If you talk with Dr. Mark Ibsen of Helena, Montana—one thing is certain- you come away with an opinion.
He runs an Urgent Care practice in Montana’s Capital City, and depending on your point of view ,he has either been thrust or has thrust himself into that state’s argument over pain medication prescribing.
The Montana Medical Board of Examiners is investigating Ibsen for his pain medication prescription practices. Their opinion of him isn’t so good. They haven’t come down with a decision yet to Ibsen’s effort to reverse the decision by the panel that concluded he should be sanctioned for over prescribing narcotic pain medications. Here’s a story on the dispute from the Helena Independent Record. In the meantime, the major chain pharmacies in Montana won’t fill his prescriptions anymore.
Meanwhile, he engenders passionate support from many pain patients in Montana, many of whom come to see him because other doctors—fearing government reprisal—have stopped prescribing pain medication.
Thus he says that he’s treating more patients and prescribing more pain medication because he says, “others aren’t and the patients need it.”
The National Pain Report first learned of the Ibsen story during the Christmas holiday season when this reporter was visiting his daughter and needed some medication for a heavy cold. I visited Dr. Ibsen’s urgent care and became interested in this story.
We reported on the story and have published some subsequent columns from Dr. Ibsen. We are not taking sides in the regulatory dispute—but we think Dr. Ibsen’s voice is interesting—as do many of our readers.
He recently shared a long digital communication he had with a friend about his battle which shed some light on what makes him go. While he thought the entire conversation would make an interesting column, we felt that sharing some of his thoughts this way might be more productive.
His friend (Monica) asked him “What do you get out of fighting the system?”
“That’s a great inquiry, one of the great inquiries of my life. I get to be heroic, no doubt…..I think the best way to put it is that I’m a continual threat to the status quo.”
He added, “I’ve long ago given up a desire to be liked, and yet some of my behaviors are those of someone who wants to be admired.”
Ibsen has been called a narcissist by some close to the investigation. He didn’t disagree.
“I’m just narcissistic enough to take on a big battle.”
When the conversation turned to narcotic pain meds, Ibsen’s comments weren’t about a patient but the system.
“As we have improved pain care (a hard earned win) we have empowered people to stay active, work, pay taxes etc. As these people lose access to pain meds, productivity drops, suicides increase, more disability benefits need to be paid, and most importantly to me, degrees of freedom are radically constricted.”
Ibsen also thinks he understands the end game that the DEA started last year.
“Opiates are going away and I am helping patients figure that out.”
He then tore into the DEA.
“The DEA has created unwritten rules which are onerous, vague and anxiety producing: that doesn’t work for anyone. I never asked for a battle with those guys, they brought it to me. And when the DEA brings you a battle you are likely to be indicated….The DEA almost always finds a way to indict a person once they go after them. So yes, I am clearly fighting for my professional life.”
Ibsen also admitted to Monica and later to this reporter in a recent phone discussion that the battle with regulators has taken its toll.
“The toll is greater than I projected, the risk has been great….If only all the risks to me were spelled out in advance..Knowing what I know now, I would’ve run to another country.”
I wasn’t sure whether publishing some of this conversation was advancing the discussion that the National Pain Report is trying to have on the challenges facing the people who suffer from chronic pain, their families and their physicians.
Dr. Ibsen is at the center of this debate—at least in Montana and sharing his views expressed in this discussion seem, on the whole, valuable to our readers. And as we said, he has expressed these opinions before on the National Pain Report.
But—and this is an important “but”—the doctor who dispenses pain medications and the patients who use them and are willing to talk about it aren’t the only voices we want to bring out.
Pharmacists, doctors who won’t dispense, pain psychologists, pain sufferers who won’t use narcotic pain medications and public health officials are all part of this discussion too. We will continue to effort to bring those voices to the National Pain Report.
As always, we appreciate your thoughts.