Aside from a fax machine and landline telephone, there isn't much technology in the office of physician Anna Konopka, 84.
Instead, her patients' records are tucked into two file cabinets, which sit in a tiny office next door to her 160-year-old clapboard house in New London, N.H. Records are meticulously handwritten, she said. Konopka does have a typewriter, but it's broken, and its parts have been discontinued.
With medicine in the United States becoming increasingly regulated — and as more doctors are expected to keep records electronically — Konopka's style of doctoring had attracted about 25 patients a week. Some had complicated conditions like chronic pain. Some didn't have insurance. Konopka says she would see anyone who can pay $50 in cash.
But she no longer can.
Konopka said she felt forced to surrender her medical license in September after New Hampshire Board of Medicine officials challenged her record-keeping, prescribing practices and medical decision-making, according to court documents. She is specifically accused of leaving the dosage levels of a medication up to a young girl's parent and failing to treat the girl with daily inhaled steroids.
Konopka said the girl's mother ignored her instructions.
State law prevents the board from releasing or discussing additional details regarding its now-closed investigation into the complaints against Konopka, a board member told the New Hampshire Union Leader. After Konopka surrendered her license, the board's medical review subcommittee received additional complaints against her, according to court documents.
Konopka said she wonders if her license was in part taken away because of her inability and unwillingness to use technology to diagnose her patients or log her patients' prescriptions as part of New Hampshire's mandatory electronic drug monitoring program. The program, signed into effect in 2014, is an effort to reduce opioid overdoses.
In 2015, more than 16,000 people died of overdoses from prescription opioids, including methadone, according to the Centers for Disease Control and Prevention. Every state except Missouri has created a prescription drug monitoring program, and most of those systems mandate some form of action by prescribers.
New Hampshire has one of the country's highest rates of drug overdose deaths, according to the CDC.
Konopka, who was a licensed medical practitioner for 55 years, insists that patients prescribed painkillers were always given small dosages. If not for her prescriptions, they would be in constant pain, she said.
“The [electronic] system right now, with this opioid war, they have no common sense with what they're doing. Bureaucrats who don't know medicine — they are getting this kind of idea that they can handle this type of pain without narcotics,” she said.
“I prescribe a small amount of OxyContin and they are doing beautifully. . . . They can work, and many of them could not work for many years. They are partially employed or fully employed and have a normal daily life,” she said.
Doctors in recent years have been encouraged to get better training in prescribing opioids. The government in July reported that the number of opioid prescriptions written by health-care providers declined between 2012 and 2015. It's an indication of progress, officials said, in curbing the worst drug epidemic in U.S. history.
Konopka was born in Rzeszow, Poland, in 1933, about 60 miles north of Slovakia and the same distance west of Ukraine. She tried to attend medical school under Joseph Stalin's regime but was blacklisted, she said, because of her unwillingness to join the Communist Party. She was eventually accepted into medical school in the mid-1950s, after Stalin's death.
She immigrated to the United States in 1961 and earned her license to practice after several writing exams and residencies. She began seeing patients at St. Catherine's Hospital in Brooklyn, she said, and opened her private practice in New London 28 years ago.
Complaints regarding Konopka's prescribing practices began in 2014 — primarily, she said, in the form of “lies” from other physicians. Then, a complaint was filed regarding her treatment of a 7-year-old girl who had seen Konopka about her asthma since she was 18 months old. Konopka said the girl came to her with tachycardia, a condition in which the heart beats too quickly. Konopka thought this was a side effect of the girl's asthma medication, and so she wrote the girl a different prescription.
In revoking Konopka's license, New Hampshire Board of Medicine officials said Konopka failed to confirm the girl's diagnosis with additional follow-up tests or refer the girl to a cardiologist, according to court documents.
“I'm not sending my patients to this doctor and this doctor. I treat everything. I have enough experience and can treat any disease,” said Konopka, who added she would seek help from other doctors when she felt she needed it.
She said modern medicine encourages doctors to use electronic records to diagnose patients. But Konopka said she does not want to learn how, as she feels she is experienced enough to diagnose a patient by examining them and talking to them.
“Even if I knew how to use [the electronic system] I would be unwilling,” she said. “I cannot compromise the patient's health or life for a system. I refuse to,” she said.
While research shows the electronic systems — especially when mandated — are effective, doctors have complained about the time it takes to log information into a database when they are already burdened by paperwork requirements.
Konopka is fighting to regain her license, which she agreed to voluntarily surrender in September after she was told it was the best option for her patients, she said. If she voluntarily surrendered, she would have until Oct. 13 to wrap up her practice as she fought to get it back. About 30 of her patients have written letters of support on her behalf.
“It stinks, but you have to find a new doctor, and it’s a rat race,” one of Konopka's patients, Stanley Wright, told the Associated Press. He saw her during the past year for chronic back pain. “The doctor I had before was overmedicating me, and she gives me a lot of herbal stuff and I was doing a lot better. Now, I’m back to being screwed. I don’t know what to do.”
But on Nov. 15, Merrimack Superior Court Judge John Kissinger dismissed Konopka's case to regain her license.
“It is clear to the court that Dr. Konopka has spent her career helping people in her medical practice and has a genuine commitment to address the needs of those not able to afford medical care elsewhere,” Kissinger wrote in his ruling. “Her motivation to seek an injunction allowing her to continue to practice comes from a sincere desire to help her patients.”
Allowing Konopka to continue her medical practice, however, would be inappropriate and would “ignore the process established by the legislature to regulate the practice of medicine in this State,” Kissinger wrote.
courtesy of Washingtonpost.com
