Physician says he's Dial-a-doc; others say he dials up addicts
Despite a narcotics arrest, Kauai's Dr. Harold C. Spear III defends his practice
HANAPEPE, Kauai » Dr. Harold C. Spear III, arrested for allegedly prescribing narcotic pain medicine to patients he never met in person, said his practice is serving a niche.
Spear, 54, said his "Dial-a-doc" service helps those who need medication right away but cannot get in to see their primary care physician. It's often cheaper than an office visit and avoids a trip to the emergency room, he said.
Critics, however, say he's nothing but a "Dr. Feelgood" who makes it easy for addicts to get drugs.
HANAPEPE, Kauai » The Kauai doctor arrested on federal charges last week said the federal government is unfairly targeting him and could kill his patients.
Federal prosecutors and some local residents, however, say Dr. Harold C. Spear III is nothing more than a "Dr. Feelgood" who does addicts a disservice.
Spear, 54, was arrested June 1 for allegedly prescribing narcotics to patients he never met. If convicted after a trial, he could face up to 20 years in prison.
Spear, who was released from jail after turning over his certificate to prescribe controlled substances, said that his methods are legitimate and his only concern is for his patients' well-being.
He worries that the federal government could kill his patients, as they go through withdrawal symptoms from the narcotics he has prescribed.
"The federal government is forcing me to abandon my patients," Spear said.
Spear, board-certified in family practice medicine, conducts most of his patient interviews over the phone and runs a "Dial-a-doc" service that almost exclusively deals with patients telephonically. He also has a radio show, "Dial-a-doc," heard across the state on Thursday mornings on radio stations KUMU and KQNG.
"I'm better at (patient interviews) on the phone," Spear said Wednesday. "I got so into doing it (that, in the office) I make them sit in another room and do it over the intercom," he added.
His "Dial-a-doc" business, listed in the state's phone books under "Urgent Care," provides a link between a patient's primary care physician and the emergency room, Spear said, and that when people call the number, they get a real doctor, 24 hours a day. The majority of the calls are for colds, the flu, urinary tract infections, erectile dysfunction or migraines -- ailments that need a quick shot of medicine, Spear added.
"Most new patients get better," he said.
But it's his pain-management practice that has raised the concerns of state and federal investigators.
Roughly 70 percent of his practice is devoted to pain-management cases, Spear said, including about 25 percent to 30 percent of his Dial-a-doc patients.
Spear says his goal is to get those who are hooked on narcotic pain medication to get away from the habit-forming pills.
"I look for pain solutions," he said. "We come at it from all these different directions," from nutrition to acupuncture.
But "Karl," a Kauai resident and recovering addict who did not want his last name used, said Spear is known throughout the Kauai community as a friend to addicts. He said he has witnessed Spear give out prescriptions for pain pills to an addict who turned around and sold them for more drugs.
Dr. Gerald McKenna, a Kauai psychiatrist, addiction specialist and former member of the Board of Medical Examiners, which oversees doctors in the state, said he would not comment directly on Spear's case.
But he did say that the abuse of pain medication accounts for roughly one-third of new clients at his Kauai outpatient clinic, Ke Ala Pono.
"Physicians are on alert," he said, adding that pill addiction "is an increasing problem."
As for prescribing medication over the phone, McKenna said, "I don't think that's an accepted practice, but we are getting into a whole different world."
With substantial upgrades in technology, surgical assistance can be done over the Internet, and telemedicine is becoming a more standard practice.
"The rules that used to be are in flux," McKenna added, "particularly in a rural state."
