Monday, January 07, 2008

Once again, irrational fear hurts everyone...

There are a lot of things wrong with this country's prohibitionist "War on Drugs." Too many to go into here, really. Prisons full of nonviolent pot smokers, the creation of a highly lucrative black market, and a system that does far more harm than good to the very people it claims to be protecting are just a few examples.

A far more insidious problem, though, is the reframing of drug use/addiction as a criminal act instead of the health issue it actually is. And guess what? We have some of that right here in Fitchburg!

The Sentinel just ran an oddly-titled article called Treating local addicts? that addresses the way some city councilors are "concerned" about the possibility of a medical practice specializing in addiction treatment opening on Summer Street.

The medical practice in question is described by its founder, Dr. Punyamurtula S. Kishore, like so:
"We are an enhanced primary care facility," Kishore said. "Everything is integrated, from people who have diabetes, to patients that need a check up and others who are addicted to alcohol, we help everyone."
Wow, scary stuff! And indeed, looking over the website for his group sure is terrifying!

I mean, they offer creepy programs like "Weight control and smoking cessation programs," "Physical exams and health assessments," and a "Home Detox Program." Someone quick, hide the children!

Speaking of which:
[S]ome City Councilors are concerned about the location of the facility, being blocks away from St. Bernard's High and Elementary Schools.

"It's right next to a school," said Councilor at-large Annie DeMartino. "I'm shocked they want to put one in there."
Umm, yeah. Because a doctor's office is totally a threat to schoolchildren who may be in the general vicinity. People seeking medical care certainly can't be allowed anywhere near children!

Oh, but this isn't about people seeking medical care, is it? No, it's about "addicts."

The word "addict" (as used by the Sentinel headline) conjures the image of a junkie shooting up in an abandoned building, so they're scary. And scary people should be kept away from children, right?

You see, in this country we don't talk about people with addictions as being people with a health problem. No, they're dangerous criminals! Never mind that the vast majority of people with addictions (which is probably about 95% of the country, to one thing or another) are no danger to anyone. Never mind that "addiction" usually doesn't involve anything illegal. Never mind that the people who'd be coming to this doctor's office are people seeking help. Let's just be ignorant and freak out about all the scary addicts!

Thomas Conry goes along with DeMartino's illogical fears and expresses concern at the location, but takes it one particularly ill-informed step farther:
Thomas Conry, an at-large councilor, said he has "very serious concerns" about the facility.

"I believe that people have to be treated, however I feel Fitchburg has enough of those types of practices now," he said.
Apparently Thomas Conry is in no way familiar with the medical landscape of this area.

This is a primary care facility with a specialization in addiction medicine we're talking about. Fitchburg has a serious dearth of primary care providers (as does most of the country).

In fact, the state is currently sending questionnaires to local doctors in an attempt to assess whether Fitchburg should be categorized as a "Low Income Primary Care Health Professional Shortage Area (HPSA)." Generally such assessments aren't undertaken unless the people involved are pretty confident they're going to qualify. Having seen the dearth of new providers coming into the area, I'd be shocked if we don't.

Additionally, the low income population of Fitchburg (and several surrounding towns) has been categorized as a "Medically Underserved Population" since 1996. (This information is easily found at http://muafind.hrsa.gov/, though I can't link to it directly.)

Now, those classifications are specific to "low income" populations, but don't read that to mean those of us with a bit more money have a good situation. While it's definitely more difficult for a low-income person to find a provider, that problem is made worse by there not being enough doctors to go around.

Low-income patients mean low reimbursement for the doctors who care for them, so many doctors try to limit their numbers. The poor also tend to have more medical problems than wealthier people, which means they take up more time and resources. Yet the reimbursement (especially from Masshealth/Medicaid) is extremely low compared to people who can actually afford reasonable insurance. So from a doctor's business perspective it's unwise to let the percentage of low-income/crap insurance patients in your practice get too high.

Without enough primary care providers in the area, the low-income people get hurt first, because it's not in the doctor's best interest to see too many of them. With the ridiculously ill-conceived Massachusetts "universal" health care sham now in effect, that's going to get even worse. And unless more doctors come into the area, it's going to move up the chain until nobody can find a doctor (it's already a tough thing to do around here).

Anyway, back to the Councilors.

DeMartino seems to harbor an irrational fear. Conry shares it and heaps on a big pile of ignorance. Now we get Norman Boisvert to take it to the next level of dumb:
Ward 2 Councilor Norman Boisvert said he doesn't know the specifics of the plan, but said he doesn't think Fitchburg should be attracting addicts to the city.

"There are ample places for the addicts to go," he said. "If we bring another center in, that's more addicts into our city, what we should be doing is running them out of town."
Hey, guess what Norm? There are already plenty of people with addictions living in this area! They fucking need treatment to help them get over these addictions! We wouldn't be attracting busloads of those scary meth-heads you picture, we'd be helping people in the community to deal with their addictions without having to drive to Worcester to do so. So they'd, you know, get better!

But apparently instead of helping people in town to get better, Boisvert thinks the right thing to do is to "run them out of town." Congratulations, Norm! You're a giant idiotic asshole!

You know, Hillcrest Nursing Home is right in the same part of town. Some of the patients there suffer from dementia or Alzheimer's, and could at times be classified as a danger to themselves or others. Let's run them out of town too! And certainly let's not let them stay near the school, what if an old person gets out and does something crazy?

It seems like the only City Councilor on the record as having any understanding of medical care is Jody Joseph:
Ward 6 Councilor Jody Joseph, whose ward the facility would be located in, defended the practice.

"It's a doctor's office, that's all it is," Joseph said. "One of the things he does is treat addictions, but it's not going to be a methadone clinic."

Joseph said people are rushing to judgment on the practice.

"People have made it into a horror show, when he's really just a general practitioner for people that don't want to go to a detox center," Joseph said. "It's for the average person."
Right on, Jody!

Joseph is quite right. People have gotten this false idea of what an "addict" is from television and the Drug War propaganda campaigns. But most people with an addiction are very much "the average person."

Smoke cigarettes? Drink too much? Eat too much? Too many lottery tickets? Four cups of coffee a day? Get stuck on painkillers after an operation? Take a medication that's addictive at its normal dosage? Or yes, even have a problem with illegal drugs?

Congratulations, you have an addiction. Norman Boisvert wants to run you out of town, and others on the city council fear you.

Meanwhile, intelligent and well-respected people like Dr. Kishore want to help you improve your life. Which would improve the lives of those around you. Which would improve the city.

And of course having a new business and some more primary care providers in a city that desperately needs both wouldn't be so bad either.

Hopefully the city council will figure out at some point that their constituents are not their enemy, that they don't need to be afraid of everything, and that helping people with problems actually helps all of us.

But don't hold your breath.


[Update: January 9th]
The suckass newspaper ran an editorial opposing the practice opening. Conry, DeMartino, and Marcus DiNatale spoke against it at the ZBA hearing. And the fools at the ZBA turned down the zoning change required to open it. So it's dead.

So we've lost an opportunity for a business to open (while simultaneously costing that business $100k), lost the chance to bring some much-needed primary care doctors into the area, and showed everyone that we're an ignorant little shithole town*.

Way to go.


*In fact, Fitchburg is not an ignorant little shithole town. But is it any surprise that we get characterized that way when this is how we present ourselves?

41 comments:

Really Rachel said...

I'm not surprised at the neanderthal remarks of several of the councilors, but Annie DeMartino's ill-informed statement has me nonplussed.

THIS from a co-founder of the only wet shelter in the area?

Kudos to Jody Joseph for putting brain into gear before mouth into motion.

I suggest the others do some research on the specialty of addiction medicine. As a physician recruiter over the past 13 years, the addiction medicine specialists I have encountered are mostly primary care physicians who have gone to the considerable trouble to become further educated and trained in this recognized medical specialty and the services they provide are invaluable.

Great, well researched and thoughtful article, Unicow.

I really do hope that this unthoughtful, knee jerk reaction by some of the geriatric members of the city council is not indicative of how the next two years is going to go!

We're taking notes, and each of these incidents will be answered for at the next general election.

Shalom

The Unicow said...

Yeah, I was a bit surprised by DeMartino's statements too.

I don't know if maybe the problem here is that the councilors just didn't learn what they were talking about before agreeing to be interviewed, or what. I'd like to think that, but maybe that's just unfettered optimism.

Boisvert's idiotic statements were preceded by a confession that he doesn't know what he's talking about, at least.

Hopefully some of the brighter councilors will have a better understanding of what's going on, and the ignorant ones can just be ignored.

Really Rachel said...

On pondering, I'm going to give both Conry and DeMartino the benefit of the doubt ... and perhaps credit for some suckering on behalf of the S&E ... considering their track record of half-quoting and sensationalizing to paint Fitchburg in a negative light.

One might draw the conclusion that the good councilors were led to believe this was some kind of treatment center similar to a methadone clinic - or the (tax exempt) children's prison that went up without fanfare or opposition on Highland Ave.

The lesson here is that before providing public comment and opinion, one might rather simply state that they are not aware of the specifics and will be happy to provide a comment upon becoming adequately informed.

"Better to remain silent and be thought a fool than to open mouth and remove all doubt...."

Chalk this one up to the "ooops" category for DeMartino and Conry. Methinks they will each revise their opinions and remarks once they understand that this bonafide medical practice is a major asset to Fitchburg - and to the neighborhood.

As for Boisvert ... well every court needs a jester. Obviously he intends to continue his role as the comic relief of the city council.

I, for one, am delighted to see a practice of this stature choose to locate an office in Fitchburg. The physicians involved are "heavy hitters" in the field of primary care - addiction medicine and it is a feather in our cap that a TAX PAYING, FOR PROFIT medical practice would locate here.

Heaven knows, we need more primary care physicians in this area, and just perhaps this practice will take some of the "primary care" load off the overloaded emergency department at Leominster Hospital.

We should kiss the feet of any physician who chooses to set up shop here.

Shalom

The Unicow said...

I'm not quite as willing to let DeMartino and Conry off the hook here.

If they didn't know what they were talking about, they simply shouldn't have commented. The Sentinel's always going to dig for dirt and controversy, the councilors really ought to know better than to feed into that.

I hope they do revise their views. This practice would be a great addition to Fitchburg.

Erica said...

Well, as we now know, it was clearly too much for the councilors to acknowledge their ignorance and do some legitimate research into this. Fitchburg truly lost out on an opportunity here - someone wanted to provide both desperately needed tax funds and desperately needed medical care, and the ZBA rejected that?

But what concerns me perhaps even more is the fact that the practice already invested $100K in construction after receiving a permit from the building department. What the #@$^* kind of message does that send to other businesses that may want to consider opening in Fitchburg??? It blatantly advertises the lack of communication among city departments and conveys that it's not worth the risk to try investing in a potential business here.

I was unfortunately unable to attend this meeting, but it seems that the concept of objective evaluation of facts in order to arrive at an evidence-based decision never even occurred to the ZBA members. (Granted, it's a total pipe dream to envision that approach informing governmental decisions, but even the most ignorant fools generally at least create the pretense of objective consideration by citing some flawed propaganda study or something.) Did anyone present any DATA showing that a clinic such as this puts neighbors at risk?

So frustrating....

The Unicow said...

Erica,

I agree with you 100%.

This sets a terrible precedent. Our city is being run by people more driven by fear and ignorance than facts and common sense.

I wasn't there, but can almost guarantee that no data were presented showing this facility would be a danger to anyone. Who needs data when you can just use fear?

Instead you had local morons who were riled up by the local sack-of-shit newspaper (which also ran an editorial opposing the practice) showing up, and a ZBA without the brains to ignore them.

Frustrating indeed.

Keri said...

I will start by saying I did go to the meeting. I may not be the best writer, but I am well educated.
The business that tried to set up as a medical office applied for a permit in the city as an individual not as a business. So when the city came to inspect the "home" it was then clear that they were going to be a business. At that time they were asked to change the permits to business. I think they need to blame themself for spending the money to quickly. I think if this company was coming in this city to help any problems and not add to them they would have had their ducks in a row in the first place. They own 12 other facilities and know how the zoning works. They were not organized and could not present any positive facts to warrant opening their facility in that location. The members of the board did their homework and presented facts for the company to challenge and they were not able to. In the end Sally Fuller (the business representative for the medical building) said that she agreed they were 90% addiction and 10 % primary care. That was only because once people went there for treatment they might stay for the primary care.
Interesting that Jody Joseph was quoted as in favor of the permit and then never showed up at the meeting to support it.
Just showing another side to the argument.

The Unicow said...

Keri,

Indeed, if the practice was that disorganized they have themselves to blame for some of this. Then again, I doubt they've often had to justify opening a medical office when faced with this level of ignorance.

What does it matter if it's 90% addiction and 10% primary care? Do people in Fitchburg with addictions not require care? This still seems to assume that somehow "addicts" are a danger, which is just plain false.

I'm curious, what facts were presented by the board that warranted turning away this business? I'd love to hear them but all I saw in the Sentinel piece was fearmongering.

I'd also like to know where the "dozens" of addiction treatment facilities Annie DeMartino claims to exist actually are. I've only been able to locate three (one housed about a block away from the contested site, oh the horror!). But that a question for her, not you.

Cheers

The Unicow said...

Sorry, that should be six addiction treatment resources, not three. And that's with fairly permissive criteria.

Anyway, it's still not dozens. I wonder if she counts every psychologist in town as a resource.

Keri said...

I think the major concern with the 90/10 is that they were trying to claim they are majorly Primary Care and in fact are not. I'm not sure if they were trying to be sneaky or just not prepared for opposition.

The board found that location not suitable for a medical practice of any kid. According to the plans Fuller produced there are 5 parking spaces for the building and there was going to be 3 employees. She claimed there were more at the back of the building but there was no evidence of that in the plans.
The board asked her to provide information that their facility would be "different" than any other in Fitchburg and she could only say they use "compassion". Her reasoning for that location as opposed to a medical type building was for anonymity. When they asked her if she researched other locations other than 199 Summer Street, she said no. They even suggested the Summer Street medical building location that has vacancies and Burbank Hospital which could use the business. The ZBA was against the location from the start, not necessarily the type of facility.

As for how many facilities there are in Fitchburg, that was questioned by many. DeMartino did claim there were dozens, she named Luk, Spectrum, one on Summer Street, and a few others. She mentioned Our Father's House too. I think maybe they were a bit vague on the term "treatment", when they were saying how many are in Fitchburg. I know you didn't expect me to answer that, but figured I did know a few she mentioned. As well as the idea that it was a stretch indeed. However, Fuller had not researched it herself so it wasn't contested.

I do agree people used fear to get them there in the first place. I can honestly say Fuller did not ease that fear with any comments she made.

The Unicow said...

Keri,

From the stuff you've related, it sounds like the only really meaningful criticism was lack of parking. Which doesn't seem like an insurmountable dealbreaker to me. Still, it may be a valid one (or it may not, depending on the volume they would do).

Of course, if this were a dentist's office looking to move in instead of a specialist in addiction treatment the other questions would never even have been asked.

There would have been no city councilors making arguments if it were a dentist's office. Nobody would ask how they were different from the other dentists around. Nobody would question whether we already have too many dentists in town. Nobody would care if it was 90% consultations and only 10% actual dentistry. Nobody would freak out about them getting too close to the local schools, or fear people with gingivitis coming in from other towns. In fact, they'd love business to come from other towns!

But not when it's "addicts."

Sadly, it still all comes down to the irrational fears. The rest is just a way to try to rationalize the decision they'd already made.

It sounds like it was handled pretty badly by the practice's representative, I suspect she hasn't had to make this argument before. It's unfortunate she had to do so here.

Anyway, thanks for the info!

EK said...

Obviously treatment facilities and resources are needed and should be available. The location of those facilities should be open for debate. People addicted to illegal drugs are more likely to commit additional crimes, both violent and non-violent, than your average person. This is not bigotry, it's just the truth. Putting any business that attracts criminals (people who use illegal drugs are by definition criminals) next to a school is probably not a great idea, from a city-planning perspective.

The Unicow said...

"People addicted to illegal drugs are more likely to commit additional crimes, both violent and non-violent, than your average person."

This correlation does exist, though causation has not been established.

Hey, know what else has a strong correlation? Having tattoos and having a criminal record!

Wait, isn't there a tattoo parlor pretty much right across the street from where this office was to have been?

Quick, let's shut it down "from a city-planning perspective!"

EK said...

Umm... no. There is a direct cause and effect between drug addiction and crime: drug habits are expensive and often need to be funded by criminal activity. Drugs are mind altering, often lowering inibitions and sometimes even increasing violent tendencies.

Body art and crime is more of a correlation, meaning at least a third factor is involved to create a cause and effect. Probably non-conformity as a personality trait in that case.

The Unicow said...

Saying there's a causal relationship between addition and crime doesn't make it true. Nor does backing it up with made-up "facts."

I can just as easily say that the correlation exists because people who develop addictions and people who commit crimes are both likely to have some problems with impulse control.

Feel free to provide evidence of causation, though. The only evidence I've been able to find is in motor vehicle violations. Everything else remains correlation. (You could cook the numbers if you count the act of buying/using illegal drugs as a crime, but that would also render any study of this meaningless.)

But of course, the vast majority of addicts in this country are addicted to alcohol or nicotine, with illicit drugs (as a whole) being a distant third.

Both alcohol and tobacco use are also highly correlated with criminal activity. As is gambling.

You know, there's a liquor store right near the school too. And a convenience store that sells cigarettes and lottery tickets! Let's shut them down while we're at it! They all attract criminals!

Fitchburg Guy said...

This company is a "test clinic" for an unproven meth, cocaine remedy called "Prometa" that has a huge receptive potential customer base in small drug riddled communities like Fitchburg. There are currently no medications that have been approved by the FDA to stop addictions to stimulants, such as cocaine and methamphetamines and there is debate over the "Prometa protocol," manufactured by the Hythiam Corp., which is complicated by the checkered Wall Street career of the company's CEO, Terren Peizer, who previously championed an anti-AIDS drug that has yet to make it to market. Hythiam, which is based in Los Angeles, launched Prometa in 2003 in private clinics, where meth and cocaine addicts, as well as alcohol abusers, pay $12,000 to $15,000 for a one-month outpatient treatment. Now the company is aggressively pushing Prometa for the mass market, and asking governments and insurers to foot the bill.

Critics note that the field of addiction treatment is littered with "miracle cures" that ultimately failed or, in a few cases, caused harm to test subjects. And they warn that Prometa has never been subjected to double-blind, placebo-controlled testing — the gold standard for determining whether therapies are safe and effective.

‘It preys on ... desperate patients’
“The marketing is way ahead of the science,” said Lori Karan, a physician-researcher at the Drug Dependence Research Laboratory at the University of California San Francisco.“It preys on the needs of desperate patients, sets unreasonable hopes and expectations and takes advantage of scarce economic resources.”

"What’s being touted here is what people have always wanted for addiction ... something dramatic that is going to fix their brain," agreed Peter Banys, director of substance abuse programs at the VA Medical Center in San Francisco. "I would never recommend that someone spend $15,000 on this with the current state of data (and) I think it’s improper to spend public money on this product at this time."

http://www.msnbc.msn.com/id/15310599/

The Unicow said...

Wow, that's... irrelevant.

First off, your article is out of date. A double-blind placebo controlled study of Prometa's effects on methamphetamine addiction was released in November (found here) which showed a statistically significant decline in cravings.

Of course more studies need to be done, but that's true about any treatment.

You are right at least that (according to the most recent information I can find), 4 of the 17 clinics run by PMA have licensed the Prometa protocol, while investigating whether to possibly expand it to others. Perhaps it's expanded by now, I don't know. Or perhaps it's been abandoned totally (I could find no mention of it on their website). Do you have recent information about this?

Prometa is of course not the only method the clinic uses (and it's unclear whether it would even have been used at all in Fitchburg, which contrary to your assertion is probably not an ideal location for it).

You also left out that in addition to cocaine and metamphetamine, it's explicity designed for alcohol addiction. I'll assume this was just an oversight on your part.

It's one of many potential treatments, and while it's not super-well proven I'd personally find more fault with the fact that the group lists an "acupuncturist" as being on-staff. Acupuncture, of course, is totally unproven.

Presumably, your reason for posting this was to suggest that the clinic would be a bunch of snake-oil salesmen "spending public money" (not the case, this is a for-profit business) on dubious treatments.

Which is silly.

If one treatment doesn't work, then another is attempted. If they try Prometa on someone and it works, great! If it doesn't work, they'd try something else. It's unlikely to be one of the first things tried due to cost, lack of insurance coverage, etc. Maybe it's an option for the rich, but probably not a big push for it in Fitchburg.

Nice try, but next time try doing a bit more research.

The Unicow said...

One other thing...

Since when is it bad for a medical facility to offer new options for treatment? Sure, not all of them will be worthwhile, but if the option is there and shows promise (which is appears Prometa does) what's wrong with offering it for those who want to try it?

(Obviously there are limits to that, because there's no sense in offering useless treatments. But useless and promising-but-needs-more-research are not the same thing.)

I guess I'm just not sure why you took issue with this in the first place. If you had a health problem would you not want to be able to explore many options?

Fitchburg Guy said...

The link and data you provided belongs to the company that's promoting its own product.

Doctors who use this method sign a disclosure agreement promising not to divulge details. What proof do you have that this clinic will be used exclusively for Alcohol treatment? Does this sound like your neighborhood friendly hair salon?
Tell that to the ZBA and the people who would be living next door to a "test" IV shop promoted by Terren Peizer, a former junk bond salesman whose business is business, not medicine. He skipped the usual medical research and government approvals to rush Prometa to the market. Why? to make millions.
http://msnbcmedia2.msn.com/j/msnbc/Components/Photos/061031/hythiam.standard.jpg
This clinic initially skipped the usual approval process and would never have been an issue had it been located in a secure "approved" medical facility where it belongs and not in a Summer street ranch house in Fitchburg.

Here's some up-to-date data.

http://addiction-dirkh.blogspot.com/2008/01/vote-of-no-confidence-for-prometa.html

http://blogs.thenewstribune.com/politics/2007/12/08/interesting_national_story_about_the_pro

The Unicow said...

The level of your irrelevance is stunning...

"The link and data you provided belongs to the company that's promoting its own product."

Yes, oddly enough companies like to promote studies that support them on their websites! Here's a different site to soothe your nerves about that.

"Doctors who use this method sign a disclosure agreement promising not to divulge details."

Since when is a NDA controversial in business? The pharmaceutical industry is a business, despite whatever fantasy world you think you're living in.

What proof do you have that this clinic will be used exclusively for Alcohol treatment?

I never said, nor do I believe, that it would. I was just questioning why you left out alcohol in your little list.

Tell that to the ZBA and the people who would be living next door to a "test" IV shop promoted by Terren Peizer, a former junk bond salesman whose business is business, not medicine.

First, it's not a "'test' IV shop" (whatever that is). It's a clinic run by a leading practitioner of addiction medicine.

Second, Terren Peizer (who promoted Prometa) has fuck-all to do with the clinic that was looking to move here. Licensing the procedure doesn't mean shit other than the fact that they're willing to offer it as an option in their clinic. They're no more beholden to him than I am to Bill Gates.

Also realize here that I don't give a shit about Prometa. It's not the only optioned offered and is totally irrelevant regardless of its own validity.

You offer it up as justification for your preconceived bias against this clinic. If you really give a shit about the efficacy of methods used around here, why aren't you out protesting chiropractors?

But hey, let's invent whatever dirt we can on them, right? If we justify ourselves (or at least pretend to) we can convince ourselves we're not assholes!

Erica said...

The link that Unicow provided did in fact link to the company's site, but it referenced the scientific article from which the conclusions were drawn. Those looking to confirm the legitimacy of it can find the study abstract in PubMed: http://www.ncbi.nlm.nih.gov/pubmed/17908523?ordinalpos=2&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum

Of note, Mayo Clinic Proceedings is a highly respected, peer-reviewed journal. The purpose of peer review is to offer assurance that a study followed accepted scientific method guidelines. It allows those of us who do not happen to be psychiatry or pharmacology experts, for example, to place some degree of trust in the findings. Obviously, critical evaluation of any publication is still warranted, but I have a lot more faith in something published in Mayo Clin Proc than on MSN or any of the random blogs that fitchburg guy referenced.

The Unicow said...

Thanks for that link, Erica.

Since this comments screen has a tendency to cut off long URLs, I've also made it a link right here.

Cheers

michael said...

Oh and KERI.................get your facts right......the company did NOT try to set up as you said as an individual. If you had been listening, they were already approved for use as a residence with a business. They had been granted permits and told to put exit signs inside. Do you have those in your home?I have been to many zoning board hearings and NEVER heard anyone justifying why they wanted to put another bar in town or pizza shop put with a 2hour question and answer session that bordered on abusive.People were attacking.If the company knew the resistance they were going to receive they could have simply rented a room to a boarder and opened without any problems.You call yourself educated GET YOUR FACTS RIGHT!

Keri said...

Well Michael-
Relax I never attacked anyone, as you just did. Were you the one man at the hearing that was in favor of the special permit. How come you never stood up to say anything?
My facts are straight. The house was already zoned for a business/homeowner when they bought it. Yes they could put up exit signs and live in it with that type of zoning. The difference is they were never planning to live there. If they had planned to put only a business in there they would have to get a different zoning. I'm pretty sure a company that has 12 other locations would know this fact. Since some of the other locations are in homes with business zonings also.
Even thought the residents stated they din't want the medical practice to be in that building, the board never stated that. They never told them they didn't want the office in Fitchburg, just not that location. When they were asked if they had looked at any other locations in Fitchburg, they said no. They were even given other places within medical buildings as options and they were not interested. If they wanted to come to Fitchburg to fill a need then why does it have to be there?
If there is truly a need it will still be useful in another location in Fitchburg.

Really Rachel said...

P*** poor prior planning. In hindsight, the medical practice totally missed the boat and made themselves a target.

Had they simply quietly applied as a physician practice without the addiction specialty fanfare, they would have sailed right through under the radar. Once approved, the city has no authority whatsoever to limit the specialty practiced in a physician's office.

Wanna bet they learned a lesson here that will be applied elsewhere - when they take their municipal tax dollars to a more welcoming municipality.

I'm telling you, it's the water here. Forget koolaid. Do NOT drink the water!

Shalom

Unknown said...

Dear Fitchburg Guy...
Preventive Medicine is not a "test clinic" for promeda. Although liscenced, and able to offer the treatment to those patients seeking it, it is not commonly used nor pushed on patients. Furthermore, at this point in time, PMA isn't even offering the treatment.

If you were to investigate the methods in which they treat addiction, you may find they offer non narcotic treatments in addiction management. Two of these methods include Naltraxone and Vivitrol injections... Both (gasp) having been approved the FDA.
Maybe you should spend more time doing research and less copying and pasting articles on Promeda.*

Anonymous said...

Punyamurtula Kishore MD aka MAD Dog Millionaire is a fraud , The American College of Addiction Medicine and the National Library of Addiction has never existed except on paper. Punyamurtula Kishore has been indicted by 3 Grand Juries for Medical Insurance Fraud , bribery and giving out and receiving kickbacks.

MAD DOG MILLIONAIRE aka PUNYAMURTULA KISHORE HAS BEEN INDICTED BY 3 DIFFERENT GRAND JURYS , SUFFOLK COUNTY, MIDDLESEX COUNTY AND BARNSTABLE COUNTY FOR MEDICAL INSURANCE FRAUD . CORRUPTION , LYING , CHEATING , and STEALING from Mass Health , Medicare , Medicaid and private insurance companies .

Exploiting his emoloyees and patients. Billing insurance companies without examining or seeing the patients. 30 years of CORRUPTION , LIES, CHEATING AND STEALING is Punyamurtula Kishore MD aka Mad Dog Millionaire's trademark .

He was involved in Corruption when he was the Medical Director at the Massachusetts Dept. of Correction , Martha Eliot Health Ctr , Roxbury Comprehensive Health Ctr. and his possess Medical Practice , Preventive Medicine Associates.formerly Addiction Medicine Associates.

He used two entities he created on paper that never existed called the National library of Addictions and the American College of Addiction Medicine to advocate his emergence in the field of addiction medicine. This unscrupulous MD used and exploited his patients and employees for financial wealth. The only thing that MAD DOG MILLIONAIRE aka Punyamurtula Kishore cared about was making money at the expense of someone elses misery.

Anonymous said...

Punyamurtula Kishore MD aka MAD Dog Millionaire is a fraud , The American College of Addiction Medicine and the National Library of Addiction has never existed except on paper. Punyamurtula Kishore has been indicted by 3 Grand Juries for Medical Insurance Fraud , bribery and giving out and receiving kickbacks.

MAD DOG MILLIONAIRE aka PUNYAMURTULA KISHORE HAS BEEN INDICTED BY 3 DIFFERENT GRAND JURYS , SUFFOLK COUNTY, MIDDLESEX COUNTY AND BARNSTABLE COUNTY FOR MEDICAL INSURANCE FRAUD . CORRUPTION , LYING , CHEATING , and STEALING from Mass Health , Medicare , Medicaid and private insurance companies .

Exploiting his emoloyees and patients. Billing insurance companies without examining or seeing the patients. 30 years of CORRUPTION , LIES, CHEATING AND STEALING is Punyamurtula Kishore MD aka Mad Dog Millionaire's trademark .

He was involved in Corruption when he was the Medical Director at the Massachusetts Dept. of Correction , Martha Eliot Health Ctr , Roxbury Comprehensive Health Ctr. and his possess Medical Practice , Preventive Medicine Associates.formerly Addiction Medicine Associates.

He used two entities he created on paper that never existed called the National library of Addictions and the American College of Addiction Medicine to advocate his emergence in the field of addiction medicine. This unscrupulous MD used and exploited his patients and employees for financial wealth. The only thing that MAD DOG MILLIONAIRE aka Punyamurtula Kishore cared about was making money at the expense of someone elses misery.

Anonymous said...

Punyamurtula Kishore MD aka MAD Dog Millionaire is a fraud , The American College of Addiction Medicine and the National Library of Addiction has never existed except on paper. Punyamurtula Kishore has been indicted by 3 Grand Juries for Medical Insurance Fraud , bribery and giving out and receiving kickbacks.

MAD DOG MILLIONAIRE aka PUNYAMURTULA KISHORE HAS BEEN INDICTED BY 3 DIFFERENT GRAND JURYS , SUFFOLK COUNTY, MIDDLESEX COUNTY AND BARNSTABLE COUNTY FOR MEDICAL INSURANCE FRAUD . CORRUPTION , LYING , CHEATING , and STEALING from Mass Health , Medicare , Medicaid and private insurance companies .

Exploiting his emoloyees and patients. Billing insurance companies without examining or seeing the patients. 30 years of CORRUPTION , LIES, CHEATING AND STEALING is Punyamurtula Kishore MD aka Mad Dog Millionaire's trademark .

He was involved in Corruption when he was the Medical Director at the Massachusetts Dept. of Correction , Martha Eliot Health Ctr , Roxbury Comprehensive Health Ctr. and his possess Medical Practice , Preventive Medicine Associates.formerly Addiction Medicine Associates.

He used two entities he created on paper that never existed called the National library of Addictions and the American College of Addiction Medicine to advocate his emergence in the field of addiction medicine. This unscrupulous MD used and exploited his patients and employees for financial wealth. The only thing that MAD DOG MILLIONAIRE aka Punyamurtula Kishore cared about was making money at the expense of someone elses misery.

Anonymous said...

Punyamurtula Kishore MD aka MAD DOG ,Pedophile and MA State registered
Level 1 Sex Offender .
There is no National Library of Addictions in Massachusetts or anywhere
in the United States , The library has never existed , except on paper ,
Punyanurtula Kishore MD aka MAD DOG is a liar and a fraud .
Punyamurtula Kishore MD aka Mad Dog Millionaire has been suspended from
several Boston and greater Boston Hospitals for sexual misconduct with
male patients . Check MA Medical reg. for order . Punyamurtula Kishore
aka Mad Dog Millionaire has admitted himself to Mcleans hospital in
Belmont , Massachusetts for sex addiction and erectile sexual
dysfunction .
If you want to live , donot seek help from Dr. Punyamurtula Kishore MD
aka Mad Dog Millionaire . Dr Kishore is a Quack . Many of his patients
relapse and die , His Treatment protocols give his patients a false
sense of hope and he continues to get rich at the expense of death .
Preventive Medicine Associates formerly Addiction Medicine Associates is
a Death Camp
Punyamurtula Kishore MD aka MAD DOG Millionaire is a Fraud. There is no
National Library of Addictions. He exploits his patients with titles of
Ambassadors of the NLA . These poor people disclose information about
thier addictions to the media to only benefit Dr. Kishore.
He hires employees and uses them for thier professional knowledge and
experience to enhance his business and then he lays them off or fires
them . Many of his patients relapse and die . His home detox protocol
does not work and he bills his patients medical Insurance companies . He
pays kickback money to the Directors of Sober and Halfway houses. His
company Preventive Medicine Associate formerly (Addiction Medicine
Associates) is under investigation for medical insurance fraud .
He uses and exploits the young , impressionable and naive employees of
his company . He increases his patient pool by referring patients from
St. Elizabeths S.E.C.A.P. substance abuse program to Preventive Medicine
Associates . He submits medical bills for reimbursements of patients
that were never seen or examined. He prescribes Vivitrol to all of his
patients who seek treatment for Substance Abuse

Anonymous said...

IS MAD DOG AKA PUNYAMURTULA KISHORE MD LICENSED TO PROVIDE ADDICTION TX?
This Fool Punyamurtula Kishore MD aka MAD DOG was never licensed by Mass. Dept of Public Health to practice Addiction Medicine. Punyamurtula Kishore MD aka MAD Dog Millionaire is a fraud , , The American College of Addiction Medicine and the National Library of Addiction has never existed except on paper. Punyamurtula Kishore has been indicted by 3 Grand Juries for Medical Insurance Fraud , bribery and giving out and receiving kickbacks.He was involved in Corruption when he was the Medical Director at the Massachusetts Dept. of Correction , Martha Eliot Health Ctr , Roxbury Comprehensive Health Ctr. and his possess Medical Practice , Preventive Medicine Associates.formerly Addiction Medicine Associates. He used two entities he created on paper that never existed called the National library of Addictions and the American College of Addiction Medicine to advocate his emergence in the field of addiction medicine. This unscrupulous MD used and exploited his patients and employees for financial wealth. The only thing that MAD DOG MILLIONAIRE aka Punyamurtula Kishore cared about was making money at the expense of HUMAN misery

Anonymous said...

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Anonymous said...

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Anonymous said...

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Sumyiaa Gbomene said...

MAD DOG MILLIONAIRE a.k.a. Punyamurtula Kishore MD, is a QUACK.
Patients Die of Improper Medical Treatment and Care Protocols!!!!
Many of Dr. Punyamurtula Kishore s patients have died because of improper treatment and care methods. This Quack MD ( Hitler of Medical Genocide ) should not be allowed to practice medicine anywhere. Preventive Medicine Associates, formerly Addiction medicine Associates was a DEATH CAMP (The Holocaust for Drug Addicts and Alcoholics, Auschwitz in Brookline, MA) I worked at his Brookline office and witness the death of many patients. Dr. Kishore should be arrested, arraigned and prosecuted for 1st. degree murder or manslaughter.
MAD DOG MILLIONAIRE aka PUNYAMURTULA KISHORE MD TRIAL DATE April 2014
Punyamurtula Kishore, M.D. and three other defendants will go on trial in April 2014 for Medical Insurance
Fraud.
Dr. Punyamurtula Kishore was reprimanded, fined $2,500 and required to perform 50 hours of Board-approved community service and to complete additional continuing professional development credits. He was found to have inappropriately filed four Temporary Involuntary Hospitalization Applications for the purpose of drug treatment and drug testing. Dr. Kishore is a 1975 graduate of Andhra Medical College in India. He specializes in Addiction Medicine and has been licensed in Massachusetts since 1978
MAD DOG aka PUNYAMURTULA KISHORE MD
Punyamurtula Kishore, M.D. and three other defendants will go on trial i for allegedly bilking MassHealth of almost $20 million, in what Coakley’s office calls an “intricate scheme” involving drug testing, sober homes, and his Preventive Medicine Associates (PMA).
According to Coakley, Kishore used various bribes or kickbacks to persuade sober house owners to require residents to submit urine tests at least three times per week. The tests were performed by PMA’s office laboratories, then billed to MassHealth, which pays $100 to $200 for such screens. Also charged in the case were Carl Smith, manager of New Horizon House, John Coughlin, president of Gianna’s House, and Thomas Leonard, part owner and manager of Marshall House—all for receiving kickbacks.
MAD DOG a.k.a Punymurtula Kidhore MD and Lil Dog a.k.a. Carl Smith L.M.H.C. are responsible for the death of Eleanor Clark of Weston , Massachusetts.
Just look at what happen to James Clark .
James Clark was a client at the same address where the Director/Manager Carl Smith resided at ,50 Draper Street in Dorchester MA. Carl Smith is suppose to be a state licensed Mental Health Clinician , If so , than why did he discharge James Clark ? James clark never tested postive for a toxicology screen for illegal or prescription drugs, than why was he discharged ?
He was discharged for behavioral and attitude problems that were related to his psychiatric and substance abuse diagnosis. Carl Smith L.M.H.C. should have been able to detect that this man had psychological problems and referred him for treatment to MAD DOG aka Punyamurtula K...ishore s Neurological Clinic for treatment and to help James Clark get back on his psychiatric medication. Instead , Carl Smith discharged him and the following day , James Clark murdered his 81 year old grandmother Eleanor Clark in Weston Massachusetts .
Punyamurtula Kishore MD aka MAD DOG Millionaire referred James Clark to Carl Smith s Program New Horizon House after James Clark was Discharged from St. Elizabeths Hospital s S.E.C.A.P. s Detoxification unit. Punyamurtula Kishore aka MAD DOG had a Contract with Carl Smith to provide New Horizon clients with Medical and Mental health Treatment. No treatment was provided except for toxicology screens . Carl Smith collected James Clark s program fee and MAD DOG Kishore billed his insurance company . Carl Smith and Dr. Kishore donot care about thier clients or patients . The only thing they cared about was making money at the expense of HUMAN MISERY !!!!!!!!

Sumyiaa Gbomene said...

30 years of CORRUPTION , LIES, CHEATING AND STEALING is Punyamurtula Kishore MD aka Mad Dog Millionaire’s LEGACY . He was involved in Corruption when he was the assistant Medical Director at the Massachusetts Dept. of Correction , Martha Eliot Health Ctr , Roxbury Comprehensive Health Ctr. and his own Medical Practice , Preventive Medicine Associates.formerly Addiction Medicine Associates. He used two entities he created on paper that never existed called the National library of Addictions and the American College of Addiction to advocate his emergence in the field of addiction medicine. This unscrupulous MD used and exploited his patients and employees for financial wealth. The only thing that MAD DOG MILLIONAIRE aka Punyamurtula Kishore cared about was making money at the expense of Human misery

Sumyiaa Gbomene said...

He was caught several years ago as he was preparing to flee the country.



Massachusetts v KishoreSentenced

Dr. Punyamurtula Kishore had Preventative Medical Associates, a drug analysis center with offices throughout the state. He collected urine from others and did unnecessary drug tests. He was caught several years ago as he was preparing to flee the country. He is sentenced to 11 months in jail and ordered to repay $9.3 million to the state. He also lost his license. His attorney said that the good doctor "dedicated his life's work to treating, assisting and serving those who have suffered from addiction. He has taken responsibility for the billing errors at his clinics. He hopes that his accomplishments in treating those suffering from addiction will not be overshadowed by this." Lots of luck.

Sumyiaa Gbomene said...

MAD DOG pleaded guilty and was sentenced to jail, and has been ordered to pay $9.3 million in restitution for running an intricate Medicaid fraud scheme involving millions of dollars in taxpayer funds,



MAD DOG pleaded guilty and was sentenced to jail, and has been ordered to pay $9.3 million in restitution for running an intricate Medicaid fraud scheme involving millions of dollars in taxpayer funds,
Dr. MAD DOG Kishore to Surrender Medical License, Sentenced to House of Correction
BOSTON – MAD DOG pleaded guilty and was sentenced to jail, and has been ordered to pay $9.3 million in restitution for running an intricate Medicaid fraud scheme involving millions of dollars in taxpayer funds, Attorney General Maura Healey announced today.
MAD DOG, 64, along with his company Preventive Medicine Associates, Inc. (PMA), pleaded guilty on Monday in Suffolk Superior Court. MAD DOG and PMA pleaded guilty to charges of Medicaid Kickbacks (8 counts), Medicaid False Claims (19 counts) and Larceny over $250 (11 counts). MAD DOG pleaded guilty to one count of Larceny over $250.
MAD DOG orchestrated a complex kickback scheme to funnel a lucrative drug screening business to his laboratories and then billed taxpayers millions of dollars for those services,” AG Healey said. “This case exhibited blatant theft of state funds that were supposed to go toward care for some of our most vulnerable residents. This is fraud that undermines the integrity of our health care system.”
Today, Superior Court Judge Janet Sanders sentenced MAD DOG to 360 days in the House of Correction, with 11 months to serve and the balance suspended for 10 years. As a condition to his sentence, MAD DOG has also agreed to surrender his medical license. Judge Sanders also ordered Kishore and PMA to pay, jointly and severally, a total of $9.3 million in restitution.
Dr. MAD DOG previously owned and managed PMA, a network of 29 medical branches throughout Massachusetts, including physician office laboratories and one independent clinical laboratory. Based on the AG’s investigation,
MAD DOG used bribes, or kickbacks, to induce sober house owners to send their residents’ urine drug screening business to his laboratories for testing. Residents were typically screened three times per week.
A urine drug screen may be billed to MassHealth by a physician if the screen is medically necessary. Drug screens generally are billed to the MassHealth program for approximately $100 to $200. manipulated his business relationships with sober house owners to illegally obtain tens of thousands of drug screens paid for by MassHealth for sober house residents who were never treated by PMA providers.
In September 2011, Dr. MAD DOG and PMA were indicted, and individually charged with Medicaid Kickbacks (8 counts), and Medicaid False Claims (8 counts). In November 2013, MAD DOG and PMA were indicted on additional charges of Medicaid False Claims (11 counts) and Larceny over $250 (11 counts) for billing MassHealth for millions of dollars in drug screens using the names of PMA physicians and nurse practitioners who were not actually treating the patients or determining the drug screens to be medically necessary. State regulations require that the services must be medically necessary and the provider must be physically present and actively involved in the treatment of the member.

Sumyiaa Gbomene said...

MAD DOG MILLIONAIRE a.k.a. Punyamurtula Kishore MD, is a QUACK.



MAD DOG MILLIONAIRE a.k.a. Punyamurtula Kishore MD, is a QUACK.
Punyamurtula S. Kishore, M.D a.k.a. MAD DOG MILLIONAIRE HAS BEEN SUSPENDED
Massachusetts Board Discipline.
This section includes final disciplinary actions taken by the Board.
Date4/9/2014Case #2014-014Action Summary Suspension.
Date9/19/2012Case #2010-025Action Reprimand, Fine, Continuing Medical Education, Community Service Instrument Final Decision and Order Fine $2,500.00
MAD DOG MILLIONAIRE a.k.a. Punyamurtula Kishore MD, Patients Die of Improper Care Protocols!!!!
Many of Dr. Punyamurtula Kishore's patients have died because of improper treatment and care methods. This Quack doctor ("Hitler"of Medical Genocide) should not be allowed to practice medicine anywhere. Preventive Medicine Associates, formerly Addiction medicine Associates was a Death Camp (The Holocaust for Drug Addicts and Alcoholics, "Auschwitz" in Brookline, MA) I worked at his Brookline office and witness the death of many patients. Dr. Kishore should be arrested, arraigned and prosecuted for 1st. degree murder or manslaughter.
Dr. Punyamurtula Kishore was reprimanded, fined $2,500 and required to perform 50 hours of Board-approved community service and to complete additional continuing professional development credits. He was found to have inappropriately filed four Temporary Involuntary Hospitalization Applications for the purpose of drug treatment and drug testing. Dr. Kishore is a 1975 graduate of Andhra Medical College in India. He specializes in Addiction Medicine and has NOT been licensed in Massachusetts TO PRACTICE Addiction medicine !!!!!!!!!!!!!
, in what Coakley’s office calls an “intricate scheme” involving drug testing, sober homes, and his Preventive Medicine Associates (PMA).
According to Coakley, Kishore used various bribes or kickbacks to persuade sober house owners to require residents to submit urine tests at least three times per week. The tests were performed by PMA’s office laboratories, then billed to MassHealth, which pays $100 to $200 for such screens. Also charged in the case were Carl Smith, manager of New Horizon House, John Coughlin, president of Gianna’s House, and Thomas Leonard, part owner and manager of Marshall House—all for receiving kickbacks.
MAD DOG a.k.a Punymurtula Kidhore MD and Lil Dog a.k.a. Carl Smith L.M.H.C. are responsible for the death of Eleanor Clark of Weston , Massachusetts.
Just look at what happen to James Clark .
James Clark was a client at the same address where the Director/Manager Carl Smith resided at ,50 Draper Street in Dorchester MA. Carl Smith is suppose to be a state licensed Mental Health Clinician , If so , than why did he discharge James Clark ? James clark never tested postive for a toxicology screen for illegal or prescription drugs, than why was he discharged ?
He was discharged for behavioral and attitude problems that were related to his psychiatric and substance abuse diagnosis. Carl Smith L.M.H.C. should have been able to detect that this man had psychological problems and referred him for treatment to MAD DOG aka Punyamurtula K...ishore's Neurological Clinic for treatment and to help James Clark get back on his psychiatric medication. Instead , Carl Smith discharged him and the following day , James Clark murdered his 81 year old grandmother Eleanor Clark in Weston Massachusetts .
Punyamurtula Kishore MD aka MAD DOG Millionaire referred James Clark to Carl Smith's Program New Horizon House after James Clark was Discharged from St. Elizabeths Hospital's S.E.C.A.P.'s Detoxification unit255

Sumyiaa Gbomene said...

MAD DOG a.k.a Punymurtula Kidhore MD and Lil Dog a.k.a. Carl Smith L.M.H.C. are responsible for the death of Eleanor Clark of Weston , Massachusetts.
Just look at what happen to James Clark .
James Clark was a client at the same address where the Director/Manager Carl Smith resided at ,50 Draper Street in Dorchester MA. Carl Smith is suppose to be a state licensed Mental Health Clinician , If so , than why did he discharge James Clark ? James clark never tested postive for a toxicology screen for illegal or prescription drugs, than why was he discharged ?
He was discharged for behavioral and attitude problems that were related to his psychiatric and substance abuse diagnosis. Carl Smith L.M.H.C. should have been able to detect that this man had psychological problems and referred him for treatment to MAD DOG aka Punyamurtula Kishore s Neurological Clinic for treatment and to help James Clark get back on his psychiatric medication. Instead , Carl Smith discharged him and the same day , James Clark murdered his 81 year old grandmother Eleanor Clark in Weston Massachusetts .
Punyamurtula Kishore MD aka MAD DOG Millionaire referred James Clark to Carl Smith s Program New Horizon House after James Clark was Discharged from St. Elizabeths Hospital s S.E.C.A.P. s Detoxification unit. Punyamurtula Kishore aka MAD DOG had a Contract with Carl Smith to provide New Horizon clients with Medical and Mental health Treatment. No treatment was provided except for toxicology screens . Carl Smith collected James Clark s program fee and MAD DOG Kishore billed his insurance company . Carl Smith and Dr. Kishore donot care about thier clients or patients . The only thing they cared about was making money at the expense of HUMAN MISERY !!!!!!!!

Sumyiaa Gbomene said...

Terrorist ,Third World Assassin and Public Enemy , MAD DOG a.k.a. Punyamurtula Kishore MD

Terrorist ,Third World Assassin and Public Enemy

Indian Doctor Steals $9 Million from U.S. Taxpayers: Gets 1 Year in Jail

Indian Doctor Steals $9 Million from U.S. Taxpayers: Gets 1 Year in Jail

Dr Punyamurtula Kishore - in healthcare, the criminals hide in plain sight
Dr Punyamurtula Kishore – in healthcare, the criminals hide in plain sight

“This case exhibited blatant theft of state funds that were supposed to go toward care for some of our most vulnerable residents. This is fraud that undermines the integrity of our health care system.”
(State Attorney General Maura Healey)

In the town of Brookline Massachusetts yet another Indian physician has been found guilty of defrauding Medicaid of millions of taxpayer funds, according to State Attorney General Maura Healey this morning.

How well do you know YOUR doctor?
How well do you know YOUR doctor?

Doctor Punyamurtula Kishore, age 64, whose ongoing scam business Preventive Medicine Associates provided an excellent cover for a monstrous kickback scheme, changed his “not guilty” plea to “guilty” yesterday in Suffolk Superior Court. He admitted to 19 counts of false Medicaid Claims; 8 counts of Medicaid Kickbacks and 11 other counts of grand theft.
Attorney General Healey said, “this doctor orchestrated a complex kickback scheme to funnel a lucrative drug screening business to his laboratories and then billed taxpayers millions of dollars for those services.”
As a result, Superior Court Judge Janet Sanders sentenced Kishore to 360 days in the jail and a 10-year suspended sentence. Kishore, age 63, was ordered to surrender his medical license and repay $9,300,000 in restitution.
Lab coat lunatic Kishore had owned and operated Preventive Medicine Associates, which managed about 30 laboratories in Massachusetts, including physician office labs. The prosecution was able to prove that Kishore used bribery to induce operators of alcohol and drug housing to refer their residents’ urine screening business to his laboratories for testing. Residents were typically screened three times per week.
By law, $100-$200 urine drug tests may legally be billed to MassHealth by a doctor if they are medically necessary. Kishore illegally obtained tens of thousands of drug screens paid for by MassHealth residents who were never qualified patients.
State regulations require that the services must be medically necessary and the provider must be physically present and actively involved in the treatment.
Here’s another look:

Our Observations:
This particular Third World Assassin graduated from Andhra Medical College in India in 1974. He immigrated to the U.S. and learned from his colleagues that the American medical system is rife with opportunities for massive theft. Had he been even slightly less greedy, it is likely he never would have been caught.

After his time in jail, do you wonder if this brazen public enemy will be deported?

Absolutely not. the United States does not deport foreign-born criminal doctors. We reward them.