Feel Good

WISH-TV's I-Team 8 has been investigating an eastside Indianapolis doctor, who also has an office in Greensburg, for over-prescribing pain killer medications. The problem has gotten so bad that some pharmacies will no longer fill his prescriptions. Rick Dawson reports:

Dr. Elmer Manalo has two offices, one on the east side of Indianapolis in Cumberland and another in Greensburg. I-Team 8 started investigating after receiving complaints about activity outside the doctor's offices. We found people waiting for hours to visit him, with time to read in their cars, to rest in their cars, and even to clean their cars. Police have had to visit too.

"We have been requested to the office over there ten times this year," said Chief Mike Crooke, Cumberland PD

It's a quick response. Police are right across the street.

"And some of the calls we've answered this year are disturbances in the parking lot where people have started to feud," said Chief Crooke.

Our investigation found that some pharmacists have stopped filling prescriptions Dr. Manalo writes for painkillers. Many office transactions are strictly in cash, $200 for a patient's first visit, $100 for additional visits. Patients say they pay up front just to get in line.

While many patients arrive in the morning, the doctor sometimes doesn't arrive until mid-afternoon. One evening in Greensburg I-Team 8 waited until the last patient left at 2:00 in the morning before seeing Dr. Manalo lock the doors.

Dr. Manalo's medical license has actually expired according to Dawson, pending a hearing next month before the Medical Licensing Board. The state cannot release information about the complaint against Dr. Manalo to the public Dawson reports.

20 comments:

Anonymous said...

There are plenty of these Doctors in Marion County, but apparently no one can be bothered to investigate them. Anyone who worked as a narcotics prosecutor can rattle those names off.

There are also those who will "backdate" a Rx for you in case you get busted for possession of a controlled substance. Good luck proving it!

Anonymous said...

Reading this coverage, you would not know that prescription painkillers are UNDERprescribed nationwide -- this according to the U.S. Government. (F.D.A.)

How about a nice expose of people who die groaning in pain, or commit suicide because of pain. Doctors are afraid to prescribe enough opiates, lest the Ninja SWAT team arrive at their office.

But f*ck it, nothing is easier to get used to than someone else's pain, right?

Anonymous said...

There are plenty of these Doctors in Marion County, but apparently no one can be bothered to investigate them. Anyone who worked as a narcotics prosecutor can rattle those names off.

There are also those who will "backdate" a Rx for you in case you get busted for possession of a controlled substance. Good luck proving it!

1:34 PM EST

To 1:34: I agree with you that there are probably plenty of doctors that cross the line when it comes to prescribing controlled substances to patients that nothing more than addicts. Your other statements, however, are off the mark. It can be a very difficult and time-consuming investigation to prosecute a doctor for unlawfully prescribing controlled substances since that is essentially what they are licensed to do. A prosecutor would need to prove that there was no legitimate medical purpose for the prescription, which requires expert testimony. For every expert that a prosecutor could produce to testify that any particular prescription was unjustified, the defense could produce two that would testify that there was a legitimate medical need. Such a case inevitably turns into a pissing match between expert witnesses while the jury sits there wishing somebody would prescribe them some painkillers. It takes several undercover witnesses who pose as potential drug-seeking patients to establish any kind of trend that a doctor is illegally prescribing. While not impossible to make such a case, it is difficult and takes time, with no guarantee that a jury will convict.

As for the "backdating" of prescriptions, while this sounds like it might produce a good defense a little analysis shoots down this theory. Let's say you get arrested by the police on June 1 for possession of a controlled substance. You go to your doctor on June 5 and say you need him to write you a prescription. For this to work you then must go to a pharmacy and get the prescription filled. What is important is not when the prescription was written but rather when it was filled. The prescription bottle, as well as pharmacy records, will show that the earliest you could have validly possessed the drugs was 5 days after you were caught with them. That's not much of a defense, and any physician that would try this would call undue attention to themselves.

This is from somebody that knows....

Anonymous said...

"It can be a very difficult and time-consuming investigation to prosecute a doctor for unlawfully prescribing controlled substances since that is essentially what they are licensed to do. A prosecutor would need to prove that there was no legitimate medical purpose for the prescription, which requires expert testimony."

It is time consuming, so we shouldn't bother? Please.

And you don't even need the prosecutor involved, all you need is the administrative board in charge of licensing these doctors to investigate and determine they are overprescribing to anyone with the right amount of cash. That could curtail a huge part of problem.

Finally, the controlled substance statute merely states you have a valid Rx when arrested. That is all you need to present, not the actual bottle. While you may technically take someone with a valid Rx to jury if they don't have the bottle, you have virtually no chance of winning.

Anonymous said...

Is this the same Dr. that Jim Irsay used? Just wondering because he too had a problem with pain killers.

kevin said...

"How about a nice expose of people who die groaning in pain, or commit suicide because of pain. Doctors are afraid to prescribe enough opiates, lest the Ninja SWAT team arrive at their office."

Very true 1:36. I had to beg my Dr. to prescribe vicadin for me after exhausting every over the counter and home remedy possibility known to man and the only reason I asked for Vicadin was because someone else gave me theirs and it was the only thing that helped my pain. Then I was made to feel like a criminal at the CVS when picking up the prescription for a measly 10 tablets of 500mg.

Anonymous said...

2:55

I just said it was difficult. I didn't say we shouldn't bother. You read that into yourself. And you also miss the point about backdating a prescription. If you still have the prescription, that is, the piece of paper the doctor wrote, then that means you could not have possibly filled it yet. The pharmacy keeps that when you fill the prescription so it doesn't matter what date a doctor puts on that piece of paper, it's when the drugs were dispensed by a pharamacist that is important. Your point about the medical licensing board is a good one, however.

GaryJ said...

possibility of "sample packs"? I have gotten them for other meds before.
The possibilities are endless, but this Dr. seems to give it out like candy!

Anonymous said...

I think this is all bull shit. Wish TV just needs to stay out of people's businesss, especially a licensed professional physician. If he wants to come in at 2pm and leave at 2am then let it be. I've been seeing Dr. Manalo for a good two and a half years and this investigation crap has been going on since then. Personally I think Dr. Manalo is a very good doctor and he deserves the respect he needs, not to be ridiculed and exploited on local news.

Anonymous said...

I've seen Dr. Manalo for close to seven years for my son's heart condition and later my own due to a heart attack/congestive heart failure caused by the neglegance of a urologist. I remember when first taking my son there for tests he received a phone call from a woman who needed to see him. She didn't drive and was worried about how she would get there, and he offered drop everything and come pick her up. This is the type of reasoning behind why you see people there at the office so late. . . .he actually spends time with the patients to determine what is really going on in their lives, etc. to cause the symptoms they have. I have not seen this type of doctoring other than on t.v.
Yes, it is something of a pain every month to be seen because of the controlled medications I require to get by on a daily basis, but I feel certain I'd have to go to numerous doctors and have additional tests, MRI's, etc. in order to receive the pain medication I need because I do not have insurance and cannot afford the surgery necessary to alleviate the pain, and I cannot afford to see numerous doctors. I feel certain that Dr. Manalo does have his patients' best interests in mind, and this situation due to the hours he keeps has been really blown out of proportion.

Anonymous said...

I work in a pharmacy in the area that has seen first hand what this "Dr." is doing. We refuse to fill his prescriptions and have for over several months. He is without a doubt providing controlled substances illegally to people and not just pain killers. Adderall, xanax, methadone, oxycontin, lortab and these are all for ONE PATIENT people! And some of these people we have personally called the cops on and have been arrested in the past for drug related offenses. Not happening! Adipex, a controlled weight loss drug similar to amphetamines for 90 pound people!. NO WAY! A man from Kentucky came all the way here to get SEVERAL controlled prescriptions from him. And when we refused to fill it, he said, "That guy owes me 100 dollars." People who I`ve known for years who are recovering addicts say some of the people who they know still abuse, call him the "candy man" because they can just get whatever they want from him. This guy is a drug dealer and needs to be arrested, and will.

Anonymous said...

I am so very glad Manalo is being exposed. I too work in a pharmacy and have seen the prescritions. Needless to say yes it is severe overprescribing. There are enough illigal drugs on the street which create addicts. A physician should not be contributing to putting prescription drugs of the streets for illicit use. I cannot imagine how many drug addicts he has created. We had one girl at our pharmacy counter with a prescription for Oxycontin and when we told her we did not have enouth to fill the prescription (we only had 40 tablets but the doctor had written for 120 tablets. Which seemingly is his favorite number of tablets to write for) she left. She evidently went to other local pharmacies andd could not get her prescription filled. She came back to our pharmacy and her lips were blue and quivering, she was shaking and asked us what she should do. She obviously had a physical dependency for the drugs. I have had one other customer break out in sweat at our counter when we told him we did not have his percocet. It is so sad to see this happen. There are too many doctors willing to write for controls just to shut up the patient and get the patient out of the office. Doctors need to get some balls and tell these patients they are not getting controls from them. Until the doctors quit handing out the prescriptions there will always be a problem. Yes, treat the patiens with pain! True pain though! Not oxycontin for a hang nail. Oxycontin was designed for patients with cancer pain, not hang nails.
I am glad to see Manalo go down!
Now for the people who have become addicts from his selfishness and carelessness-Get yourself clean and get a job and live like respectable people in our community! For those of you who strictly are selling the junk -- Get a real job -- get honest--
And for the pharmacists who refused to fill his prescription --God bless you for watching out for your patients well being. For those pharmacists who did fill -- Shame on you -- your greed is the same as Manalo's. Peoples lives are worth more than the # of prescripions you take in on a daily basis. Numbers aren't always the most important thing in live!

Anonymous said...

I you are here defending this doctor then you are obviously a dealer or an addict. Who do you think you are fooling?
Get a life. And lady (re- reply above this) if you are taking your son to this doctor for heart problems you should have your son removed from your custody.
Why would anyone wait 8 hours to let their son see a cardiologist. Call IU and see how long it takes to get your son into an appointment with a real caridologist

Anonymous said...

I AM DEFENDING THIS DOCTOR BECAUSE HE IS A FRIEND OF MINE AND HE IS A GOOD AND CARING DOCTOR AND AS FOR THOSE OF YOU THAT SAY YOU WORK IN THE PHARMACY YOU ARE JUST MAD BECAUSE YOU AREN'T SMART ENOUGH TO BECOME A DOCTOR AND THAT IS WHY YOU WORK IN THE PHARMACY SO YOU SHOULD JUST KEEP YOUR MOUTH SHUT AND DO YOUR JOB AND FILL THE PRESCRIPTIONS THAT THE ONES THAT ARE SMART ENOUGH TO BECOME A DOCTOR WRITES.AND THAT IS WHY YOU ONLY MAKE $10.00 A HOUR AND HE MAKE 5,000 A DAY.

Anonymous said...

To the ignorant person with the poor english that wrote "we should just do our jobs and fill his prescriptions"..you are an idiot. Pharmacist make $50 an hour and go to 6 years of college which I imagine is about 6 years longer than you. "Doing our JOB" requires us to fill prescriptions in the best interests of our patients and not to potentiate an addiction. Pharmacists that blindly fill prescriptions can be held legally responsible and liable if they do what you want. I am not surprised a "friend of his" would say such things. How close a friend are you? I heard he is being investigated for a prostitution ring as well. Care to comment on that?

Anonymous said...

When the only Prescriptions are for Xanax 2 mg (for a stick thin little tiny woman), and high doses of Hydrocodone (known to you street people as "Vicodin"), you tend to wonder. Occasionally we'll see Rx's for Morphine or Oxycontin, but I'm betting that's only when the Patient had enough cash to shell out. These people are NOT in pain, and they are NOT legitimate. You tell them that you cannot fill their Rx's, and they smile and leave. If it were legitimate, I would bet there would be a struggle or an argument, but is there? Because they KNOW that his practice is shady, and they KNOW that they are either: a)going to abuse the meds or b) going to sell the meds. If Manalo is such a great friend of yours, borrow his books and go to Medical school. I'm sure he may have some grammar books as well that wouldn't hurt you any. Or for that matter, go to Pharmacy school. Why? Too easy? You're right. Vicodin goes for $5 a pill on the street, Xanax for who knows how much, and Oxycontin?? Wow! Jackpot. You could make more than a Pharmacist: Who needs brains?

Anonymous said...

Wow. These arguments could go back and forth forever. Here's a question for someone who truly knows how I am going to deal with my dilema. I have be denied insurance by numerous insurance companies, including Indiana Comprehensive who supposedly is there for non-insurable people.
My last surgery cleaned me out of any and all savings and created the need for me to see a cardiologist. I suffer from pain in four areas all of which need to be corrected by surgeries that I can in no way afford nor take time off of work to have. I realize this seems ridiculous, but none of these pains are life threatening (possibly one of them could lead to serious problems). Each of these areas require a different type of doctor. I simply cannot afford this nor the expensive tests that go along with each. I make a decent living and could give you a pile of good references as to my character, etc. yet I don't believe I'm going to be able to locate a doctor willing to prescribe me pain medication (nothing as strong as oxycontin) to get through a day being capable of performing my job as well as day-to-day activities unless I pay them the initial appointment fees and have the ultrasounds, MRI's, etc. that they will require. Not to mention the continuous follow-up visits, etc. Dr. Manalo has helped me to carry on with a normal life by prescribing me pain medication to do so (I'd like to say I live totally pain free, but I do not as he has never been willing to prescribe anything stronger than vicodin, but it does help quite a bit). Does anyone know another doctor that will be able to help me without it costing me a fortune?
I'm open to any ideas.

Anonymous said...

I am a 45 year old man who lived for 3 years in SEVERE pain. I very seldom even got out of my bed because i have bone cancer. All i could get other doctors to give me was Percocet 10mg. I went to several doctors and they told me that the pain was not that bad and bone cancer is one of the most worst pain cases there are. Then approximately 1 year ago I met Dr.Manalo and he told me that he would let me live happy when i die! I did not believe this man so he began to prescribe me a very strong drug that alot of people say is wrong and hate. So he prescribe me Oxycodone 30mg-4 times daily. Within 3 days I went oustide for the first time in 1 month. I was happy, I felt NO PAIN!! I could not believe that I felt alive!! I could play with my grandkids, show my own kids how to work on a car and even shot basketball for the first time in years. Now I can enjoy the things I do on my days off from WORK like boating,fishing, and many more recreation, I know I don't have many days to live on this earth but I enjoyed it. If I have to go to California to get my drugs to live happy I will. THank you Dr.Manalo for giving me strenght, life, and courage. But now I have fallen back into my depression. I now feel more SEVERE pain than ever and I feel that I may not be here much longer. I just want everyone reading this to know that this drug was created to give you comfort for people like myself to make you not feel pain and it works!! Now it has been taken from me and the Government is happy because I don't have a life in me. Before I die hospice will come and feed me all the drugs I want, but that is OKAY because when they come I will only have weeks to live. The government wants me to live in suffering and pain. The government wants it to make it look like they are actually doing SOMETHING by saying he is "over prescribing" medicine that people need to have a real LIFE! Thank you DEA for making me suffer...death will come to all people and when pain comes I hope the people who are against them I hope that they never see any pain medicines and they suffer to the maximum to where they want to BLOW THEIR BRAINS OUT because they are so blind and lost!!!

-John L.Hicks
Indianapolis, IN

Anonymous said...

When the only Prescriptions are for Xanax 2 mg (for a stick thin little tiny woman), and high doses of Hydrocodone (known to you street people as "Vicodin"), you tend to wonder. Occasionally we'll see Rx's for Morphine or Oxycontin, but I'm betting that's only when the Patient had enough cash to shell out. These people are NOT in pain, and they are NOT legitimate. You tell them that you cannot fill their Rx's, and they smile and leave. If it were legitimate, I would bet there would be a struggle or an argument, but is there? Because they KNOW that his practice is shady, and they KNOW that they are either: a)going to abuse the meds or b) going to sell the meds. If Manalo is such a great friend of yours, borrow his books and go to Medical school. I'm sure he may have some grammar books as well that wouldn't hurt you any. Or for that matter, go to Pharmacy school. Why? Too easy? You're right. Vicodin goes for $5 a pill on the street, Xanax for who knows how much, and Oxycontin?? Wow! Jackpot. You could make more than a Pharmacist: Who needs brains? ( YOU SOUND LIKE YOU ARE THE DRUG DEALER THAT IS WHY YOU WORK IN THE PHARMACY YOU ARE STEALING THE PILLS AND SELLING THEM ON THE STREETS I THINK SOMEONE SHOULD LOOK IN TO YOU!!!! )

Anonymous said...

Most of you ppl on here I would gladly show you my MRI CAT scan xrays. And filled script for the last 15 yrs . Then I want you to come back after you've seen everything and tell me I'm not in pain. I haven't slept in 4 days now. I dont want to wish nothing bad on you ppl that are against ppl getting their meds. But one day I hope no one in your family friends ect.. wont ever be in pain. But if you ever are I want to know so I can make you feel like a drug dealer.. like I said I have about 15yrs of xrays mris cat scans and meds going all the back to at least 15 yrs old. I may look like I'm not in any pain but a lot of ppl that have cancer most of them you cant tell they are sick. Why can ppl in prison get meds in their and thats right??? I will show my rx bottles. And if you work for a pharmacy you can. find oit what I've been on anyway. I was a pharmacy tech in Little Rock AR. Then I moved back home and got a job with GM. And now I cant get nothing. And thats where I got very hurt. And I can prove that too. You betty start praying that you will never be in pain. Because if you I want to see how much pain you're in. And I will just say to you...what comes around goes around. Thank very much