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Longtime Sonoma Valley doctor fired by hospital

Sonoma Valley Hospital's dismissal last month of longtime family physician Dr. John Schafer has disturbed many patients – some are upset that he was let go, others that it took this long to stop a doctor they believe over prescribed dangerous drugs.

Longtime patient Gayle Woebcke wrote to the Index-Tribune Feb. 7 blasting hospital management for its 'horrible' treatment of Schafer.

'Sonoma Valley Hospital expects us, the community, to support them when they do not support us, the community, by firing one of the best doctors Sonoma Valley Hospital has ever had,' wrote Woebcke about SVH's Jan. 29 termination of Schafer.

Added Woebcke: 'Dr. Schafer, your community loves you.'

Known in the community as the doctor who rides the scooter, Schafer, 86, has been practicing medicine in Sonoma since 1962, and earned his license in 1960.

When he received a termination notice from the hospital, he was also escorted out of the clinic at 270 Perkins St., where he shared a practice with two other physicians.

Schafer told the Index-Tribune that he was not allowed to access any files or given a chance to talk to his patients before he left the building. The hospital notified patients about Dr. Schafer's 'departure' via a hard-copy letter sent to their homes.

Schafer reached out to patients through a letter to the editor published in the I-T in early February, which, in part, acknowledged his understanding of why he was terminated:

'I apologize for the letter some of you have received from Sonoma Valley Hospital regarding their abrupt termination of my agreement with them,' wrote Schafer. 'The reasons for their action was my not strictly adhering to their guideline for narcotic prescribing, and my not supplying a written notice of a prior assertion from the DOJ, even though they were aware of it. Their sudden action occurred at noon on Jan. 29 without prior notification or recourse. This is a shabby way for the hospital to treat our patients.'

Schafer said the 'guideline for narcotic prescribing' to which he refers is a clause in a 19-page agreement between him and the hospital that limits the amount of opioids that a doctor can prescribe at any time. There are also strict state guidelines for prescribing opioids.

Schafer disagrees with the guideline's strict prescription limits.

'They want you to just cut them off,' Schafer said, adding that he thinks that is 'inhumane' and 'cruel.'

'I want to ween them off,' he said referring to patients who are addicted to pain medications such as Norco and Vicodin. Vicodin and Norco are both combinations of hydrocodone and acetaminophen (Tylenol), differing only in the amount of Tylenol. Oxycodone can be prescribed by itself or combined with Tylenol as Percocet

According to the Centers for Disease Control (CDC), anyone who takes prescription opioids can become addicted to them. 'As many as one in four patients receiving long-term opioid therapy in a primary care setting struggles with opioid addiction,' according to the guidelines for prescription opiods at cdc.org. 'Once addicted, it can be hard to stop. In 2016, more than 11.5 million Americans reported misusing prescription opioids in the past year.'

And taking too many of those drugs can lead to death, according to the CDC.

An accusation regarding an unnamed patient of Dr. Schafer's, filed in May, 2019 with the Medical Board of California, alleges that Schafer was 'guilty of unprofessional conduct and subject to disciplinary action,' 'committed gross negligence and/or exhibited incompetence,' 'failed to review past medical records,' and 'failed to conduct detailed questioning of' the unnamed patient.

The patient was able to get prescriptions of Norco filled nine times in a three month period for a total of 2,160 tablets between Nov. 25, 2012 and Feb. 25, 2013. The patient also filled a prescription of methadone on Jan. 23, 2013. Methadone is used to help addicted patients get off opioids and other drugs. Experts said the two should never be taken together.

The medical board filing said that each prescription of Norco 10/325 was filled for 240 tablets each on several dates, some refills just days apart. Schafer said the 240 tablet amounts to eight pills a day for 30 days.

The patient refilled the prescriptions in 2012 and 2013: Nov. 25, Nov. 29, Dec. 13, Dec. 23, Dec. 29, Jan. 10. Jan. 21, Feb. 4, and Feb. 25.

According to the medical board filing, on Jan. 23, 2013, the patient filled a methadone prescription. The patient was pronounced dead on Feb. 16, 2013, the cause of death 'was determined to be hydrocodone intoxication,' and it is unclear how the prescription was filled on Feb. 25, nine days after the man died.

The laws regulating opioids have changed considerably since 2012, and are much more restrictive now.

Schafer said he was told the patient 'committed suicide,' which the medical board could not confirm. Schafer also said that the man refilled the prescriptions without Schafer's knowledge.

A spokesperson for the medical board said no charges have been filed and no action has been taken against Schafer.

In a Feb. 17 statement about its dismissal of Schafer, the hospital said it 'cannot comment on a specific personnel matter like this,' and 'that decisions involving all physician contracts with the hospital are made only after careful consideration and review of a number of factors including patient safety, the needs of the community, and review of any applicable regulatory guidelines.'

The hospital decisions such as this are done with 'considerable effort to understand the situation and take any available corrective actions in advance of termination,' the statement said.

The brother of another patient of Schafer's accuses Schafer of feeding his sister's addiction.

Tony Davenport said his sister was 'using mostly street drugs' and got fired from her job for 'being high on the job.'

'She had a noted drug problem,' he said, and later went to meetings for addicts. She got better and got off drugs.

But she was able to get legal, medically prescribed drugs from Schafer, Davenport said.

Davenport said Schafer prescribed Xanax, OcyContin, Flexeril and codeine.

'He prescribed multiple opioids. He prescribed them as if she was taking them all in the same day,' he said. 'She had bottles and bottles and bottles of the stuff,' Davenport said.

Several of Schafer's patients sent letters of support to the Index-Tribune saying that Schafer is a 'kind, compassionate man' and expressed outrage at the manner in which he was fired. Bill Foley of Sonoma called the patient notification letter 'terse' and 'opaque.' Pat Bonnoitt said the 'hospital issued a cold letter to some of his patients.'

Schafer told the Index-Tribune he is not retiring and considered suing the hospital for wrongful termination and illegal patient abandonment, but decided against a lawsuit after speaking with attorneys. He wants to continue to work and is hoping to find a position with another local clinic.

Schafer's situation marks the second time in the past 12 months a Sonoma-based doctor has been disciplined for over-prescribing opioids. On May 1 of 2019, longtime Sonoma physician Clinton Lane surrendered his license to the state Medical Board after being accused of 'a pattern of repeated negligence involving the prescription of opioids to four of his patients.'

Contact Anne at anne.ernst@sonomanews.com.

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