Dr. Stephen Swetech is a doctor being prosecuted in Pennsylvania, and I have a few questions. According to fake patients sent in to see him by the state, the doctor said “I’m not a big fan of Percocet, you know that? And anybody taking Norco or Percocets are actually drug addicts and anybody giving it is a drug pusher.” Really? Did he say that? My main question is… Is this one tape? Or is it just something someone claims he said? The difference is very important. People in legal trouble and whose lives can be destroyed at the whim of law enforcement have been known to occasionally lie to avoid said destruction. On the other hand… People, even doctors, sometimes say very stupid things without thinking about how it sounds.
Dr. Swetech, now retired, was seeing patients back in 2017. These patients claimed to have pain, and he was prescribing them medications approved for that purpose. So far, so good. The government sent in three undercover officers posing as patients. During one of these visits, he supposedly said, “If you keep coming back, I’m going to think you’re a druggie.” This is not a smart thing to say on several levels if that’s really what he said. First. Druggie is a belittling and stigmatized term. If you think someone might have a drug problem, do your SBIRT and find out and get them help. SBIRT is screening, brief intervention and referral to treatment. Every doctor should know how to do this or have someone on staff who does.
Apparently, the doctor said this to “Sarah,” not her real name. Making the “druggie” comment on her first visit and then asking if she preferred Norco or Percocet, according to the state. He could very well have asked “which one has worked best for you in the past?”, which is a perfectly legitimate question for a chronic pain patient. All opioids do the same thing… At equianalgesic doses for a particular patient, provided there are no genetic limitations on enzymatic activity. See what I did there? Opioid treatment is about as individualized as you can get in medicine next to cancer chemotherapy, so if something worked well in the past, you want to know and will probably continue that medication.
That being said. WATCH WHAT YOU SAY TO PATIENTS. At no time is it safe to assume, in this era of Medical Big Brother, that your words won’t be taken down and turned against you. Heck, posters and signs like “Dare to Be Different” have been used against doctors and pharmacists in court to show they weren’t “usual.” A metric that simply does not exist for any INDIVIDUAL doctor or patient. Back to the “anybody taking Norco or Percocets are actually drug addicts and anybody giving it is a drug pusher.” That is what some opioid prohibition extremists insist, and it is NOT true. On the other hand, for heaven’s sake, if you believe this, then DON’T prescribe them. You are basically saying that you are a drug dealer? Again, is this on tape?
The prosecutor pointed out during her questioning: “This is the second time he says that to the same patient, yet it is the second time he turns around and prescribes Percocet to her.” This would be very odd behavior indeed. If true perhaps he is along in years and prone to making sarcastic statements not uncommon in those with extended life experience (old). Swetech is 70. I’m calling “Twain Syndrome.” At some point, we seem to quit caring as much about hurting feelings and just say things. This is dangerous, and lots of elderly physicians have been going to prison lately, Dr. William Bauer was sentenced to 5 years at the age of 83; can’t let dangerous people with only 50 years of dedicated service to humanity loose on our streets of course.
A government paid medical expert, named Dr. Timothy Munzing, testified on the second day, after which the judge will decide whether probable cause exists to bind the case over trial. Munzing is from California and claims that Dr. Swetech failed to follow a “national standard of care.” I take exception to that statement. This entity simply does not exist. The concept was created by the federal government to target doctors who practiced medicine in a way the agents don’t like, paying “experts” to convince juries that there is one. Every state has different rules and regulations regarding the practice of medicine. Oregon lets you write an opiate to terminate a patient’s life, the very thing that Arkansas says you absolutely CANNOT do.
Munzing said that “Dr. Swetech failed to follow the proper national “standard of care” by failing to obtain a detailed medical history, including potential mental-health or substance-abuse issues, about patients and conduct a thorough medical examination of patients before prescribing one of them with Percocet and the other with Norco.” According to an article in the Macomb Daily, going on to say that “The assessment, the history were minimal,” for one of the visits with the fake patient called “Renee.” First, a minimal history is sufficient if someone comes to you on current or recent treatment for a documented chronic medical condition. If someone says they have diabetes we don’t wait for another HgA1c before giving insulin.
Secondly, there is no law saying that you cannot treat a patient for chronic pain if they have an addiction as long as the medication is being prescribed to treat the pain and NOT to maintain or treat the addiction. According to Ruan the only thing that matters is whether or not the doctor believed the medications prescribed were best for the patient. That’s it. In this case I see a physician possibly making somewhat inflammatory statements to patients to judge their reactions. If you make harsh comments about serial killers and an acquaintance objects, maybe keep an eye on that one. In this case, the doctor is clearly worried about patients abusing medications; he’s not saying, “Go do it.” A true criminal doctor would say nothing.
And physical exams are FOR THE DOCTOR. There is nothing magical about tapping your knee with a hammer or listening to your heart for a back problem. It’s good to be thorough but it is not a crime to be focused. Also, there is no “national standard” here. Florida says an exam AND detailed history and Arkansas says OR. But not even Florida tries to tell doctors WHAT to do in an exam. A physician with Dr. Swetech’s experience can watch a patient walk into a room and hear them speak and discern more than a freshly minted physician can with an eleven-system examination. That is the nature of medicine and there is absolutely no law that says doctors MUST do whatever some drug agent or officer THINKS they should do in medical practice.
All that being said… Take some pictures. Of the antecubital fossae, to document a lack of track marks, of the injury site to document discoloration, scarring etc. And update the patient’s ID picture EVERY visit. This will show a lack of jaundice, time lapse of overall appearance, and the fact that they were there that day. Doctors have been targeted because of computer errors claiming patients were not seen or were dead at the time of visit. (If they were really dead you are hit). This is a perfect example of noncrimes being propagated as criminal activity. Dr. Rifai of Pennsylvania was just recently able to prove that the software algorithms used by the government to target him were faulty. Good for him but what about everyone else?
But wait! There’s more! “The fake patients told Swetech they did not have health insurance and paid him in cash.” CASH! That evil green lucre, the love of which, is the root of all evil. That being the case, why does the government love it so much? But I digress. Ok. Were they supposed to pay him in chickens like the old days? Since when has been illegal to take cash? The answer is that’s not, but they’ll still try to lock you up for it. Ever since 2017 when the FBI stopped policing insurance companies on behalf of the people and started policing people on behalf of the insurance companies, not paying the vig to this industry will get you targeted. Not just monopolistic, this is Communocapitalism, destroying you for a better tomorrow.
The dastardly doctor then asked, according to the article, “Do you want to run up a heavy-duty medical bill or do you want me to keep it at a minimum?” What? How dare he?! Asking a patient about their ability to pay a large bill. Every doctor understands that there are things we MUST know and things we would LIKE to know. Where on this spectrum our diagnostics land is influenced by a patient’s ability to pay. We will usually ALWAYS order the former and differ the latter if it means the patient will starve. This goes also to the DEA prosecuting doctors for not ordering “objective tests” like MRIs and EMGs etc. If there are plenty documented in the chart, why would we? Except to keep cover our behinds, which we should not have to do.
The state goes on to say that Dr. Swetech asked “Sarah” if she wanted blood tests or shoulder imaging done and she declined. Munzing thought this was “shocking” apparently. Really? You have a patient with no insurance, and you are not going to let them be an active part of the medical decision making? I wish I found that ‘shocking’ but I don’t. The current direction of American medicine is to cut the pain patient completely out of the equation and make all decisions based on what our great and benevolent state and federal governments think is best for them. Assuming them to be so addled by “psychogenic” problems and past traumas as to be completely unreliable partners in their own healthcare. Next, we’ll be locking them all up.
The doctor said that he would approve imaging if she got insurance, which brings up another point. Doctors are prosecuted for not ordering tests. Doctors are prosecuted when they order tests that aren’t done because the patient couldn’t afford them. And doctors are prosecuted when they order tests, the patients scrape up the money, and some overpaid wag of an “expert” opines that the image does not show sufficient “pain.” Every credible pain management textbook and expert will tell you that it is IMPOSSIBLE to determine pain levels from images. A patient of mine had a needle sized sliver of bone stabbing her sciatic nerve after back surgery and the pain was absolutely intolerable. It did not show up on any image and was found in surgery.
Dr. Swetech hired a healthcare specialist criminal defense team from the Chapman Law Group to defend him, so he clearly has some marbles left or someone, perhaps that great physician in the sky, is looking out for him. A lot of doctors don’t understand the importance of specialist representation, I know I didn’t, but we learn the hard way that this is not about truth, it’s about “winning” as some state or federal functionary sees it, and for them that means conviction at all costs. And some cold hard cash. Nothing says “a civil penalty is fine for this one” better than a few million dollars. In this case the state tried to take $45,000 in cash, two cars, and jewelry in civil asset forfeiture; sounds a bit like a home invasion robbery, and it is, in a way.
The powers that be have decided that if the state yells “drugs!” You no longer have the right to your property. This takes almost no evidence at all for them to do usually, which is why Circuit Judge Julie Gatti’s decision to order the return of the doctor’s money and cars very unusual. It makes me think that the state might be using inflammatory statements to discredit the doctor before trial. Apparently, the doctor told Sarah that pain patients scared him, and that he was worried about potential abuse. This will be used against the doctor in court under the argument that he “should have known” that she was lying to him. He has good reason to be scared. It is not safe to treat pain, addiction, anxiety or ADD in the United States today.
Especially for older doctors and those with assets. Older physicians are getting obliterated at trial and sent to prison for not knowing what was purposely kept from them and younger ones are retiring or just quitting. It’s not worth it anymore. If this doctor was truly a criminal, THEY WOULD NOT NEED TO LIE ABOUT PAIN TO GET MEDICATIONS. Period. “Swetech also prescribed an antidepressant prescription drug to Renee and Sarah as a sleep aid after they complained about difficulty in sleeping, which Munzing said also seemed unnecessary.” What kind of insanity is this? When doctors don’t prescribe medications other than opiates it is used against them at trial, when they do, it is also used against them, at trial.
You can’t possibly practice according to these new rules because the rules don’t, in fact, exist. They are created wholesale for each prosecution and redefined, by paid government “experts” and DEA agents, to be whatever you did not do, as clearly differentiated, for that trial anyway, from what they can convince a jury you should have done. Not based on evidence, but solely extreme opinions. These new rules, according to a government paid expert medical witness in Dr. Bauer’s trial, cannot be found in textbooks or online education, but only in the minds of experts like him. There’s a very good reason for this. These prosecutions are not based on the usual practice of medicine, and they do not target doctors treating for illegitimate reasons.
They are based on the premise that pain is not a “real” diagnosis anymore and that opioids are essentially poison and, if not illegal, they should be, so we’ll lock up anyone who prescribes them to make a point. Point taken. Get out of pain management while you can, before it’s too late. Swetech is free on a $10,000 personal bond. I for one hope he stays that way. The man’s retired. Don’t make him spend his last days staring at concrete walls on the false premise that doctors caused the opioid crisis. They did not. The DEA caused the opioid crisis, by failing to intercept tons of fentanyl coming across our borders. Then calling all non-heroin related deaths “prescription medication deaths,” and targeting every doctor treating pain.
The destruction of hundreds of pain doctors, prosecuted with false metrics and extreme medical opinions, pushed hundreds of thousands of pain patients to the streets, where they were poisoned by fentanyl laced heroin and fake medications, also laced with fentanyl and now xylazine. The attempted destruction of Dr. Swetech is a microcosm of the dangers physicians face, as the crime creation industry grinds on, having given up on the war on drugs for much easier targets. Patients with pain or addiction, and the physicians who try to help them. With half a million dead in the last several years, it is time to change course, and for the governments, state and federal, to acknowledge that they were wrong.
