BY JIM HALL
A Fredericksburg physician has been reprimanded by state medical authorities for liberally prescribing pain medicines and for failing to keep good records.
A committee of the Virginia Board of Medicine told Dr. Larry Boulware this month that he is permanently barred from treating chronic-pain patients.
The committee also said that he must:
Attend 35 hours of classes on proper prescribing and medical record-keeping.
Notify his pain patients of the state's action.
And transfer their care to another doctor.
Boulware is an internist at the Medic 1 clinic in Fredericksburg. He appeared before the disciplinary board in Richmond April 9.
Boulware said this week that he will appeal the committee's decision. He has until May 20 to request a hearing before the full Board of Medicine, or the committee's action stands.
"This has been devastating to me," he said in a phone interview. "I have worked all my life to do positive things for patients."
Boulware was critical of the medical board, saying that he felt that he was guilty until proven innocent.
"My trip down there and the time I spent with them, two hours being grilled, meant nothing. They didn't prove anything other than I'm sloppy," he said.
The allegations center on events that occurred from 2005 to 2007 while Boulware was medical director at the Colonial Beach Medical Center.
He was medical director at Stafford Primary Care in Garrisonville before moving to Colonial Beach. He has been at Medic 1 for the past 14 months.
Boulware said the state began an investigation of him in 2006, after one of his patients was heard to say in a local pharmacy, "You can call Dr. Boulware. He'll give me anything that I need."
The allegations focus on three patients, listed as "Patient A," "Patient B" and "Patient C" in state records.
Boulware is alleged to have prescribed narcotics for these patients even though he:
Did not have a treatment plan for them.
Did not document why he chose the medicines he did.
Did not monitor their progress on the medicines he prescribed.
Did not require them to sign pain-management contracts, which spell out their responsibilities.
The controlled substances he prescribed were alprazolam, Ambien, Dalmane, diazepam, Dilaudid, Endocet, flurazepam, hydrocodone, hydromorphone, Lorcet, methadone, oxycodone, Percocet, Valium and Vicodin.
The state also accuses him of renewing prescriptions for the patients without examining them and with no medical indication other than information provided by the patients.
"I told them I realize I have a problem," he said. "In spending time with the patient, I don't leave myself enough time for what you would think would be appropriate documentation."
Boulware is a resident of Spotsylvania County and has been a doctor for 34 years. He moved from Ohio to Virginia in 2004. He celebrated his 64th birthday this week.
Boulware said he invited the three doctors who reviewed his case to examine his current record-keeping.
He said he now makes patients who seek narcotic pain relief sign contracts. He also calls a central pharmacy line if he suspects a patient of seeing more than one doctor.
"If they're concerned about whether I'm going to hurt the patients or hurt the public, they should come and see my records," he said.
Boulware has "courtesy privileges" at Mary Washington Hospital and Stafford Hospital Center.
He can refer patients for lab and imaging tests and get test results. He does not admit patients or treat them at the hospitals.
A hospital spokeswoman this week declined to comment on whether the hospital had taken any disciplinary action against him.
Jim Hall: 540/374-5433
Email: jhall@freelancestar.com