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State board cites Stafford physician page 2


 Williams
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Date published: 1/15/2013

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Williams, who represented himself at the hearing, said his style with patients was "informal and personal," according to board documents.

He said he was treating Patient J for liver problems, and when a test indicated that she was going to be OK, he hugged her out of happiness. The kiss was not planned, he told the board.

"He doesn't know why he kissed her on the lips, except that it was the closest area," according to the board report.

The board committee also was critical of Williams' record-keeping. For example, it found that he:

Prescribed narcotics to Patient A and to other patients even though he did not obtain comprehensive patient histories, did not indicate why he was prescribing narcotics, and did not obtain records from prior treating doctors.

Did not have pain-management contracts with his patients, or if he did, did not monitor them.

For example, one patient, described as Patient D, used seven pharmacies rather than a single pharmacy to hide his drug dependency. Another patient, described as Patient E, used three different pharmacies.

Did not order random drug screens, conduct pill counts, or check the Virginia Prescription Monitoring Program to see if his patients were taking their medicines as prescribed.

The Board of Medicine has adopted guidelines for the treatment of chronic pain, including the use of a patients' medical histories, physical exams, diagnostic tests, treatment plans, pain-management contracts and period review.

"The Board of Medicine expects doctors treating chronic pain with narcotics to do things Dr. Williams failed to do," Jennifer Deschenes, deputy executive director of the board, wrote in an email.

In his statement, Williams defended his care. He wrote, "To rely on clinical judgment and a mutual patient/physician trust relationship is no longer adequate given the national focus on prescription opiate misuse, abuse, etc.

"The extent of documentation and monitoring now expected is, however, beyond what most primary care doctors will have time for.

"The misfortune for many of my patients with limited resources is that they will be either living with more pain or paying big bucks to someone who will maintain their treatment."

As part of Williams' probation, he is prohibited from prescribing narcotics "for more than 60 days for the treatment of acute pain."

Williams "does not have to stop seeing the patient at day 60, he just can't prescribe any more drugs after 60 days," Deschenes said.

Williams also must attend 53 hours of continuing education classes in four topics: the proper prescribing of controlled substances, pain management, medical record keeping and "maintaining professional boundaries."

Williams graduated from Dartmouth Medical School in 1975. He did his residency training at VCU in Richmond and received his Virginia medical license in 1978.

Jim Hall: 540/374-5433
Email: jhall@freelancestar.com


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