New London, New Hampshire, a community of 4,400 is not bursting at the seams with doctors. Nevertheless, there may soon be one fewer, thanks to state regulators.
The state's Board of Medicine has taken away 85-year-old Anna Konopka's medical license, and they're resisting her efforts to get it back.
Konopka's problems started with an accusation earlier in the year that she wasn't properly treating a 7-year-old with asthma. She says the child's mother wasn't following her instructions, but the Board of Medicine reprimanded her.
Since then, four additional complaints have been filed against Konopka, but the details have not been disclosed. When the board began disciplinary procedures, she agreed to voluntarily surrender her license, but said she was essentially forced to do so or the board would have shut her down immediately. The "voluntary" surrender allowed her to practice to the end of October. She's gone to a judge to ask to get her license back.
It may well be those complaints are serious, but a significant detail in the matter may have been overlooked: Konopka is mostly computer illiterate. She has no computers in her office, keeps patient records in filing cabinets, and says she doesn't have the time to learn how computers work.
This has made it impossible for her to comply with reporting guidelines put in place in New Hampshire in 2014 to "fight" the opioid overdose crisis, according to the Associated Press. Doctors who prescribe opioids are supposed to participate in this reporting program and check a patient's drug history in the register before prescribing them.
Also worth noting: Konopka often takes care of the medical needs of people without insurance who feel like they don't have many choices or treatment alternatives. From the Associated Press:
She often attracts patients who have run out of options, many with complicated conditions, such as chronic pain. She also draws patients who have no insurance and little means to pay. She takes anyone willing to pay her $50 in cash.
"I'm interested in helping people. I didn't go to medicine for money, and I didn't make money," she said, noting she works alone and can't afford things like and administrative assistant or even a nurse.
So Konopka's inability to participate in the opioid reporting program would be a terrible reason to revoke her license. In fact, in the hearing with the judge Friday, several of her patients came to speak on her behalf, and one claimed that she helped him get off oxycontin and use other remedies. He said that his previous doctor was responsible for overprescribing medications.
We're well along in the mistaken belief that prescription-based pain treatment is the source of our opioid overdose crisis, and the Trump administration is buying into it. Jacob Sullum explained just last week that this narrative is misguided and that the risk of overdose among patients seeking a doctor's assistance for fighting chronic pain is relatively low. In fact, it's government crackdowns and interventions in pain management that are sending patients to the much more dangerous black market.
Poor New Hampshire residents may have one fewer treatment option because the state decided a doctor wasn't keeping records the way the state wants her to. And those demands are, in part, guided by a mistaken grasp of the opioid crisis.