The arrests of eight physicians on charges of illegally distributing powerful narcotic medications such as oxycodone recently brought U.S. Attorney General Eric Holder to Tampa to tout progress in the fight against the prescription drug abuse epidemic.
Today, all but two of the doctors still have clear licenses to practice medicine in Florida.
"I can see where someone would look at this and say, 'How can this be?' " said state Surgeon General Dr. Frank Farmer, whose duties include protecting Floridians from dangerous doctors.
But in this case, he said, federal prosecutors haven't given state health investigators the information they need to suspend the doctors' licenses.
"All I get sometimes is what I read in the paper. That's not going to be enough," Farmer said.
The situation highlights an ongoing problem in Florida, where an average of more than seven people a day die of prescription drug abuse. Despite the state's reputation as the epicenter of illegal prescribing in the U.S., disciplining doctors has long been plagued by lengthy delays, light penalties and finger-pointing among authorities.
In recent months, communications have improved between state and local law enforcement agencies and the state agency that oversees medical licenses, Farmer said. But the U.S. Attorney's Office has not been so forthcoming, he said, speculating that federal prosecutors fear that sharing details could jeopardize their cases.
Consider last month's announcement of the indictments of eight doctors and three pharmacists, mostly from the Tampa Bay area, under an initiative dubbed "Pill Nation II."
So far, the state has suspended the license of only two physicians, most recently Dr. Sanjeev Grover of Tampa, accused of selling dozens of prescriptions for oxycodone in Walmart, Burger King and Walgreens parking lots. The other six doctors still have clear and active licenses, and if consumers look them up on the state website, there is no indication of the criminal charges they face.
"We know those individuals have been arrested," Farmer said. "It certainly sounds like it's inappropriate, but we have not been able to get the information that we would need in order for me to get an emergency suspension order."
He explained that state officials need to have well-established cases before they can take action, because an emergency suspension order triggers a 20-day period during which the physician can demand to see the incriminating evidence to defend himself.
The U.S. Attorney's Office acknowledged that the needs of everyone involved in these complex cases don't always coincide.
"We try to work with all relevant parties to ensure that the integrity of the investigation, enforcement actions and effective prosecution efforts are preserved — through the conclusion of the case," the Tampa-based U.S. Attorney's Office for the Middle District of Florida said in a statement.
For three of the eight Pill Nation II doctors, the office noted, bond restrictions allow them to keep practicing, but prohibit them from prescribing the powerful painkillers they are accused of illegally distributing.
Dr. Ronald John Heromin, now living in South Florida, agreed to the prescribing restriction, said attorney Todd Foster, acknowledging the judge's concerns about the nature of the charges.
"But he maintains his license, and he maintains his innocence," Foster said. "The levelling of an accusation is proof of nothing."
State officials agree an accused doctor's rights to due process must be balanced against protecting the public. Farmer says the process for issuing emergency suspension orders has accelerated since he became surgeon general and dedicated staffers in his office to high-priority cases.
Now Farmer is looking into legislation that would allow even faster action when a doctor is arrested on serious charges.
“We just need to see if we can find a common ground," he said. "Doctors certainly do not want people with M.D. or D.O. after their name who are really drug dealers out there representing them and being a part of the medical profession."
Times researcher Carolyn Edds contributed to this report. Letitia Stein can be reached at firstname.lastname@example.org or (727) 893-8330.