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Drive Thru Doc raises concerns (video)

By JR Ortega
June 1, 2013 at 1:01 a.m.
Updated June 2, 2013 at 1:02 a.m.


RELATED STORY

Read how some Victoria pharmacies refuse to fill Drive Thru Doc prescriptions, click here.

What does the law say?

Rule 190.8 in the Texas Administrative Code defines medical violations. It states:

When substantiated by credible evidence, the following acts, practices, and conduct are considered to be violations of the Medical Practice Act.

(L) Prescription of any dangerous drug or controlled substance without first establishing a proper professional relationship with the patient.

(i) A proper relationship, at a minimum requires:

(I) establishing that the person requesting the medication is in fact who the person claims to be;

(II)establishing a diagnosis through the use of acceptable medical practices such as patient history, mental status examination, physical examination and appropriate diagnostic and laboratory testing.An online or telephonic evaluation by questionnaire is inadequate;

(III) discussing with the patient the diagnosis and the evidence for it, the risks and benefits of various treatment options; and

(IV) ensuring the availability of the licensee or coverage of the patient for appropriate follow-up care.

SOURCE: Texas Administrative Code

A Victoria doctor is writing prescriptions without seeing patients, a practice setting off alarms within the medical community.

Dr. Courtney Morgan's Drive Thru Doc opened in January at 302 W. Rio Grande St, where a car lot once was.

Doctors are prohibited by state and federal law from writing prescriptions without first establishing a professional relationship with a patient. How Morgan defines that relationship is under scrutiny.

The 42-year-old's former employer, Citizens Medical Center CEO David Brown, said he was highly concerned with Morgan's current medical practices.

"This practice is very irregular and contrary to the rules of the Texas Medical Board," Brown said.

At minimum, a doctor-patient relationship has several requirements, including a physical examination, according to the Texas board. Two Victoria women and an Advocate reporter, who tested the clinic, all reported they didn't receive a physical examination.

One of the women, Felicia Hardt, 40, said Morgan prescribed zolpidem tartrate, or Ambien, a controlled substance, without seeing her.

Hardt paid $80 cash up-front for a prescription March 26 and was surprised when all it took was her standing at a drive-thru window saying she had insomnia.

No doctor, no phone call - just a prescription with Morgan's first name misspelled on it. However, she also couldn't find a pharmacy willing to fill it.

Hardt said she went to Walgreens, Wal-Mart and CVS and in the end gave up. She wanted a refund but was too frustrated to deal with the situation.

"It was kind of embarrassing," Hardt said about her experience in March. "They said there was no doctor-patient relationship. It was a waste of time."

In an interview May 22, Morgan said he does see each patient at Drive Thru Doc, even when it means leaving his private family practice at 2710 Hospital Drive, Suite 104, and driving a mile to the drive-thru site to do so.

"Like I would put my name on something that's illegal," Morgan said about the allegations. "After all these years of studying, it doesn't make sense for me to do that."

The Advocate sent reporter Jessica Priest to the business May 23 for a prescription for a health issue she was experiencing. Morgan did not come to the drive-thru site to examine her, despite what he said the day before.

Priest, 24, suffers from allergies and reported over-the-counter medication was not working.

The Advocate had Priest video record the experience. In that visit, the receptionist put Morgan on the phone to talk with Priest.

After a five-minute conversation, the woman at the window printed out a prescription for the steroid prednisone. The prescription also had Morgan's name misspelled and contained his signature even though he was not present.

"An online or telephonic evaluation by questionnaire is inadequate" when attempting to establish a proper relationship, according to the Texas Administrative Code.

The Advocate attempted to talk to Morgan last week about the three patients who said he did not examine them, but Morgan refused, restating he does see each patient.

Morgan has worked in Victoria since 2007 and said in an earlier interview that the mission of his business is to make clinic visits convenient and affordable - but only for acute care, which means any illness that is not chronic, including some sexually transmitted diseases, upper respiratory infections and headaches, just to name a few.

Since finishing his residency, Morgan said, he has been trying to make the world of medicine mesh with advancing technology.

Drive Thru Doc is the answer, he said.

"If it wasn't needed, patients wouldn't have come," he said. "It's my way of simplifying things."

The Texas Medical Board will not comment about Morgan's practice without first conducting a full investigation, said Leigh Hopper, the board's spokeswoman.

A complaint must first be filed against any doctor or business for the board to begin its own investigation, she said.

"This sounds odd," Hopper said about Morgan's practice. "There is not a way to really know enough about what's going on."

The Texas Medical Board verified that Morgan, who was born in Jamaica and graduated in 2001 from Howard University College of Medicine in Washington, D.C., is an active, licensed physician through the end of the year. Since the issuance of his license in November 2007, the board has not put any license restrictions or begun any investigations, according to the database.

Morgan also has a record label, Hop Records, and produces music under the name Courtney "Grand Police" Morgan. His debut single was "Wassup Wassup."

Music is one of his passions, he said.

"My money doesn't come from medicine. That's why I don't see a lot of patients," he said. "My money comes from dealing with stock markets and my music. Medicine has always been - and it's weird - but I've always considered medicine a hobby."

Drive Thru Doc has raised red flags for Dr. Taylor Starkey, a Victoria physician of more than 25 years.

Starkey said he and several of his colleagues worry about how the business is handling patients.

"It's a very novel way to practice," he said. "I'm not sure if that would constitute a patient-physician relationship."

If legal, Starkey said, he would be concerned about where medicine is going in terms of patient care.

"It takes looking at that person face to face. We're not like a call center. We want to have that relationship," he said. "It's so fulfilling to see them and have them trust you."

Sarah Stewart, a 30-year-old Victoria woman who visited Drive Thru Doc, said she also received no physical examination or phone call.

She was prescribed azithromycin, an antibiotic, for her respiratory infection.

At first, Stewart said, she liked the idea of fast service and cheaper drugs but later realized prescribing without an examination could be dangerous for others.

"There could be other factors," she said. "It could be a bad thing for people on lots of medicine. Some medicines conflict with others."

In the May interview, Morgan said he did have trouble with several pharmacies filling his prescriptions, but they had recently started filling them.

When the Advocate reporter received her prescription, the woman at the drive-thru window told her only Central Drug on Laurent Street would fill it.

When asked why Walgreens could not fill it, the woman said the business and Walgreens were in a dispute. No record of any legal disputes involving the business could be found in Victoria district or federal courts.

One lawsuit filed in 2012 lists Morgan as a plaintiff against Bank of America. The lawsuit alleges Morgan was being harassed by the bank on a home foreclosure. The lawsuit is pending.

Morgan said he was aware of the medical community's concern about his business. He said he did enough research of the state law to be within his legal right to write prescriptions as he is.

Morgan said he hopes to expand Drive Thru Doc to other cities and even online to practice telemedicine.

"I could understand why it piqued a lot of interest," Morgan said of Drive Thru Doc. "The name does throw people off, but that's a good thing in a different way. That's the attention that's needed toward it."

Advocate reporters Jessica Priest and Keldy Ortiz contributed to this report.

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