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Prosecutors resist Gosy on modified role for pain medications

The warnings of a public health crisis didn’t start with Dr. Eugene J. Gosy, but the Amherst pain specialist used them to up the ante last week.

Seven weeks after his arrest on federal charges, Gosy asked for a major change in his bail, a change he insists is essential to keeping his pain medication practice open and avoiding the crisis that local health officials predicted.

Gosy is not asking for the authority to prescribe painkillers – he lost that after he was charged with writing thousands of illegal prescriptions. But he does want the ability to ask other doctors to prescribe them.

Federal prosecutors say no way.

They also contend that nothing stands between Gosy and a return to his medical practice.

“There are a myriad of legitimate ways to treat pain without prescribing controlled substances,” Assistant U.S. Attorneys George C. Burgasser and Elizabeth R. Moellering said in court papers opposing the request by Gosy, who faces charges that he issued illegal prescriptions and cheated the state workers’ compensation system.

They also contend that “there is nothing in the court’s conditions limiting the defendant’s ability to diagnose or consult on diagnoses of the cause of pain.”

The prosecution’s response came just days after Gosy’s request put the government in the position of either agreeing to the change or opposing it and risking a shutdown of his practice.

Local health officials have pointed to the size of Gosy’s practice – he has more than 9,000 active patients – to suggest that closing the office could lead to thousands of patients with nowhere else to go and, ultimately, a public health crisis.

Prosecutors say they don’t have a problem with Gosy returning to his practice. What they are dead set against is giving the neurologist and pain management specialist the ability to prescribe narcotics or ask others to prescribe them on his behalf.

They also challenged Gosy’s suggestion that his office was “forced to close” for two weeks after his arrest. “That is not accurate,” the prosecutors said in their response. “It was the defendant’s decision to close his office.”

In his request for a change in bail conditions, Gosy included a statement of support from Dr. Robert A. Milch, one of three doctors who stepped forward and reopened Gosy’s practice after his arrest in late April.

Milch, in a statement to the court, predicted that the office would close within two weeks and said that the only way to keep it open is for Gosy to return. He said Gosy’s experience and expertise are crucial to the treatment of his patients’ complex medical problems.

The doctor also warned of a “veritable tsunami” of chronic pain patients flooding the community looking for care if Gosy’s practice was allowed to shut down. Milch offered to stay on as a supervising physician and made it clear that Gosy would not prescribe narcotics.

“We’re doing everything we can to keep the practice open,” said Joel L. Daniels, Gosy’s defense lawyer. “We’re trying to avoid a major health care crisis.”

In his statement, Milch said Gosy’s return, even on a limited basis, is essential to keeping the office open and avoiding an even worse pain medication crisis here. He said Gosy should be allowed to examine and treat individual patients, perform interventions when necessary, collaborate with nurse practitioners and physician assistants, and recommend treatment options.

Daniels said that there were “no surprises” in the prosecution’s opposition to Gosy’s request and noted that the final decision rests with U.S. Magistrate Judge H. Kenneth Schroeder Jr. The two sides will appear before Schroeder on Monday.

Prosecutors say their opposition to Gosy’s bail request is rooted in what they contend the doctor did wrong. They provided a laundry list of allegations in their court papers, including that Gosy issued hundreds of thousands of prescriptions for controlled substances without proper medical review.

They also allege that the doctor continued to prescribe addictive drugs even when there were clear indications that patients abused them.

In short, they consider Gosy a danger to the community.

“Allowing Dr. Gosy to return to his former practice of prescribing controlled substances or having others prescribe them on his behalf, even under the supervision of a single doctor, is inadequate,” the prosecutors said.

They also were quick to remind the court that Gosy knew about the federal investigation into his practice long before his arrest, but never made plans to keep his office open. “The defendant took no steps to create a contingency plan for his practice or his patients,” they said.

Gosy, 55, of Clarence, is charged with conspiracy to distribute controlled substances, unlawful distribution of narcotics, conspiracy to commit health care fraud, and health care fraud. If convicted, he could face up to 20 years in prison.

email: pfairbanks@buffnews.com