CLEVELAND, Ohio – For more than 25 years, patients suffering in pain sought out Dr. William Bauer.
They had crippling injuries from car crashes and work accidents, chronic headaches and debilitating spine issues. At 83, Bauer had a practice in Sandusky that cared for many of the same patients for 10 to 20 years.
Then the government showed up.
Federal prosecutors have accused the neurologist of illegally prescribing thousands of opioid pills. He is charged in U.S. District Court with 246 counts of distribution of controlled substances and 24 counts of healthcare fraud. His trial is set for January.
His patients said the government overstepped. They said Bauer is a caring influence, not a pill-mill doctor who shoveled painkillers for cash.
“I will defend that man until my dying breath,” said Nathan Sanger, 42, of Norwalk, who has been a patient of Bauer’s for about 10 years, following a serious car accident. “He tried to help people no other doctor would see. He stood up against the wave of over-regulation, and he is being crucified for it.”
Bauer is one of a growing number of physicians, many specializing in pain management, who have been charged criminally with distributing excessive amounts of opioids. Since 2017, more than 450 doctors and medical personnel across the country have been accused of opioid-related charges, according to the U.S. Justice Department and published reports.
But in recent months, there has been a growing undercurrent of resistance. Patients have questioned the government’s motives on social media.
In court documents and interviews, lawyers for doctors said the government has focused on independent physicians who specialize in pain management.
They claimed that prosecutors and the U.S. Drug Enforcement Administration based their cases solely on the number of prescriptions that doctors have written. They said that many pain-management specialists are often the sole treatment option in communities, drawing hundreds of patients in need of help.
“Prosecutors nationwide are unfairly targeting physicians – particularly pain-management physicians – for criminal prosecution,” said Richard Blake, a former federal prosecutor in Cleveland who now represents doctors and medical companies.
“For more than 20 years, government regulators, medical boards and hospitals instructed these doctors to lower patient pain levels and evaluated them on this criteria. The government is now holding physicians to a more conservative ‘post-opioid crisis’ standard for medical decisions made years earlier.”
As thousands of cities and counties across the country seek to hold the pharmaceutical industry responsible for the opioid crisis, critics said the Justice Department is trying to take a larger role in the fight against the epidemic.
Authorities have stepped up investigations by using prescriber databases to build criminal cases against physicians and peer into their practices like never before.
Many physicians, however, have said that they were duped and misled for years about the addictive nature of opioids by drug companies.
Many of those same companies have reached out-of-court settlements in courtrooms across the country, including the nation’s largest opioid litigation in U.S. District Court in Cleveland.
Some doctors who followed those companies’ marketing ploys face federal indictments.
“I’m not aware of one case where the DEA went after a doctor who prescribed opioids appropriately,” said Dr. Andrew Kolodny, the executive director of Physicians for Responsible Opioid Prescribing and a professor at Brandeis University in Boston.
“What we have now is a lot of patients who are fearful and angry that drugs are no longer overly prescribed.”
Cases across Ohio
Authorities have charged a handful of doctors in Ohio in recent, major opioid cases. Take Dr. Troy Balgo.
He was indicted on federal charges last fall and accused by prosecutors of “polluting the population of Ohio [and] fueling residents with unnecessary prescriptions for addictive opioids for years.”
Balgo, the Belmont County coroner, has denied the charges and is scheduled to go to trial in October. His attorney, Sam Shamansky, has said Balgo ran a pain-management practice that drew residents from surrounding rural counties who were struggling with such serious pain that they could barely function.
Another doctor, Gary Frantz of Mansfield, has been accused of illegally prescribing tens of thousands of opioids from 2005 through 2017. Prosecutors have alleged Frantz prescribed thousands of painkillers to a patient who later sold them.
Frantz is scheduled to go to trial in U.S. District Court in Youngstown in August on more than 200 charges, including conspiracy to distribute and dispense controlled substances. He has denied the allegations.
In another case, prosecutors obtained a temporary restraining order in 2018 to keep Dr. Gregory Gerber from prescribing medications. Gerber had a pain-management practice, and he is accused of overprescribing painkillers from his Sandusky office. The case is pending.
Gerber is seeking to return to medicine, though not in pain management, said his attorney, John B. Gibbons.
‘He kept me going’
The case of Bauer, the pain specialist from Sandusky, stands out.
He became a licensed doctor in Ohio in 1967. He had offices in Norwalk, Bellevue and Sandusky and focused on pain management for years. He also volunteered at the University of Toledo, where he earned a doctorate degree in biomedical sciences, a university spokeswoman said.
In 2016, the university named a brain-imaging laboratory after him in its College of Medicine and Life Sciences.
Bauer’s patients were a diversified lot: About 1,000 received narcotics for pain. Many came to him after suffering work injuries or car accidents, while others struggled with degenerative issues, according to court records filed by his attorneys, Orville Stifel and Gibbons.
Most of his patients had been referred to Bauer by other doctors. He also treated residents who have multiple sclerosis, Parkinson’s disease and chronic headaches.
One man, a 25-year patient who suffered a significant injury in a construction accident, said Bauer used several different treatment options over the years, not just pain pills.
“He kept me going,” said the patient, who declined to be identified. “I don’t know where I would be without him.”
In 2016, the State Medical Board investigated Bauer for giving prescriptions to 13 patients without checking a state database that logged the dispensing of practitioners. Bauer told investigators that the database added too much time to his day and that his own system was better.
The medical board reprimanded him and ordered him to pay a $7,500 fine. His practice ran into another issue in about 2018, when corporate pharmacies stopped filling prescriptions of independent pain specialists. The decision forced Bauer’s patients to find smaller, non-chain pharmacies.
Last August, a federal grand jury indicted him on distributing charges that accused him of improperly prescribing opioids and other painkillers between 2015 and 2018.
The indictment said he also performed inadequate examinations, failed to consider non-opiate treatment options and prescribed “high doses of opioids to patients without regard to any improvement in pain level.”
After the indictment, Herdman, the U.S. Attorney, said in a statement that authorities “will pursue doctors who flood our streets with pills and patches just as aggressively as we do the cartels and drug traffickers who seek to profit from the drug epidemic here in Ohio.”
Bauer denied the charges. If convicted, he could spend years in prison.
U.S. District Judge Jack Zouhary ordered Bauer to stop prescribing medications and dealing with patients. In the days after the indictment, his patients struggled to find new doctors who could treat their pain.
Bauer was released after posting cash and property bonds. Citing the ongoing case, Gibbons declined to allow Bauer to participate in an interview for this story.
Gibbons and Stifel wrote that Bauer was targeted not because of his work as a doctor, but because he has attacked the DEA and regulators for years.
“Dr. Bauer has been a long-standing, vocal critic of interference in the physician-patient relations by the DEA, by the ‘War on Drugs/Opioids,’ by the insurance industry and by Big Pharma,” the attorneys said in documents.
After the charges were filed in August, Bauer spoke to the Sandusky Register in a broadcast interview. In it, he blasted government interference in a patient-doctor relationship.
“What bothers me is that I stuck around in this because I loved to help patients,” Bauer told the paper. “I can’t stand to see this happen to them.”